Black hairy tongue

Diagnosis

The appearance of the tongue, along with potential causes or risk factors, are used to make the diagnosis of black hairy tongue. When diagnosing a medical condition, it’s important to rule out other medical conditions that could have a tongue-like appearance, such as:

• Differences in tongue color.
• Foods or medications that cause tongue discoloration.
• Fungal or viral infections.
• Patches that develop on the tongue, like oral hairy leukoplakia.
• Pseudo-black hairy tongue, also known as blackened tongue. Using bismuth-containing products, such as Pepto-Bismol, may result to this condition.

If the healthcare provider is unsure about the diagnosis or suspects that the patient may have other health issues, they might recommend a biopsy, which is an examination of tissue taken from the tongue. 

Treatment

Treatment for black hairy tongue is typically not necessary. Even though it might not appear good, this is typically a mild, temporary condition. 

The most common treatment for black hairy tongue is improved oral hygiene at home. It’s also important to eliminate factors that may contribute to the condition, such as avoiding tobacco use and irritating mouthwashes. If these measures are ineffective, a healthcare provider may recommend medication or, in severe cases, surgery. 

• Oral hygiene: The first action a person should undertake is to make improvements to their oral hygiene. Make sure to thoroughly clean their tongue with a toothbrush or tongue scraper after they’ve finished brushing and flossing. 
• Medication: If black hairy tongue persists despite improved oral hygiene, it can be treated with antibiotics, antifungal medications, mouthwash, or retinoids. Never discontinue taking any prescription medication without first consulting with a healthcare provider.
• Surgery: When all other methods have failed to resolve the issue, traditional or laser surgery may be an alternative.