Black hairy tongue

Overview

Black hairy tongue is a condition of the tongue that gives it a dark, furry look. The look usually results from a buildup of dead skin cells on the many tiny, rounded bumps on the surface of the tongue. These bumps, called papillae, contain taste buds. When these bumps become longer than usual, they can easily trap and be stained by tobacco, food, drinks, bacteria or yeast, or other substances.

Black hairy tongue may look alarming, but it's usually painless and doesn't cause any health problems. The condition usually goes away by dealing with the causes and by regular mouth and tongue cleaning.

Symptoms

Symptoms of black hairy tongue include:

Black color of the tongue, but the color may be brown, green, yellow or white.
A hairy or furry look to the tongue.
Changed taste or a metallic taste in your mouth.
Bad breath.
Gagging or tickling feeling in your mouth, if the papillae are very large.
Rarely, a burning feeling on the tongue if hairy black tongue is caused by a yeast or bacterial infection.

When to see a doctor

Though it doesn't look good, black hairy tongue is usually a harmless condition. It's usually short term when steps are taken to get rid of or manage the cause.

See your healthcare professional or dentist if:

You don't know what's causing black hairy tongue and want to talk about what steps to take.
You're worried that it might be related to a health issue.
Black hairy tongue doesn't go away even though you brush your teeth and tongue twice a day.

Causes

Black hairy tongue usually happens when the many tiny, rounded bumps on the tongue, called papillae, grow too long because they don't shed dead skin cells. Food, drinks, tobacco, bacteria or yeast, and other substances can get trapped on the papillae and stain them. This makes the tongue look dark and hairy.

The cause of black hairy tongue can't always be found. Possible causes of black hairy tongue include:

Changes in the healthy bacteria or yeast found in the mouth when taking antibiotics.
Poor cleaning of the mouth and tongue.
Dry mouth.
Eating a soft diet that doesn't help to rub dead skin cells from your tongue.
Regularly using mouthwashes that have oxidizing agents, such as peroxide, that can irritate your mouth.
Using tobacco.
Drinking a lot of coffee or black tea.
Regularly drinking large amounts of alcohol.
Certain medicines.
Having a condition that lowers your ability to fight infections, such as cancer or HIV.

Risk factors

Poor mouth and tongue cleaning, dry mouth, and eating only soft foods may raise your risk of black hairy tongue.

If you're male or an older adult, if you smoke, or if you've had hairy black tongue in the past, you may have a higher risk of the condition.

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 an 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.