Black Hairy Tongue- Symptoms, Causes, Complications, And Treatment

The black hairy tongue has different names in the world of science, names like lingua villosa nigra, hyperkeratosis of the tongue, nigrities linguae, keratomycosis linguae, and melanotrichia linguae are also used to describe the Black hairy tongue. The first case of this illness was reported back in 1557 and till then it has become a rare disease.

Black hairy tongue is less serious than it appears to be, it generally gives an illusion of dark furry hair grown on your tongue which is visible with the naked eye.

A black hairy tongue is a condition that is painless and doesn't cause any kind of health problems in a shorter span. Prolonged exposure to the disease will lead to other health products.

This texture of the tongue is due to the deposition of dead skin cells concentrated on the papillae of the tongue. Papillae are also known as taste buds, which help us identify the nature of the food we consume.

It also helps in sensing the taste and flavors of the food that we consume. In this case, the papillae grow a little longer than usual, which makes them more vulnerable to bacteria or viruses stuck in the hairs.

Too much yeast or bacteria growth is one of the most common causes of black hairy tongue. So instead of shredding it out of the tongue surface, the bacteria starts to grow on the papillae, leading to the development of hair-like projections. If not treated on time, the length of the hairs can be grown up to 15 times its size, and start growing bacteria or yeast within.

The bacteria can also feed on the food that got stuck in the long papillae, boosting the growth and dying the tongue color darker, like the name. Depending upon the bacteria type, the color of the tongue can be green, blue, black, yellow.

Bacteria and yeast do not grow on their own, there can be certain reasons associated with the blackening of the tongue:

• Using mouthwash regularly contains peroxide, witch hazel, or menthol.
• Excessive intake of alcohol or caffeine.
• Dehydration.
• Intake of medications contain bismuth salt and oxidizing salts like sodium perborate, sodium peroxide, and hydrogen peroxide.
• Long term consumption of antibiotics like penicillin, cephalosporin, chloramphenicol, streptomycin, and tetracycline.
• Oral health product like toothpaste containing neomycin.
• Low production of saliva.
• Poor hygiene practices, especially oral.
• Radiation therapy near the head and neck area.
• Intravenous drugs use.
• Infected from AIDS.
• Trigeminal neuralgia (chronic pain condition associated with the trigeminal nerve, which is responsible for carrying sensation of your facial muscles to the brain).
• Increased keratin deposition on the tongue.

The disease does not have any physical pain or discomfort whatsoever, although, in the case of candida Albicans, it can create burning sensations called glossopyrosis. Other than that, all the changes related to color change and taste. In rare cases, some might feel:

• Tickling sensation in the backside of a mouth.
• A metallic taste.
• Nausea.
• Bad breath ( also called halitosis).
• Hairy or furry appearance on the backside of the tongue.

The field of medical study that works on diseases related to the oral section of the body is known as dentistry. A dentist is an ideal medical health professional to seek in the case of Black Hairy Tongue.

Although, your nearby primary care provider (PRP) can also check upon the disease and give you first aid treatment. But it is advisable to go for a professional if it looks serious or has a burning or tickling sensation.

To diagnose the severity of the case, your doctor initially will start from a general examination of the tongue and detailed history of the patient's medical and lifestyle history. Based on that, your doctor might prescribe you a couple of tests to differentiate it from other look-alike diseases like:

1. Pseudo-BHT:

   A condition in which there is no significant growth of papillae, but they do appear at the back of the tongue and create a color change.

2. Acanthosis nigricans:

   This medical condition often develops a brown-to-black and velvety texture of the skin. Unlike black hairy tongue, It can be found in various body folds, such as the lateral and posterior folds of the forehead, armpits, groin, neck, navel, and other areas of the body.

3. Oral hairy leukoplakia:

   Is a rare condition triggered by the Epstein-Barr virus (EBV). It shows a sign of white patches on your tongue as a symptom. Sometimes the white patches can also appear in other parts of your mouth.

4. Congenital melanocytic:

   This type of tongue disease is found in newborns. This is a type of birthmark not seen so often in children. In layman's terms, it is known as a mole on the tongue.

Based on the results of the diagnosis, your doctor will recommend a couple of self-care tips and medical treatment drugs and procedures.

BHT is an easily diagnosed disease. Since 1925, nobody showed interest in the disease, the facts related to the disease might be clouded and poorly understood by medical professionals. Diagnosis is very important as it can be misunderstood with a pseudo-hairy tongue. The term pseudo-hairy tongue refers to brownish-black discoloration of the tongue without any sign of elongated filiform papillae.

To remove bacterial growth in the mouth, developing better hygiene is the first thing. Use a toothbrush with bristles and an attached tongue cleaner.

Use it twice a day for effective oral hygiene, gently scrape the tongue area for effective cleaning, and change the mouthwash containing peroxide, witch hazel, or menthol.

Keep yourself hydrated, helps to clean the dying but also keeps your digestive system healthy. Add more roughage to your diet as soft food doesn't have the quality to clean your bacterial growth.

Avoiding the consumption of alcohol and tobacco can help you reduce the color of bacterial growth.

Consult your dentist for early detection and treatment, they might prescribe a combination of antibiotics or antifungal drugs to reduce the Black Hairy Tongue growth. Also, a healthy intake of vitamin A can help to cure the infection on the surface of the tongue.

In critical conditions where antibiotics or antifungal drugs don't work, your doctor might go for Local medications like tretinoin (Retin-A), or electrosurgery of papillae. In electrosurgery, they clip off the whole infected area.

The disease does not show any sign of being “contagious” in nature and does not spread through oral connection or sexual intercourse. The disease itself does not cause any physical discomfort and pain, although it is advisable to hold on to any oral connection with your partner until treated, even though the disease is not contagious, the foul smell and dyed appearance of the tongue can create a bad impact.

Black Hairy Tongue is an acute, rather temporary condition of tongue darkening and giving an outlook furry surface. It doesn’t develop any chronic illness development or a side effect rather it might be acting as a side effect for major diseases like HIV.

With better hygiene practices and management, one can easily get rid of the blackish and hairy disease.

Even though the disease is easy to detect and cure, the black hairy tongue is quite rare to see. As per the statistics taken by researchers around the globe, the probability of having a BHT is 1 in 1 million people. It is almost like 13% of the whole world’s population.

Also, the disease seems to infect men more than women. As men consume more alcohol, tobacco, and caffeine-oriented consumables than females do.

Furthermore, it is quite general in mature stages of life ( age group between 40 and above ) than younger ones, since it is caused due to chronic buildup of bacteria or yeast it might take a time.

To decrease the coloration and infection, your doctor might prescribe you a high fiber diet. Fiber helps to wash down the bacterial growth off the tongue. Here is a list of food items that can be added to your diet to enrich the value of fiber:

1. Fruits:

   These fruits are not only high in fiber but also increase your vitamin and nutrient content. Fruits like Pears (3.1 grams), Strawberries (2 grams), Avocado (6.7 grams), Apples (2.4 grams), Raspberries (6.5 grams), and Bananas (2.6 grams) are good for Black Hairy Tongue treatment.

2. Vegetables:

   It is a crucial part of the meal and to cure BHT, vegetables like Carrots (2.8 grams), Beets (2.8 grams), Broccoli (2.6 grams), Artichoke (5.4 grams), Brussels sprouts (3.8 grams), Lentils (7.3 grams) and Sweet potatoes (2.5 grams) are protein-rich and high in fiber which will help in overall health.

3. Grains:

   Like Kidney beans (6.8 grams), Split peas (8.3 grams), Chickpeas (7 grams), Quinoa (2.8 grams), Oats (10.1 grams), and Popcorn (14.4 grams) is the easiest source of fiber. They are easy to add into your daily routine diet and help the patient to treat black hairy tongue at home.

4. Nuts and seeds:

   Nuts are known to be high in fiber and nutrients. So nuts like Almonds (13.3 grams) and Chia seeds (34.4 grams) are good to treat BHT.

   Also avoiding soft food like cream, white bread, cooked fruits, and vegetables without any seeds or skin. They might feel good on the pallet but not good to cure the black hairy tongue.

Vitamin A is good to cure oral infections, it helps to build immunity that fights against bacterial growth. Vitamin A is usually found in animal products. Here is the list of vitamin A-rich food that can enhance your immunity system.

• Cod Liver Oil
• Hard-Boiled Egg
• Liver Sausage
• Beef Liver
• Caviar
• Lamb Liver
• King Mackerel
• Salmon
• Bluefin Tuna
• Goose Liver Pâté

One might feel a little hesitant to try direct animal products but there are some by-products that are also rich in vitamin A:

• Goat Cheese
• Butter
• Limburger Cheese
• Cheddar
• Camembert
• Roquefort Cheese
• Trout
• Blue Cheese
• Cream Cheese
• Feta Cheese

These options are good to add while incorporating some high fiber components in the meal. These are known as soft food products. Apart from the above animal and dairy products, here are some vegan options to increase vitamin A in your diet.

• Sweet Potato
• Winter Squash
• Kale
• Collards
• Turnip Greens
• Carrot
• Sweet Red Pepper
• Swiss Chard
• Spinach
• Romaine Lettuce
• Mango
• Cantaloupe
• Pink or Red Grapefruit
• Watermelon
• Papaya
• Apricot
• Tangerine
• Nectarine
• Guava
• Passion Fruit

These fruits and vegetables are ideal for vegan lovers to increase the level of vitamin A in the diet. Although, it is advisable to seek a dietician or dentist before adding the products to your diet.