What causes black hairy tongue?

Black hairy tongue is often caused by an overgrowth of papillae (taste buds) on the tongue. It results in a dark, furry appearance of dead skin cells on the surface of the tongue that can be stained from bacteria, food, or tobacco. Although it may be unpleasant, it doesn't usually require medical treatment and it's temporary and harmless.

What causes black hairy tongue?

Risk factors for black hairy tongue include:

• Antibiotic use that can lead to changes in the normal flora of the mouth (includes: penicillin, erythromycin, doxycycline, and neomycin)
• Poor oral hygiene
• Use of oxidizing mouth washes (for example: hydrogen peroxide)
• Dry mouth (xerostomia) or open mouth breathing
• Heavy tobacco use
• Drinking a lot of coffee or black tea
• Eating only a soft diet
• Excessive alcohol use
• Radiation treatments

Men have been shown to be about three times more commonly affected than women

A "pseudo-black hairy tongue" (that mimics the look of black hairy tongue without the elongated cells on the tongue) can also occur from using products containing bismuth, such as Pepto-Bismol.

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What does black hairy tongue look like?

You may have:

• A discoloration of the tongue, ranging from black, brown, tan, green, blue, yellow or white
• A hairy or furry appearance of the tongue
• A bad taste or metallic taste in your mouth
• Bad breath (halitosis)
• Gagging or tickling feeling in your throat (rarely occurs)

How do you get rid of black hairy tongue?

Be sure to practice good oral hygiene and brush your teeth (and tongue) twice a day. Discontinuation of the causative agent, such as medications, may be needed. Always speak with your healthcare provider before stopping a prescribed medication.

Visit your dentist regularly and maintain a well-balanced diet. Talk to your doctor to see if any of your medications may be the cause. If your symptoms do not improve, contact your healthcare provider for further evaluation.

This is not all the information you need to know about this condition and does not take the place of your doctor’s directions. Discuss this information and any questions you have with your doctor or other health care provider.