What is Black Tongue? (9 Common Causes You Should Know)

What is a Black Tongue?

Finding that your tongue has changed to a dark hue and in some cases shows a hairy appearance generates an immediate question: What is the cause of the black tongue? Why do I have a black tongue?

Although this oral health condition does not cause alarm, it is important to know why it occurs, its symptoms, and how to prevent it.

Black tongue is a temporary, painless oral condition, also known as hairy tongue, that results from the buildup of dead skin cells on the taste buds.

The American Academy of Oral Medicine indicates that black tongue affects approximately 13% of people from different population groups at some point in life. This tongue condition is more common in people over 65 years of age. 

Why is the tongue black? 

The tongue changes color due to the excessive growth of papillae that favor the accumulation of food residues, a condition that generates a change in the balance of oral bacteria and color.

The hairy appearance the tongue shows in some cases is caused by the accumulation of keratin, a fibrous protein that fulfills a protective function. Usually, this is shed along with normal skin cells, but sometimes the keratin is stored in the papillae and produces a fuzzy appearance.

Other common causes of the black tongue are:

1. Antibiotic medications

2. Excessive consumption of alcohol, coffee, tea or tobacco

3. Poor oral hygiene

4. The use of mouthwashes that contain astringent (menthol), oxidizing (peroxide) or irritating substances

5. Cases of differential diagnoses for weakened immune systems (people with diabetes, HIV)

6. Xerostomia (dry mouth)

7. A diagnosis of trigeminal neuralgia, a condition that affects the facial nerves

8. Radiotherapy treatments

9. A soft diet that does not favor the exfoliation of dead cells on the tongue and generates this oral health condition 

What are the symptoms of black tongue?

The first sign is a change in the color of the tongue, which can turn black, yellow, brown, green, or white. The alteration in the pigment of the tongue can also present other signs, such as:

• Velluted appearance on the tongue.

• Halitosis (bad breath).

• Metallic taste sensation on the tongue or change in taste.

• Burning, tickling, or nausea from the overgrowth of the papillae

The diagnosis is made based on the pigmentation (color) of the tongue and the information provided by the person to the health professional.

Generally, this condition of the tongue is overcome with oral hygiene, which is why it is suggested to improve oral hygiene practices. If after a week the situation persists, you should consult your doctor to follow the corresponding treatment. 

Can it be prevented?

Making changes in your eating habits, consumption of certain foods and oral prophylaxis will allow you to avoid this condition.

1. Brush your tongue with fluoride-containing toothpaste after each meal.

2. Consuming raw fruits and vegetables helps clear the tongue.

3. At night, avoid eating or drinking after brushing.

4. Do not use mouthwashes that contain peroxide or other oxidizing substances.

5. Use tongue scraper to remove accumulated bacteria and debris.

6. Reduce the consumption of alcohol, coffee, tea, and tobacco.

It should be taken into account that if the color change in the tongue is an adverse reaction to the consumption of any medication, your doctor should be consulted to make a change in the respective treatment protocol.

More information about the diagnosis and treatment for black tongue can be found in this blog.