Black Spots on Tongue: Causes and Treatment Options

Apr 25, 2024 | 4 min read

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Black spots on your tongue can be alarming but are usually harmless, though they might signal underlying health issues. These spots can be caused by hyperpigmentation, infections, medication side effects, and serious conditions like cancer

It's important to manage this condition to prevent complications such as oral infections or more severe health problems.

black spots on tongue

Causes of Black Spots

Tongue discoloration can stem from various conditions, ranging from benign to serious. Here's a detailed overview incorporating additional insights:

  • Hyperpigmentation: This can cause spots in shades of blue, purple, brown, black, or grey in the mouth, often due to systemic conditions. Addison's Disease, an adrenal disorder, and Peutz-Jeghers Syndrome, a rare genetic disorder, are known for causing such hyperpigmented spots on the tongue.
  • Black Hairy Tongue: This benign condition occurs when dead skin cells accumulate on the papillae of the tongue, giving it a black, "furry" look. Factors contributing to this condition include poor oral hygiene, antibiotic use, tobacco consumption, and diets rich in soft foods or high in coffee and alcohol. Improving oral hygiene can often resolve this condition, though antifungal medications may be necessary in some cases.
  • Injury and Trauma: Oral piercings or injuries such as bites or cuts can leave dark spots on the tongue as a sign of damage. Persistent sores that don't heal, hurt, or appear infected require medical attention.
  • Chemical Exposure: According to the Mayo Clinic, the color change on the tongue can be a result of exposure to bismuth, a component found in certain upset stomach medications. This discoloration typically resolves once the chemical exposure ends.
  • Tongue Cancer: Rarely, dark patches might be a sign of tongue cancer, indicated by scabs or sores that don't heal, along with lumps, swelling, or swallowing difficulties. Early treatment significantly enhances effectiveness.
  • Medication Side Effects: Some medications, including those containing bismuth, antipsychotic drugs, antimalarial medications, and tricyclic antidepressants can cause harmless black staining on the tongue.
  • Dietary Factors: Consuming certain dark-colored foods and beverages can temporarily stain the tongue, leading to discolorations such as black or dark brown spots. Additionally, dietary factors can also cause an orange tongue
  • Oral Candidiasis: This fungal infection can lead to black spots due to an overgrowth of yeast, often related to a compromised immune system or recent antibiotic use.

When to See a Doctor

It's important to be vigilant about changes in your tongue's appearance, as they can indicate health issues. Here are key signs that you should consult a healthcare professional:

  • Persistence: If discoloration persists despite good oral hygiene and eliminating potential causes.
  • Accompanying Symptoms: Pain, swelling, itching, a burning sensation, difficulty swallowing, or changes in taste.
  • Change in Texture: Development of a hairy or unusually rough texture.
  • Spreading or Growth: If the discoloration spreads or changes size or shape.
  • Systemic Symptoms: Unexplained weight loss, fever, or night sweats.
  • Non-Healing Sores: Sores or lesions on the tongue that do not heal within two weeks.
  • Impact on Daily Activities: If changes affect eating, speaking, or swallowing.

For those unsure about the severity of their symptoms, the online tool Symptom Checker can be a helpful resource. It assists in checking symptoms, identifying potential causes, and understanding when it's necessary to seek medical help.

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How to Remove Black Spots on the Tongue Naturally

Removing black spots on the tongue can often be achieved with simple home remedies and good oral hygiene practices. Here are some effective natural methods:

  • Proper Oral Hygiene: Brush your teeth twice daily and use a soft toothbrush to gently clean your tongue. This can help remove bacteria, fungi, and debris that could be causing the discoloration.
  • Tongue Scraping: Regular use of a tongue scraper can effectively remove the buildup of bacteria, food particles, and dead cells on the tongue’s surface. This simple tool can help reduce or prevent the appearance of black spots.
  • Hydration: Drinking plenty of water helps keep your mouth clean and aids in the removal of bacteria and food particles that could contribute to black spots.
  • Dietary Changes: Reduce the intake of foods and drinks that can stain your tongue, such as coffee, tea, and dark-colored berries. Increase your intake of fresh fruits and vegetables, which can promote oral health.
  • Baking Soda: Mix baking soda with a little water to make a paste and apply it to your tongue. Baking soda can help remove dead skin cells and promote the renewal of tongue surface cells.
  • Salt: Gently scrubbing the tongue with salt can act as a natural exfoliator, helping to remove any dead cells and debris. Follow this by rinsing thoroughly with water.
  • Aloe Vera: Apply aloe vera gel to the tongue to soothe any irritation and help heal infections. Aloe vera has antimicrobial properties that can be beneficial for oral health.
  • Tea Tree Oil: A rinse made with a few drops of tea tree oil mixed in water can act as a natural antiseptic to cleanse the tongue and reduce bacterial growth.
  • Quit Smoking: If applicable, quitting smoking can significantly improve the health of your mouth and may reduce or eliminate black spots caused by tobacco.
  • Regular Dental Checkups: Regular visits to the dentist can help identify and treat underlying issues contributing to black spots on the tongue.

Remember, while home remedies can be effective for treating some causes of black spots, they should not replace advice from a dental or medical professional.

Other Treatment Options for Black Spots on the Tongue

If natural remedies do not fully address the black spots on your tongue, or if the spots are due to a more serious condition, there are additional treatment options that can be considered. Here are some common medical treatments:

  • Antifungal or Antibacterial Medications: If the spots are due to infections like oral candidiasis, doctors may prescribe antifungal or antibacterial treatments.
  • Medication Review: If a medication is suspected to be causing the discoloration, a healthcare provider might adjust or change the prescription.
  • Laser Therapy: For persistent hyperpigmentation, laser treatment can be used to lighten the spots.
  • Cryotherapy: This involves freezing the affected areas to remove dark spots, typically used for benign but persistent lesions.
  • Biopsy or Removal: If there is any suspicion of cancer or other serious conditions, a biopsy might be performed, and any problematic tissue could be surgically removed.

Consultation with a healthcare provider is essential to determine the appropriate treatment based on the specific cause of the black spots on the tongue.

Frequently Asked Questions

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  • Black spots on the tongue can stem from various factors, including hyperpigmentation, infections, medication side effects, and serious conditions like cancer. 
  • Consult a healthcare professional if discoloration persists, is accompanied by symptoms, or affects daily activities, especially to rule out serious conditions.
  • Simple home measures like maintaining oral hygiene, using tongue scrapers, and natural cleaning agents (baking soda, salt) can effectively manage and reduce black spots on the tongue.
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