Hairy Tongue


Hairy Tongue, Black Hairy Tongue, Furry Tongue, Black Tongue

  • Pathophysiology
  1. Hyperplasia of Filiform Papillae on dorsal Tongue
    1. Papillae may elongate to >1 cm (usually 1 mm)
  2. Response to poor Desquamation, excessive keratinization
  • Risk Factors
  1. Tobacco Abuse
  2. Inadequate Oral Hygiene
  3. Oxidizing mouth wash use
  4. Overgrowth of oral fungus (Thrush)
    1. Aspergillus niger
    2. Candida albicans
  5. HIV Infection or other Immunosuppression
  6. Epstein Barr Virus has been identified on biopsy
  7. May follow antibiotic therapy
  • Symptoms
  1. Painless
  2. May cause gagging Sensation or altered Taste Sensation
  3. Halitosis may occur from food accumulation
  • Signs
  1. "Hair" of elongated papillae on 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
  • Management
  1. Improves with Tongue brushing with soft brush
  2. Avoid predisposing factors above