Symptoms and causes

Symptoms

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 your 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

Causes

Black hairy tongue typically results when projections on the tongue called papillae grow longer because they don't shed dead skin cells like normal. This makes the tongue look hairy. Debris, bacteria or other organisms can collect on the papillae and result in discoloration.

Although the cause of black hairy tongue can't always be determined, possible causes or contributing factors include:

  • Changes in the normal bacteria or yeast content of the mouth after antibiotic use
  • Poor oral hygiene
  • Dry mouth (xerostomia)
  • Regular use of mouthwashes containing irritating oxidizing agents, such as peroxide
  • Tobacco use
  • Drinking excessive amounts of coffee or black tea
  • Excessive alcohol use
  • Eating a soft diet that doesn't help to rub dead skin cells from your tongue
June 10, 2017
References
  1. Hairy tongue. American Academy of Oral Medicine. http://www.aaom.com/hairy-tongue. Accessed Feb. 25, 2017.
  2. Gurvits GE, et al. Black hairy tongue syndrome. World Journal of Gastroenterology. 2014;20:10845.
  3. Tongue, hairy. National Organization for Rare Disorders. https://rarediseases.org/rare-diseases/tongue-hairy/. Accessed Feb. 25, 2017.
  4. Goldstein BG, et al. Oral lesions. http://www.uptodate.com/home. Accessed Feb. 27, 2017.
  5. Mangold AR, et al. Diseases of the tongue. Clinics in Dermatology. 2016;34:458.
  6. Brushing your teeth. American Dental Association. http://www.mouthhealthy.org/en/az-topics/b/brushing-your-teeth. Accessed Feb. 27, 2017.
  7. Wilkinson JM (expert opinion). Mayo Clinic, Rochester, Minn. March 16, 2017.