Has your tongue been feeling hairy and discolored recently? Have no worries for hairy tongue syndrome or black hairy tongue is usually a temporary, harmless problem.

What is hairy tongue disease?

Hairy tongue disease is a condition in which there is elongation of the many small nodules (filiform papillae) on the surface of the tongue resembling stubby hairs and there is lack of normal shedding of the tongue cells. The papillae can sometimes grow up to 1 cm in length and can become stained, usually black from coffee, tea, cokes or overgrowth of pigment-producing bacteria and fungi. The debris and organisms collected on the tongue can also result in yellow and brown discoloration.

Causes of hairy tongue

The exact cause for hairy tongue disease is unknown but hairy tongue is usually seen in heavy smokers and in those following antibiotic therapy which causes change in normal bacteria content in the mouth. Other potential factors that may contribute to hairy tongue include:

• poor oral hygiene,
• mouth breathing,
• poor diet
• excessive use of antiseptic mouthwashes containing oxidizing agents like hydrogen peroxide.

Signs and symptoms of hairy tongue

The condition is usually symptomless but a gagging and nauseating sensation may be felt due to ‘tickling’ of the soft palate. The overgrowth of bacteria on the tongue may also cause bad breath or a burning sensation.

Black hairy tongue disease should be distinguished from a simple staining of the tongue where there is no overgrowth of the surface of the tongue. The tongue surface may sometimes become black without the elongation of the papillae. This may be due to staining by drugs used to treat anemia but it is temporary.

Hairy tongue treatment

There is no exact hairy tongue cure.

• The best measure most likely to succeed is to scrape the surface of the tongue and vigorously clean the tongue surface with a firm soft-bristled toothbrush or tongue scraper. This removes the overgrown papillae and bacteria mechanically, making them less likely to grow back but hairy tongue disease may recur.
• Practice good oral hygiene
• Try to reduce smoking
• Eliminate use of potential causative factors.

How to prevent hairy tongue disease

Hairy tongue disease may reoccur due to poor oral hygiene or local causative factors that still persist. Therefore it is best to:

• Practice good oral hygiene with proper tooth brushing techniques and the usage of floss and mouthwash
• Brush after eating or drinking
• Brush your tongue using a tongue scrapper
• Make regular appointments with your dentist to get your teeth professionally cleaned and examined to spot problems early on and ensure your mouth stays in a healthy condition
• Maintain good general health by having proper nutrition and exercise
• Stop smoking
• Avoid overusing mouthwashes that contain oxidizing agents

Other types of hairy tongue

Yellow hairy tongue

Yellow hairy tongue is most often an early sign for black hairy tongue and rarely, a sign of jaundice, a condition that causes yellowing of the eye and skin that may indicate liver or gallbladder problems.

Treatment for yellow hairy tongue is usually unnecessary.

White hairy tongue

An unstained hairy tongue tends to be white in color.

Hairy leukoplakia

Hairy leukoplakia is caused by Epstein-Barr virus and presents as a white patch that frequently affects both lateral borders of the tongue and cannot be scrapped off. The sides of the tongue tend to have vertical white folds with a raised or hairy surface which is soft and usually painless. This condition is common in those suffering with late-stage HIV infection but hairy leukoplakia can also occur in non-HIV infected individuals receiving immunosuppressive therapy (for example heart transplant patients) and rarely, in apparently healthy persons.

It is best that you find your dentist or doctor to confirm whether you have hairy leukoplakia. Treatment is usually not required since the condition is symptomless and it can regress spontaneously. There is no evidence that hairy leukoplakia is a pre-cancerous lesion but it can indicate a poor immune system, a more rapid progression to AIDS and a poor prognosis.

Furry tongue

The tongue surface can be coated with dead cells and debris, usually seen in heavy smokers, systemic upsets especially of the stomach and in infections in which the mouth becomes dry. A furred tongue can also be seen in childhood fevers, especially scarlet fever.

When to see a doctor

• When there is persistent discoloration of your tongue.
• There is yellow coloring on other surfaces of your skin and whites of your eyes suggesting jaundice.
• There is a white patch on your tongue that cannot be removed.