II. Epidemiology
- Prevalence: 0.5 to 11%
- More common in older patients
- More common in males (3 fold more common than in females)
III. Pathophysiology
- Hyperplasia of Filiform Papillae on anterior two thirds of dorsal Tongue (retention hyperkeratosis)
- Papillae may elongate to >1 cm (usually 1 mm)
- Response to poor Desquamation, excessive keratinization
- Results in trapping of debris and Bacteria
- Bacterial colonization may result in black appearance
IV. Risk Factors
- Tobacco Abuse
- Alcohol Use
- Inadequate Oral Hygiene
- Low fiber diet
- Hyposalivation
- Mouth breathing
- Oxidizing mouth wash use
- Overgrowth of oral fungus (Thrush)
- Aspergillus niger
- Candida albicans
- HIV Infection or other Immunosuppression
- Epstein Barr Virus has been identified on biopsy
- Radiation Therapy
- Medications
- See Medication Causes of Dry Mouth
- Recent Antibiotic therapy (e.g. Linezolid)
V. Symptoms
- Painless
- May cause gagging Sensation or altered Taste Sensation
- Halitosis may occur from food accumulation
VI. Signs
VII. Management
- Improves with Tongue brushing with soft brush
- Use a standard ToothBrush or scrape the Tongue
- May apply a 1.5% Hydrogen Peroxide
- Avoid predisposing factors above (including drug-induced causes of Xerostomia)
- Increase Dietary Fiber
- Tobacco Cessation
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| Definition (NCI) | A benign condition affecting the dorsum of the tongue. It is characterized by defective desquamation resulting in elongation of the filiform papillae. The dorsum of the tongue has a furry appearance and is usually stained black. |
| Definition (MSH) | A benign condition of the tongue characterized by hypertrophy of the filiform papillae that give the dorsum of the tongue a furry appearance. The color of the elongated papillae varies from yellowish white to brown or black, depending upon staining by substances such as tobacco, food, or drugs. (Dorland, 27th ed) |
| Concepts | Disease or Syndrome (T047) |
| MSH | D014064 |
| SnomedCT | 81934005, 255225007 |
| English | Hairy Tongues, Tongue, Hairy, Tongues, Hairy, Overgrowth filiform papillae, Tongue hairy, hairy tongue (physical finding), hairy tongue, Tongue, Hairy [Disease/Finding], hairy tongues, tongue hairy, Overgrowth of filiform papillae, Overgrowth of filiform papillae (disorder), Hairy tongue, Hairy Tongue |
| Spanish | Lengua Vellosa, Lengua pilosa, Lengua Pilosa, hiperplasia de papila filiforme (trastorno), hiperplasia de papila filiforme, lengua vellosa |
| Swedish | Hårtunga |
| Czech | jazyk chlupatý, Chlupatý jazyk |
| Finnish | Karvakieli |
| Russian | IAZYK VOLOSATYI, ЯЗЫК ВОЛОСАТЫЙ |
| Portuguese | Língua vilosa, Língua Pilosa |
| Dutch | tong harig, Haartong, Lingua villosa nigra, Tong, haar- |
| Italian | Lingua villosa, Lingua pelosa |
| Japanese | ﾓｳｾﾞﾂ, 絨毛舌, 毛舌, 毛舌症 |
| Polish | Język kosmaty, Język czarny włochaty, Czerniaczka języka |
| Hungarian | Hajas nyelv |
| Norwegian | Svart hårtunge, Hårtunge |
| German | Lingua villosa nigra, Haarzunge |
| French | Langue pileuse |
Ontology: Black hairy tongue (C0235347)
| Concepts | Disease or Syndrome (T047) |
| MSH | C538420 |
| ICD10 | K14.3 |
| SnomedCT | 81934005 |
| English | TONGUE BLACK, TONGUE BLACK FURRY, black hairy tongue, tongue papillae hypertrophy black hairy tongue, black hairy tongue (diagnosis), Tongue black furry, Tongue black hairy, Lingua Villosa Nigra, Lingua Nigra, Black;tongue, black tongues, blacking tongue, tongue hairy black, black furry tongue, hairy black tongue, melanoglossia, black tongue, tongue black, Lingua villosa nigra, Black tongue, Melanoglossia, Black hairy tongue (disorder), black; hairy tongue, hairy tongue; black, lingua; nigra, nigra; lingua, Tongue black, Black hairy tongue |
| French | LANGUE NOIRE PILEUSE, LANGUE NOIRE, Langue noire pileuse, Langue noire, Langue noire villeuse |
| Spanish | LENGUA NEGRA VELLOSA, LENGUA NEGRA, Lengua pilosa negra, Lengua negra, Lengua negra y pilosa, Lengua negra peluda, lengua negra, lengua pilosa negra (trastorno), lengua pilosa negra, lengua vellosa negra, melanoglosia |
| Portuguese | LINGUA COM PELE NEGRA, LINGUA NEGRA, Língua vilosa negra, Língua negra, Língua saburrosa negra |
| German | SCHWARZE HAARZUNGE, ZUNGE SCHWARZ, Zunge schwarz pelzig, Zunge schwarz, schwarze Haarzunge |
| Dutch | tong zwart harig, tong zwart, zwartharige tong, zwarte haartong, haartong; zwart, lingua; nigra, nigra; lingua, zwart; haartong |
| Italian | Lingua nera, Lingua nera pelosa, Lingua nera patinata |
| Czech | Černý chlupatý jazyk, Černý jazyk |
| Japanese | ｸﾛｹﾞｼﾞﾀ, 黒毛舌, 黒舌, ｺｸｾﾞﾂ, ｺｸﾓｳｾﾞﾂ, ｺｸﾓｳｼﾀ |
| Hungarian | Fekete szőrös nyelv, Fekete szőrnyelv, Fekete nyelv, Fekete hajas nyelv |
