Here’s what you need to know about what causes black tongue, what to do if you have the condition, and when you should see your doctor or dentist.
What Causes a Black Tongue?
Black tongue is more common in older people but can happen at any age. The condition might be more common in men than women, however, the condition is more strongly linked to the smoking status and oral hygiene habits of an individual.
Black tongue is often related to poor dental hygiene, but there are also other risk factors including:
Drinking a lot of coffee or teaTobacco useExcessive alcohol consumptionCertain medicationsSome mouthwashesDehydrationIntravenous drug useCancerTrigeminal neuralgiaCompromised immune systemRadiation therapyDry mouth
Certain medications are associated with black tongue including:
Erythromycin Doxycycline Penicillin Tetracycline Lansoprazole Neomycin Olanzapine Erlotinib Linezolid
Symptoms
Although the name for the condition implies that the tongue turns black, the discoloration can also be brown, white, or yellow. The discoloration is typically focused on the center of the tongue.
Some people do not experience other symptoms. However, other symptoms that may occur with black tongue include:
Bad breathChange in the way food tastesBurning sensationGagging sensationTickling sensationNausea
Diagnosis
Doctors and dentists can usually diagnose black tongue just by looking at your mouth. If there’s any doubt about the diagnosis, your doctor may want to do more tests. For example, perform a biopsy to rule out cancer.
If you have discoloration on your tongue, make an appointment with your doctor. You might also need to see your dentist.
Other tests that might be needed include:
Bacterial culture swabsFungal scrapings
Treatment
You can prevent black tongue by maintaining good oral hygiene. Scraping or brushing the tongue can prevent food and bacteria from getting stuck on the tongue’s surface. When possible, try to avoid things like substances or medications that are known to cause black tongue.
Oral hairy leukoplakia (a condition caused by Epstein-Barr virus) Pigmented fungiform papillae of the tongue Acanthosis nigricans
For example, if a medication that you take is the cause of black tongue, your doctor might suggest changing to a different prescription.
Likewise, if the tongue discoloration is related to something you frequently eat or drink, dietary changes—like cutting out or limiting your intake of alcohol, coffee, or tea—can also help.
If you see your dentist about black tongue, they might suggest that you stop using mouthwashes that contain peroxide. Switching formulas may help prevent a recurrence of black tongue.
Sometimes, avoiding these things or making changes might not help the black tongue go away. If this is the case, your doctor may prescribe an antifungal medication or retinoid. In rare cases, laser surgery is required to treat the condition.
A Word From Verywell
Black tongue is not a serious condition, but it can be distressing. Even if the only symptom that you have is a change in your tongue’s appearance, you might feel embarrassed about it.
If you have discoloration on your tongue, talk to your doctor or dentist. They can usually diagnose the condition easily and help you find the best treatment.
