What is Black Hairy Tongue?

Black hairy tongue, also termed as lingua villosa nigra, is a frequently observed impermanent condition where the tongue looks hairy and becomes black, pink, white, brown or green or any color depending on the contributory factors. Hairy tongue is more frequent in the male population and the incidence rate differs broadly from 8.3% in children and adults to 57% in persons with drug addiction. The exact cause is not purposely recognized but it is considered that the appearance may be attributable to the increased number of fungi and bacteria that naturally live in the mouth. In this condition, there is an elongation of the filiform papillae on the superficial part of the tongue. At times, the small protuberances grow liberally thicker than normal making it look dark furry. As food enters the mouth, the ends of the papillae will be rubbed away, causing the remains to combine among the finger like projections of the papillae. While this oral condition may appear disturbing, it does not initiate a health problem at all since it resolves without undergoing treatment.


Other than the furry appearance of the tongue, individuals with black tongue may not experience any discomfort or alarming symptoms. But some people may have a tickling-like feeling in the back of the roof especially during swallowing. If there is a large number of Candida albicans in the mouth, people will feel a burning sensation on the tongue. In rare severe circumstance, there is exaggerated gagging reflex and occasionally, bad breath. Some may become nauseated and will have metallic taste.


Hairy tongue is characterized by lengthening and elongation of papillae with a defective desquamation. On average, these filiform papillae are just about 1 mm in length, in the case of a black tongue; the papillae are more than 15 mm in length.

The exact predisposing factor of black, hairy tongue can’t always be verified. Then again, there are possible causes which consist of the following:

  • The most common cause is the disruption in the normal number of bacteria or yeast in the mouth following antibiotic therapy. Once the medication is discontinued, the tongue returns to normal.
  • Poor oral care leads to build up of bacteria.
  • Dehydration
  • Radiation therapy from head to neck
  • Drinking coffee and tea
  • Mouth breathing
  • Medications such as Pepto-Bismol which contains chemical bismuth
  • Habitual application of astringent agents and mouthwash that contain oxidizing agents like peroxide.
  • Heavy tobacco use can cause tongue discoloration.


Although it may come out as very disturbing, black hairy tongue is not a severe health condition. This is commonly undisruptive and can be managed easily with conventional procedures, lifestyle modifications and proper mouth hygiene and avoidance of potential contributory factors.

Oral Care

The management for black hairy tongue is flexible. In most cases, plainly brushing the tongue or utilizing a commercially presented tongue scraper is most satisfactory to get rid of stretched out filiform papillae and delay the development of additional papillae. Use a soft-bristled toothbrush and provide your teeth, mouth and tongue a gentle brushing to remove food fragments, dead cells and microorganisms. Do this at least two times a day, and preferably, every after meal using toothpaste with fluoride content. Correct flossing at least once daily is advised to eliminate particles and plaque sandwiched between teeth.

Surgical Care

When less invasive therapies are confirmed to be unsuccessful, surgical removal of the elongated papillae by electrodesiccation and carbon dioxide laser is the very last option.

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