What is Black Hairy Tongue?

By Tim McMahon

Black Hairy Tongue is a tongue problem characterized by a blackish or brownish discoloration or staining of the taste buds (filiform papillae) on the surface of the tongue and what makes it “hairy” is the elongation of the papillae. Such changes often begin at the dorsal posterior (top back) of the tongue and work their way forward. But never involve the undersurface where there are no taste buds.   Black Hairy Tongue in “doctorese” is known as ” lingua villosa nigra”. 

What causes black hairy tongue?

A black hairy tongue obviously has two different problem components- the first of course is the coloration and the second is the lengthening of the papillae or taste buds. And they are related in that as the taste buds get longer they tend to allow things to get trapped between the papillae more easily. Papillae can actually get up to 15 times their normal length.

As things get trapped there they get stained and attract bacteria which begins to grow and make matters worse.

Interestingly, one thing that may allow the bacteria start growing in the first place is taking antibacterial medication.  At first this doesn’t make sense but the drugs kill off the good bacteria and allow Candida (or yeast) to grow.  When you stop taking antibacterial drugs the Candida  flourishes and begins to take over causing all kinds of seemingly unrelated issues.  A close look at the Black hairy Tongue to the right will show you that although at first it looks black it is actually white around the edges.  So it could very well be candida (yeast) that is coating the tongue which is then turning black due to some other cause like caffeine, nicotine or some other staining or bacteria growing on the yeast.  (see thrush for more info).

Some medications can cause the papillae to grow longer, one such medication is Peridex (Chlorhexidine Gluconate) an oral rise prescribed by dentists to help kill bacteria that causes gum disease.

The biggest cause of Black Hairy tongue however is smoking which coats the tongue with Tar and Nicotine. Another cause is taking any medication with Bismuth in it such as Pepto Bismol.

Black Hairy Tongue is not considered serious or life threatening but healthy people rarely get it and if they do it is easier to resolve.  Black hairy tongue is more common in persons who have poor oral hygiene, tobacco use (including smoking and chewing), or drink a lot of caffeinated beverages like coffee or tea. Dehydration can be a contributing factor along with not producing enough saliva.  It can also be related to getting radiation therapy to the head and neck.  Black hairy tongue is more common in middle-aged men, I-V drug users, and those who are HIV-positive.

Having all that fur on your tongue can cause related discomfort like a tickling feeling in the back of the roof of the mouth or throat or even a gagging feeling. Sometimes, food getting caught inside the extra-long papillae can cause bad breath , a nasty metallic taste in your mouth, or nausea.

How can I get rid of black hairy tongue?

Practicing good oral hygiene is the best way to treat black hairy tongue. Gently brush your teeth and gums twice a day with a soft toothbrush. Also, brush your tongue.  Drink plenty of water throughout the day to help keep your mouth clean and hydrated.

In addition to brushing your tongue you can use a tongue scraper to make sure you’re thoroughly cleaning the dorsal posterior (top-back) area of the tongue where it is difficult to reach with a toothbrush. Some tongue scrapers are too sharp and can actually injure your tongue. And some are too tall.  The best one I have found is a nice gentle plastic one available from Dr. Katz at Threabreath. 

He doesn’t call it a “tongue scraper”  which even sounds painful. This cute yellow job is called a “Therabreath tongue cleaner“, I’ve had mine for several years now and although I don’t use it every day, I use it often enough that I can’t imagine living without it and at $3 bucks you can’t go wrong.  Although I’ve seen some at CVS that were about that price but I didn’t like the shape.

One thing I like about this one is that it is nicely streamlined, so it doesn’t gag you when you try to scrape the back of your tongue. You can actually reach almost all the way back to your uvula (that little hangy thing in the back of your throat).  Of course you don’t want to touch it or you will gag for sure! But this is important for black hairy tongue, since it starts in the back and you have to be able to reach it.  Often a toothbrush and a lot of the other tongue cleaners are too high (or too wide) to get back there.

You might also be interested in Dr. Katz’ ThreaBreath toothpaste and mouth rinse.  His products help increase the amount of oxygen in your mouth thus killing anaerobic bacteria naturally. He has recently added a line of products that include probiotics to help you re-establish the good bacteria in your mouth and fight the bacteria that are growing on your tongue.  I personally use Dr. Katz’ TheraBreath toothpaste and oral rinse all the time, along with the tongue cleaner.

If you are experiencing systemic problems like brain fog, run down feeling, allergies, etc. in addition to your Black Hairy Tongue you may have Candida Issues.  If so check out this video on How to Cure Candida.

Black hairy tongue and other tongue problems are covered in more detail in my book  “Treating and Beating Geographic Tongue and Other Tongue Problems”

If you would like more information see:

• Black Tongue
• How to Get Rid of a Black Hairy Tongue
• The 25-Cent Geographic Tongue Eliminator Doctors Don’t Know About
• 3 Words Doctors say about Geographic Tongue that Make Me Mad! 

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