II. Epidemiology

  1. Prevalence: 0.5 to 11%
  2. More common in older patients
  3. More common in males (3 fold more common than in females)

III. Pathophysiology

  1. Hyperplasia of Filiform Papillae on anterior two thirds of dorsal Tongue (retention hyperkeratosis)
    1. Papillae may elongate to >1 cm (usually 1 mm)
  2. Response to poor Desquamation, excessive keratinization
  3. Bacterial colonization may result in black appearance

IV. Risk Factors

  1. Tobacco Abuse
  2. Alcohol Use
  3. Inadequate Oral Hygiene
  4. Low fiber diet
  5. Hyposalivation
  6. Mouth breathing
  7. Oxidizing mouth wash use
  8. Overgrowth of oral fungus (Thrush)
    1. Aspergillus niger
    2. Candida albicans
  9. HIV Infection or other Immunosuppression
  10. Epstein Barr Virus has been identified on biopsy
  11. May follow antibiotic therapy

V. Symptoms

  1. Painless
  2. May cause gagging Sensation or altered Taste Sensation
  3. Halitosis may occur from food accumulation

VI. Signs

  1. "Hair" of elongated papillae on anterior two thirds of Tongue dorsum
    1. Yellowish to brown or black coloration
    2. Velvety, or shaggy, asymptomatic keratoses
    3. Unable to wipe off Plaque
    4. Color altered by foods, Tobacco, coffee, tea
  2. Distribution
    1. Dorsal Tongue surface

VII. Management

  1. Improves with Tongue brushing with soft brush
    1. Use a standard ToothBrush or scrape the Tongue
    2. May apply a 1.5% Hydrogen Peroxide
  2. Avoid predisposing factors above
  3. Increase Dietary Fiber

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Related Studies

Ontology: Hairy tongue (C0040414)

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
Portuguese Língua vilosa, Língua Pilosa
Dutch tong harig, Haartong, Lingua villosa nigra, Tong, haar-
Italian Lingua villosa, Lingua pelosa
Japanese モウゼツ, 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 クロゲジタ, 黒毛舌, 黒舌, コクゼツ, コクモウゼツ, コクモウシタ
Hungarian Fekete szőrös nyelv, Fekete szőrnyelv, Fekete nyelv, Fekete hajas nyelv