Black Hairy Tongue

What is Black Hairy Tongue?

Black Hairy Tongue is the name given to the appearance of an abnormal coating of the tongue.

It is a benign disorder characterised by thickening of the filiform papillae (these are mushroom-shaped projections covering most of the top surface of the tongue) of the tongue.  A brownish-black discoloration of the papillæ

Why does it happen?

  • There is defective shedding of the cells in the central column of the filiform papillae of the tongue resulting in the formation of highly elongated, horn-like spines or “hairs” – the hallmark of this disease.  The cause for this is unknown and often no definite cause can be identified.
  • Often there are no symptoms other than the cosmetic or anxiety over its cause.
  • Some patients complain of gagging, nausea, alteration of taste or bad breath.

Contributing factors may include:

  • Administration of topical or systemic antibiotics
  • Soft diet
  • Hypo-salivation
  • Poor oral hygiene
  • Smoking
  • Alcohol
  • Use of mouthwashes
  • Ion compounds use of medications containing bismuth such as Pepto-Bismol
  • Antiseptic lozenges

How is it treated?

The condition may be very persistent and treatments include:

  • Increasing hydration and salivation
  • Discontinuing smoking
  • Using a tongue scraper
  • Brushing the tongue with a soft tooth brush followed by use of a dilute solution of hydrogen peroxide
  • Scraping the tongue with a peach stone
  • Eating pineapple
  • Using sodium bicarbonate mouthwashes
  • Topical retinoids or steroids
  • Gentian violet, thymol, salicylic acid or vitamin B complex and surgical excision of the papillæ.
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