Diagnosis

Diagnosis of black hairy tongue is based on how your tongue looks and possible causes or risk factors. Making a diagnosis also includes checking for other conditions that may cause a similar look to the tongue, such as:

  • Normal differences in tongue color.
  • Foods or medicines that have stained the tongue.
  • Fungal or viral infections.
  • Patches that occur on the tongue, such as oral hairy leukoplakia.
  • Blackened tongue, called pseudo-black hairy tongue. This can happen if you use products containing bismuth, such as Pepto-Bismol.

Treatment

Black hairy tongue usually doesn't need medical treatment. Though it may not look good, it's usually a short-term, harmless condition.

Good mouth and tongue cleaning can help get rid of black hairy tongue. So can stopping things that may lead to the condition, for example, not using tobacco or irritating mouthwashes. Don't stop any prescription medicine without talking to your healthcare professional first.

If you smoke, talk with your healthcare team about options for quitting, including smoking cessation programs. These use proven techniques to help people quit.

Lifestyle and home remedies

To keep your mouth and tongue healthy:

  • Brush your tongue. Give your tongue a gentle brushing whenever you brush your teeth. This removes dead cells, bacteria and food bits. Use a soft-bristled toothbrush or a flexible tongue scraper.
  • Brush after eating. Brush your teeth at least twice a day and ideally after every meal. Use a fluoride toothpaste.
  • Floss at least once a day. Proper flossing gets rid of food bits and plaque from between your teeth.
  • Visit your dentist regularly. Get professional teeth cleanings and regular mouth exams. This can prevent problems or help your dentist spot them early. Your dentist can let you know how often you should visit.
  • Eat a healthy diet. Drink plenty of water and eat a balanced diet that includes fresh fruits and vegetables.

Preparing for your appointment

Here's information to help you get ready for your appointment, and to know what to expect from your healthcare professional or dentist.

What you can do

Before your appointment, make a list of:

  • Any symptoms you're having. Include any that may not seem related to the reason for your appointment.
  • All medicines. List prescription medicines, vitamins, herbs, other supplements and medicines you can buy without a prescription. Include the doses you take.
  • Questions to ask your healthcare professional or dentist.

Some questions to ask include:

  • What is likely causing my symptoms?
  • What is the best plan to treat my condition?
  • Is there anything that I should do or not do to help this condition get better?
  • What kind of follow-up, if any, should I have?

Feel free to ask other questions during your appointment.

What to expect from your doctor or dentist

Your healthcare professional or dentist may ask you questions, such as:

  • When did you first notice the symptoms?
  • Do your symptoms come and go, or do you always have them?
  • 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 medicines, herbal products or other supplements do you take?
  • Do you breathe through your mouth?
  • Have you had any recent infections or illnesses?

Be ready to answer questions so that you have time to talk about what's most important to you.