Black hairy tongue is a temporary, harmless oral condition that gives your tongue a dark, furry appearance. The distinct look of black hairy tongue usually results from a buildup of dead skin cells on the numerous tiny projections (papillae) on the surface of your tongue that contain taste buds. These papillae, which are longer than normal, can easily trap and be stained by tobacco, food or other substances, and bacteria or yeast.

Although black hairy tongue may look alarming, typically it doesn't cause any health problems and is usually painless. Black hairy tongue usually resolves without medical treatment.

Signs and symptoms of black hairy tongue include:

  • Black discoloration of the tongue, although the color may be brown, tan, green, yellow or white
  • A hairy or furry appearance of the tongue
  • Altered taste or metallic taste in mouth
  • Bad breath (halitosis)
  • Gagging or tickling sensation, if the overgrowth of the papillae is excessive

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
  • Black hairy tongue persists despite brushing your teeth and tongue twice daily

Black hairy tongue typically results when projections on the tongue called papillae grow longer 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 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
  • Dry mouth (xerostomia)
  • 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
  • Tobacco use
  • Irritation due to drinking hot beverages, such as coffee or tea
  • Eating a soft diet that does not help to rub dead skin cells from your tongue

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

Prepare a list of questions to ask your doctor or dentist, including:

  • 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, including:

  • 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, herbal products or other supplements do you take?
  • Do you breathe through your mouth?
  • Have you had any recent infections or illnesses?
  • Have you had any recent mouth infections or other mouth symptoms?

Diagnosis of black hairy tongue includes eliminating other conditions that may cause a similar appearance to the tongue, such as:

  • Normal variations in tongue color (pigment)
  • Poor oral hygiene
  • Foods or medications that have stained the tongue
  • Fungal or viral infections
  • Inflammation of the lining of the 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 may contribute to the condition — such as tobacco use or medications that contain bismuth — help resolve black hairy tongue. Be sure to talk to your doctor or dentist before stopping a prescribed medication.

To practice good oral health and to remove the tongue discoloration:

  • Brush your tongue. Give your tongue a gentle brushing whenever you brush your teeth to remove 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 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 teeth cleanings and regular oral exams, which can help your dentist prevent problems or spot them early. Your dentist can recommend a schedule for you.
May 16, 2014