Black, hairy tongue is a temporary, harmless (benign), painless oral condition that gives your tongue a dark, furry appearance. The distinct look of black, hairy tongue usually results from an overgrowth of bacteria in the mouth.
Although black, hairy tongue may look alarming, it doesn't cause any health problems. Black, hairy tongue usually resolves without medical treatment.
Signs and symptoms of black, hairy tongue include:
- Black, yellow or brown discoloration of the tongue
- A hairy or furry appearance of the tongue
- Altered taste or metallic taste in mouth
- Bad breath (halitosis)
- Gagging sensation in some people
When to see a doctor
Though unattractive, black, hairy tongue is usually a temporary, harmless condition. See your doctor if:
- You're concerned about the appearance of your tongue
- Your signs and symptoms persist for more than 10 days
Black, hairy tongue typically results when projections on the tongue called papillae grow longer (elongate) and don't shed like normal. This makes the tongue look hairy. Debris, bacteria or other organisms can collect on the papillae and result in black, yellow or brown discoloration.
The cause of black, hairy tongue can't always be determined. However, potential causes include:
- Changes in the normal bacteria or yeast content of the mouth following antibiotic use
- Poor oral hygiene
- Breathing through your mouth
- Medications containing bismuth, such as Pepto-Bismol
- Regular use of mouthwashes containing oxidizing agents, such as peroxide, or astringent agents, such as witch hazel or menthol
- Heavy tobacco use
If black, hairy tongue persists despite brushing your teeth and tongue twice daily, make an appointment with your doctor or dentist. Here's information to help you get ready for your appointment, and to know what to expect from your doctor or dentist.
What you can do
Consider preparing a list of questions to ask your doctor or dentist. Some questions you may want to discuss include:
- What is likely causing my symptoms?
- What is the best course of action?
- Are there any restrictions that I need to follow?
- Can I wait to see if the condition clears up on its own?
- What kind of follow-up, if any, should I expect?
Don't hesitate to ask any other questions you have.
What to expect from your doctor or dentist
Your doctor or dentist may ask you questions about your symptoms and dental care practices. He or she may ask:
- When did you first notice the symptoms?
- Is the condition bothersome?
- Are your symptoms occasional or continuous?
- How often do you brush your teeth or clean your dentures?
- How often do you floss?
- What kind of mouthwash do you use?
- How much coffee or tea do you drink?
- Do you use tobacco products?
- What medications do you take?
- Do you breathe through your mouth?
Black, hairy tongue typically doesn't require medical treatment. Though unattractive, it's a temporary, harmless condition.
Practicing good oral hygiene and eliminating factors that potentially contribute to the condition — such as tobacco use or medications that contain bismuth — help resolve black, hairy tongue. Talk to your doctor or dentist before discontinuing a prescribed medication.
To practice good oral health and to remove the tongue discoloration:
- Brush your tongue. Giving your tongue a gentle brushing whenever you brush your teeth removes dead cells, bacteria and food debris. Use a soft-bristled toothbrush or a flexible tongue scraper.
- Brush after eating or drinking. Brush your teeth at least twice a day and ideally after every meal, using a fluoride toothpaste. If you can't brush after eating, at least try to rinse your mouth with water.
- Floss at least once a day. Proper flossing removes food particles and plaque from between your teeth.
- Visit your dentist regularly. Get professional tooth cleanings and regular oral exams, which can help your dentist prevent problems or spot them early. Your dentist can recommend a schedule for your situation.
Apr. 22, 2011
- Goldstein B, et al. Oral lesions. http://www.uptodate.com/home/index.html. Accessed Jan. 25, 2011.
- Images in clinical medicine: Black hairy tongue. The New England Journal of Medicine. 2006;354:67.
- Cleaning your teeth & gums. American Dental Association. http://www.ada.org/2624.aspx. Accessed Jan. 28, 2011.