Black Hairy Tongue

Black hairy tongue (lingua villosa nigra) is the excessive growth of fungi that normally live in the mouth. The exact cause of Black hairy tongue is not known specifically but it is thought that it is a result of an overgrowth of the bacteria normally present in the mouth causing a discoloration of the tongue. This extra tissue can get stained by food or tobacco and become yellowish brown or black. Bacteria can then accumulate on the finger-like projections from the surface of the tongue (papillae). Some types of bacteria and yeast make red blood cell pigments (porphyrins) which give the tongue a black color. Also the papillae may sometimes grow liberally causing the tongue to look as though hair covers it. Some causes of black hairy tongue have been linked to fungi following antibiotic treatment which changes the normal bacterial content of the mouth. Poor oral hygiene and the use of medications containing bismuth such as Pepto-Bismol as well as smoking and chewing tobacco can also cause the black discoloration of the tongue. An inappropriate diet which contains no roughage especially fruits vegetables and cereals can also play a role.

The occurrence of hairy tongue varies widely from 8.3% in children and young adults to 57% in persons who are addicted to drugs and incarcerated. Hairy tongue has been reported with greater frequency in males. Although hairy tongue is reported more often in males it is not uncommon in females especially those who drink coffee or tea and/or those who use tobacco.

People who suffer from black hairy tongue normally spot the condition whilst brushing and mistake it for a potential tumor. In most cases lesions are noted as part of an intraoral examination performed by a dentist. Hairy tongue clinically appears as an elongation on an area of the tongue. The hairy papillae appear pinkish white often retain pigments from food beverages and candies resulting in the varying colors associated with the condition (e.g. black brown white green pink). The tongue has a thick coating in the middle with a greater inflection toward the back.

You can remove the discoloration by gently brushing your tongue with a toothbrush twice a day. Diluted hydrogen peroxide ラ one part hydrogen peroxide to five parts water ラ also may help bleach the color. You can rinse your mouth with it or apply it with a toothbrush. Avoid swallowing the solution. Rinse your mouth with water afterward. Other treatments involve lifestyle management which includes drinking lots of water and eating raw fruit and vegetables such as celery apples and carrots to provide roughage on the tongue. One final way to treat the disorder is to cut a thin slice of fresh pineapple into eight segments. Slowly suck a segment on the back of the tongue for 40 seconds and then slowly chew it. Repeat this until the slice is finished.

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