Black hairy tongue occurs when the tiny bumps on your tongue that contain taste buds trap dead skin cells. Because these bumps are slightly larger on the back of your tongue, the buildup that happens can look like fur or hair and is called papillae. Dark foods, dark beverages like coffee, tobacco products, and some types of yeast or bacteria can stain the trapped skin cells, giving the coating a black appearance.
You can get black hairy tongue if you don’t brush your teeth and tongue and follow good oral hygiene practices. It can also occur if you have taken some medications, such as antibiotics or anything containing bismuth, that change the normal bacterial or yeast balance in your mouth. Some people develop black hairy tongue from using mouthwashes or other oral care products that contain oxidizing agents like peroxide. Frequent tobacco use and drinking hot, dark beverages like coffee and tea can also contribute to the condition.
Most symptoms of black hairy tongue are visual.
You’ll see a discoloration on the back of your tongue; this is often black or brown but can be yellow, green or white as well. The back surface of your tongue will have a hairy or furry texture that is apparent during a visual inspection.
Sometimes, the trapped bacteria on your tongue can give you bad breath, otherwise known as halitosis, and you’ll notice an unpleasant, metallic taste in your mouth. The buildup on your tongue may also trigger gagging or feel ticklish if it becomes thick enough.
Black Hairy Tongue is caused by a buildup of keratin on the filiform papillae, which are the conical shaped projections on the tongue. This results in the papillae being much longer than usual, which makes it easier for food, bacteria and yeast to accumulate on them. This is what creates the blackened or brown, hairlike appearance of the tongue.
In many cases, poor oral hygiene is to blame for black hairy tongue, because brushing the teeth and tongue regularly helps the affected papillae to shed and prevents the keratin buildup. However, certain other things can contribute to the condition.
Excessive consumption or tea or coffee and use of tobacco can contribute to black hairy tongue. It’s also known that certain medications, particularly antibiotics, can cause the condition because they alter the natural balance of bacteria or yeast in the mouth. Radiation treatment to the head and neck is also known to cause black hairy tongue.
People with no teeth or very few teeth are susceptible to black hairy tongue because they tend to eat lots of soft foods, which is detrimental to the natural shedding of the papillae.
Black hairy tongue can be resolved by brushing the tongue with a regular toothbrush or using a tongue scraper. This may need to be done consistently over a period of days or weeks to fully remove the buildup. Your doctor may recommend making changes to your oral care routine or your diet to avoid additional issues. In some cases, surgery to remove the papillae is necessary.
Black hairy tongue can be prevented by adopting good oral hygiene habits. Teeth should be brushed twice each day, and the tongue brushed at the same time to aid with the shedding of papillae and to remove any buildup of bacteria or food on the tongue. Tongue scrapers may also help with this process.
It’s also wise to cut down on the amount of tea and coffee that you consume, as this can contribute to the darkened appearance of the tongue. Keeping the mouth moist is also helpful, so drink plenty of fluids and chew sugar-free gum regularly if you find yourself suffering from dry mouth on a regular basis.