Why Is My Tongue Black?

Why Is My Tongue Black?

A black tongue is usually caused by a harmless condition called black hairy tongue, where keratin builds up on the papillae and traps stain, bacteria, or yeast.

Coffee, tobacco, medicines, and poor oral hygiene can all contribute to a black or dark coating on the tongue. Most cases improve with better brushing and tongue cleaning, but pain, swelling, or mouth sores should be evaluated.

Other Symptoms

A black hue to your tongue might be the only symptom you notice. Additional symptoms that can occur with a black tongue include:

• A hairy appearance on the tongue
• Fuzzy or sticky sensation in the mouth
• Bad breath or bad taste
• Gagging or nausea
• Burning sensation

4 Potential Causes of a Black Tongue

The primary causes of a black tongue include:

1. Black Hairy Tongue

The primary cause of black discoloration on the tongue is a benign condition called black hairy tongue syndrome.

A healthy tongue sheds keratin cells continuously. A black hairy tongue occurs when that process stops, causing the papillae to remain long. These long papillae give your tongue a hairy or furry appearance.

The discoloration in a black hairy tongue is due to staining from external factors, such as beverages, tobacco, and bad oral hygiene.

Risk factors for black hairy tongue include:

• Poor oral hygiene
• Tobacco use (smoking or chewing)
• Excessive alcohol consumption
• Frequent coffee or black tea consumption
• Dry mouth
• A soft diet or eating very little, which reduces the natural shedding of papillae
• Use of peroxide mouthwashes
• Certain antibiotics or other medications
• Radiation therapy to the head and neck
• Cancer, HIV, or other immunocompromising conditions
• Being male (BHT is more common in men)

A black hairy tongue usually clears up with regular brushing and tongue cleaning once the cause is addressed. Most cases improve within one to two weeks. If the discoloration sticks around longer, see your dentist or doctor for an evaluation.

2. Infection

Bacteria or yeast buildup can contribute to black hairy tongue, and some oral infections or lesions can cause tongue color changes that need evaluation. Other symptoms you might experience with an oral infection are:

• Facial swelling
• Fever
• Pain in your jaw, teeth, or gums
• Bleeding of the gums
• Lesions on the tongue or mouth

Contact a doctor if you have a black tongue and symptoms like these.

3. Lifestyle Factors

Your tongue may turn black due to habits you perform daily. Lifestyle factors that can cause a dark color on your tongue include:

• Poor oral hygiene
• Frequent smoking, tobacco use, or alcohol consumption
• Excessive drinking of coffee, black tea, or dark sodas

4. Medication Side Effects

Certain medications can cause a black tongue as a side effect. Medicines that may trigger black discoloration include:

• Antibiotics
• Antipsychotics
• Cancer treatments
• Bismuth-containing products like Pepto-Bismol, which can temporarily blacken the tongue

Discuss any side effects you notice after starting a new medication with your doctor.

Is a Black Tongue Serious?

No, a black tongue isn’t typically serious. Most cases of black tongue are benign and can be treated by maintaining good oral hygiene.

Outlook for a Black Tongue

The outlook for a black tongue is positive. Most cases clear up within one to two weeks of consistent brushing and tongue cleaning once the cause is addressed.

How is a Black Tongue Diagnosed and Treated?

A doctor will perform an oral examination to diagnose a black tongue. They will also conduct a medical history to eliminate or identify underlying conditions.

At-Home Treatments

The primary treatment for a black tongue is improving your oral hygiene practices. At-home remedies your doctor might recommend include:

• Practicing excellent oral hygiene — You should brush your teeth twice daily with fluoride toothpaste and floss once daily. Include tongue brushing or scraping as part of your regular routine.
• Brushing after eating — If your tongue is prone to staining, you might want to brush your teeth 30 minutes after eating or drinking dark foods and beverages.
• Avoiding tobacco or alcohol — If your black tongue comes from tobacco or alcohol use, cutting back on either will improve the condition.
• Eat a healthy diet — Drink plenty of water and eat balanced meals with fruits and vegetables to help your tongue stay healthy.

Professional Treatments

Medical treatment is not typically required for a black tongue. If an exam or testing turns up a separate bacterial, fungal, or viral infection, your doctor or dentist may prescribe a treatment aimed at that specific cause.

Your doctor may change your prescription if a medication is causing your tongue discoloration. They may also review what oral care products you use and recommend changes if necessary.

Why is my Tongue Black When I Wake Up?

If your tongue is black when you wake up, you might need to improve your oral hygiene. Your tongue could have a bacterial overgrowth due to not taking care of your oral health properly.

You may also develop a black tongue overnight if you consumed dark foods and beverages the night before. It’s especially common if you don’t clean your mouth effectively before bed.

What Should a Healthy Tongue Look Like in the Morning?

A healthy tongue is usually pink to dark pink, with a thin whitish coating. Natural tongue color can vary based on your skin pigmentation, so a slightly darker baseline is normal for some people. The whitish coating comes from keratin and everyday debris on the tongue’s surface. The small bumps you see are papillae, and some of them house your taste buds.

You may need to consult a doctor if your tongue is another color or if your papillae seem long or patchy.

Tips for Preventing a Black Tongue

You can prevent a black tongue by practicing excellent oral hygiene. Follow these tips to avoid developing a black tongue:

• Brush and floss your teeth daily
• Use a tongue scraper or brush your tongue daily
• Avoid mouthwashes with alcohol
• Brush 30 minutes after eating or drinking dark food and liquids
• Visit your dentist regularly
• Quit smoking and excessive alcohol use
• Cut back on coffee and black tea

Summary

A black tongue typically develops from poor oral hygiene. Your tongue may also turn black from lifestyle factors like smoking, excessive alcohol consumption, consuming dark foods and beverages, and infections.

Most cases of a black tongue are benign and will resolve with good oral hygiene practices. Sometimes, your doctor may need to prescribe medication to treat an underlying condition.

The prognosis for a black tongue is positive. You can prevent it from happening by taking good care of your oral health, avoiding tobacco and dark beverages, and visiting your dentist for regular cleanings.