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What causes a black tongue?

While it’s always alarming to see, a black tongue generally isn’t a sign of anything serious. You might also notice that your tongue looks slightly hairy. But rest assured, those aren’t hairs. These are both signs of a temporary condition that’s sometimes called “black, hairy tongue.”

Read on to learn more about why this happens and how you can treat it.

Your tongue is covered in hundreds of tiny bumps called papillae. Usually, you don’t notice them much. But when dead skin cells start to collect on their tips, they start to look longer.

These long papillae are easily stained by bacteria and other substances, giving your tongue a black, furry appearance.

Experts aren’t sure why the tongue sometimes stops shedding dead skin cells, but it may be related to:

  • Poor oral hygiene. Dead skin cells are more likely to accumulate on the tongue if you aren’t regularly brushing your teeth and tongue or rinsing out your mouth.
  • Low saliva production. Saliva helps you swallow dead skin cells. When you don’t produce enough saliva, these dead skin cells can hang around on your tongue.
  • Liquid diet. Eating solid foods helps to scrape dead skin cells off your tongue. If you follow a liquid diet, this doesn’t happen.
  • Medication side effects. Some medications have dry mouth as a side effect, which makes it easier for skin cells to accumulate on the papillae.

When you have a buildup of dead skin cells on your tongue, bacteria and other substances can get caught in them. This can make your tongue look dark brown or black.

Contributing factors include:

  • Antibiotics. Antibiotics kill both good and bad bacteria in your body. This can affect the delicate balance of bacteria in your mouth, allowing certain yeasts and bacteria to thrive.
  • Tobacco. Whether you’re smoking or chewing it, tobacco is one of the biggest risk factors for black tongue. Tobacco very easily stains the elongated papillae on your tongue.
  • Drinking coffee or tea. Coffee and tea can also easily stain elongated papillae, especially if you drink a lot of either of them.
  • Some mouthwashes. Certain harsh mouthwashes that contain oxidizing agents, such as peroxide, can affect the balance of bacteria in your mouth.
  • Bismuth subsalicylate (Pepto-Bismol). Bismuth subsalicylate is a common ingredient in some over-the-counter gastrointestinal medications. When it reacts with traces of sulfur in your mouth, it can stain your tongue, making it appear black.

A black tongue usually doesn’t require much treatment. In most cases, regularly brushing your tongue with a toothbrush should help to remove dead skin cells and stains within a few days.

If you suspect that a medication or prescribed liquid diet is causing your black tongue, make an appointment with your doctor. They might be able to adjust your dosage or prescribe an antifungal or antibacterial medication to help manage yeast or bacteria in your mouth.

A retinoid medication may also help to increase cell turnover on your tongue.

For stubborn elongated papillae, a doctor can remove them using carbon dioxide laser burning or electrodessication, which simultaneously cuts and seals the papillae.

However, you can usually take care of the condition yourself:

  • Brush your tongue. Using a soft toothbrush, gently brush your tongue twice a day to help manually remove dead skin cells and bacteria.
  • Use a tongue scrapper. Using a tongue scraper every time you brush your teeth will help keep skin cells from accumulating on your papillae. You can buy one on Amazon.
  • Brush after eating. Brushing your teeth and tongue after every meal will help keep food debris and bacteria from getting trapped in the papillae.
  • Brush after drinking. Brushing after drinking coffee, tea, and alcohol will help prevent staining.
  • Stop using tobacco products. Quitting smoking or chewing tobacco is the best thing you can do for yourself and your tongue. If you can’t quit, brush your teeth and tongue after every time you use tobacco or about every two hours.
  • Floss before bed. Flossing your teeth at least once per day will prevent food debris and plaque from building up in your mouth.
  • Schedule a cleaning. Getting a cleaning at your dentist’s office will help you maintain good oral health.
  • Drink plenty of water. This will help to keep your mouth hydrated, which allows you to swallow dead skin cells. Not sure how much you should be drinking? Find out.
  • Chew gum. Chewing a sugar-free gum, or a gum designed for people with dry mouth, will help you produce more saliva to wash down dead skin cells. As you chew, the gum also helps to dislodge trapped skin cells.
  • Eat a healthy diet. A diet full of fruits, vegetables, lean proteins, and whole grains will help you maintain a healthy balance of bacteria in your mouth.

Having a black tongue is harmless and temporary. With a few lifestyle changes, you should see quick improvement.

If you’re still noticing a black color after a week or two, make an appointment with a doctor. You may need to adjust your medication dosage or have the elongated papillae removed.