The Truth About Black Hairy Tongue: One Scary Health Condition You Really Don't Want

Although it sounds truly awful, this health condition is not dangerous. It’s a little scary to discover it in your mouth perhaps, but no serious risk at all. The medical term for Black Hairy Tongue is "lingua villosa nigra", and this is purely because of its appearance. The tongue becomes black or brown in color on the top surface of the tongue. The tongue is covered in small round bumps and these elongate to give the appearance of hair or fur. Hence the name, Black Hairy Tongue.

Are There Any Symptoms?

The main symptom of Black Hairy Tongue is the appearance. Other symptoms that some people may experience are as follows:

• Other discoloration such as green, yellow or white
• Altered taste
• Metallic taste in the mouth
• Halitosis (bad breath)
• Gagging or tickling sensation

The alteration of taste is because of the effects of the papillae, which contain taste buds. Halitosis is due to existing conditions of the oral cavity, such as diseased gums and teeth, poor oral hygiene, or because of the bacteria that causes Black Hairy Tongue. Thankfully, all of these symptoms are temporary, and none of them are serious or lead to other serious conditions.

What Causes Black Hairy Tongue?

The definitive cause of Black Hairy Tongue cannot always be identified, but it is believed to be due to a build-up of bacteria or yeast microorganisms. These accumulate on the papillae on the surface of the tongue. Normally the papillae shed, but when there is this excess of bacteria or yeast on them, it instead causes them to grow and elongate, which creates the hair-like projections. Unbelievably, these can grow to up to 15 times more than their usual length.

• Poor oral hygiene
• Cigarette smoking
• Excess coffee or tea drinking
• Certain antibiotic use
• Dehydration
• Some medications
• Decrease in saliva production
• Mouthwash with certain ingredients
• Radiotherapy
• Soft diet

Poor oral hygiene is the number one cause of many disorders and diseases of the mouth and oral tissues. Regular brushing of the teeth and tongue can help to remove bacteria and yeast from the mouth. Mouthwashes are useful, although those that contain peroxide, menthol or witch hazel have been known to cause Black Hairy Tongue. Regular checkups and treatments by a dentist will not only keep your oral cavity healthy, but will also enable the dentist to pick up on any potentially developing problems.

Antibiotic usage may cause Black Hairy Tongue, but unfortunately the antibiotics are only prescribed when necessary and must be taken. If you are on a course of antibiotics it is a good idea to be extra vigilant about your mouth, and take extra care to regularly brush your teeth and tongue. Other medications can also increase the levels of microorganisms including those that contain the chemical Bismuth. This is generally seen in antacid preparations such as Pepto-Bismol.

See Also: Pros and Cons of Tongue Piercing

Hyposalivation is a condition where there is a decrease in the production of saliva. This can be due to a problem with the salivary glands or in cases of dehydration. Saliva is the body’s natural mouthwash, and is used to remove food particles and microorganisms, as well as stopping the mouth from drying out. If you have hyposalivation, you need to see your doctor or dentist to discuss potential causes and treatments.

How Is Black Hairy Tongue Treated?

Black Hairy Tongue: Treatment

In the majority of cases, Black Hairy Tongue does not have to be treated at all. Black Hairy Tongue is a condition that will usually disappear by itself. Regular brushing of the teeth and scraping of the tongue will help to remove the excess bacteria and yeast. If you are a smoker, it is a good idea to quit, as even if this time the Black Hairy Tongue resolves by itself, it may come back if you are still practicing the same habits.

It is recommended to drink lots of water during the day to help rinse out the mouth. A diet with a higher level of roughage may also help to remove the excess microorganisms. Those on a soft diet are more likely to develop Black Hairy Tongue, as the soft food doesn’t have the same effect on removing debris in the mouth.

Sometimes medication may be needed to treat oral candidiasis, which may occur as a secondary infection. This could be in the form of tablets, drops or sprays. In severe cases of Black Hairy Tongue that is not resolving on its own, laser or electrosurgery can clip off the elongated papillae, but this is only as a last resort if all other methods have failed.

How Is Black Hairy Tongue Diagnosed?

Black Hairy Tongue is one of those disorders that can be diagnosed completely accurately simply by observing the appearance of the tongue. However, occasionally a small tissue biopsy may be taken just to confirm. Also, scrapings and samples may be taken to check exactly what bacteria or fungus is present so that the right medications can be prescribed.

Occasionally Black Hairy Tongue can be confused with another condition called hairy leukoplakia, despite the differences in appearance. Hairy leukoplakia occurs on the sides of the tongue and only occurs in those who have a weak immune system and is associated with an Epstein-Barr virus. Immunocompromise is almost always due to human immunodeficiency virus, but other medical conditions can weaken the immune system.

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Conclusion

Despite its unpleasant and perhaps frightening appearance, there is nothing to be seriously concerned about if you have Black Hairy Tongue. Black Hairy Tongue is completely benign and often resolves all by itself. If you do need treatment, the options are simple and short, as this is a temporary condition. If you concerned at all, please see your doctor or dentist.