Why is My Tongue Black?
A black tongue is a common but alarming phenomenon. The unpleasing look often leads to insecurities and psychosocial problems. The tongue's surface color may appear on a range from natural pink to black. This appearance is most common in older men.
The tongue will also take on a dark and furry appearance. This change is due to the buildup of skin cells on the tongue’s surface and the accumulation of excess keratin. A typical papilla is 1mm in length, but it can grow as long as 18mm. Food debris and other materials accumulate on these cells, leading to a discolored look.
Fortunately, many of the causes of a black tongue are temporary and reversible.
Black Hairy Tongue
Black hairy tongue is the most common diagnosis accompanying a black tongue.
Black Hairy tongue does not typically cause discomfort. If it is accompanied by a yeast infection, there is a possibility of experiencing burning mouth syndrome. Some patients report a metallic taste in the mouth or even nausea. Bad breath may also be present.
Additional Contributing Factors
- Poor oral hygiene
- Pellagra (Vitamin B3 deficiency)
- Smoking tobacco
- Betel chewing
- Certain medications (such as those containing bismuth found in Pepto Bismol, iron, chlorhexidine, and other metals)
- Low saliva production (it may be medication or radiation related)
- Drinking a lot of coffee and tea
- Utilizing mouthwashes with peroxide, witch hazel and menthol
- Antibiotic usage (case reports related to minocycline, Linezolid, Metronidazole, Piperacillin-tazobactam, erythromycin, doxycycline)
Appropriate treatment involves keying in on the primary cause of the discoloration.
- Increasing daily brushing
- Tongue scraper
- Warm saltwater rinses
- Sodium bicarbonate rinses
- Dry mouth rinses (if the underlying cause
- Antifungal medications are utilized in yeast-associated cases
Avoid mouthwashes with oxidizing agents (peroxides in whitening mouthwashes are oxidizing agents as are chlorine dioxide in breath-freshening