Black tongue is a harmless and temporary oral condition. Despite its name, black tongue does not always cause the tongue to turn black. In fact, the primary symptom is that the tongue appears hairy with visible growths.
Black tongue usually occurs due to a buildup of the protein keratin on the tongue’s surface.
However, an overgrowth of bacteria or fungi within the mouth can also cause the tongue to appear black. Black tongue is temporary and tends to clear up without treatment.
Read on to find out more about the causes of black tongue. We also outline some home remedies and treatments that may help clear black tongue and prevent its recurrence.
There are two main types of black tongue: black hairy tongue and pseudo-black hairy tongue. Each has a different cause, which the following sections will cover in more detail.
Black hairy tongue
The skin of the tongue is covered in a protein called keratin.
Normally, keratin sheds when skin cells shed. Sometimes, however, keratin accumulates on the tongue. This can cause the tongue to look black and discolored. Doctors refer to this as black hairy tongue.
The following factors increase the risk of keratin building up on the tongue:
- poor oral hygiene, which may result from not regularly brushing or scraping the tongue
- drinking coffee or black tea
- smoking and other forms of tobacco use
- recent or prolonged use of antibiotics
- having a weak immune system due to a medical condition, such as diabetes or HIV
- a condition called trigeminal neuralgia, which affects the facial nerves
- radiation therapy
Pseudo-black hairy tongue
Some people may experience pseudo-black hairy tongue.
This refers to a black, furry tongue resulting from a fungal infection, a bacterial infection, or another oral disease.
Black tongue may cause different symptoms depending on its underlying cause.
Black tongue does not always cause the tongue to turn black. Instead, the primary symptom is that the tongue looks hairy due to the presence of long, thread-like growths.
People with black tongue usually do not experience any other symptoms. However, some people may experience the following:
- a discolored tongue that is black, brown, gray, or yellow
- a tongue that feels fuzzy or sticky
- a bad taste in the mouth
- bad breath
- a burning sensation
Black tongue is harmless. However, it can indicate that a person is at risk of developing an oral health issue.
Maintaining good oral hygiene can help clear black tongue. People can try:
- regularly brushing the tongue with a fluoride toothpaste
- using a tongue scraper to remove plaque, bacteria, and other debris from the tongue
- rinsing the mouth with warm salt water to improve cleanliness and reduce bad tastes and odors
- brushing the tongue after every meal, and not eating after brushing at night
- applying baking soda or hydrogen peroxide to the tongue
- drinking plenty of water to help keep the mouth clean
- eating more raw fruits and vegetables, which can help clean the tongue
If black tongue does not clear on its own within a few days, a person should seek medical treatment.
A doctor or dentist may recommend the following treatments for a person who presents with a black tongue:
- Antibiotics: These medications will help treat bacterial infections of the tongue.
- Switching medications: A person who develops black tongue as a result of antibiotic use may need to switch antibiotics.
- Antifungal treatment: These medications can help treat fungal causes of a black tongue.
- Other medications or supplements: Anecdotal evidence suggests that certain medications — including salicylic acid, retinoids, and B complex vitamins — may ease symptoms of black tongue. However, people should not use these treatments without first talking to a doctor.
- Surgical treatment: If other treatment options do not work, a doctor or dentist can perform a procedure to remove the long, thread-like growths on the tongue. This clipping procedure is safe and effective. However, black tongue may return following the procedure.
Black tongue can be alarming, but it is not a medical emergency.
It is safe to wait a few days and try some home remedies before seeing a doctor or dentist. However, people should seek help from a healthcare provider if their symptoms persist or worsen.
Sometimes, black tongue occurs with other symptoms of an oral health problem, such as:
People should see a doctor or dentist as soon as possible if their black tongue is accompanied by any of the following symptoms:
- visibly damaged teeth
Noticing a black tongue can be alarming, but it is not a sign of a serious illness. In some cases, however, it can indicate that a person needs to improve their oral hygiene.
It is generally safe to wait a few days before seeking treatment for a black tongue. In the meantime, people can try home remedies such as tongue brushing or scraping and saltwater rinses.
A person should see a doctor or dentist if their symptoms persist or worsen, or if they are accompanied by pain and swelling. The doctor or dentist will work to diagnose the cause of black tongue and will provide appropriate medical treatments.