Hairy tongue is formed by the excessive elongation of filiform papillae, appearing black or dark brown, primarily located in the middle and posterior parts of the dorsal surface of the tongue.

bubble_chart Etiology

It is commonly seen in patients with poor oral hygiene, long-term antibiotic use, excessive smoking, and those who have undergone extensive radiotherapy for head and neck cancer. The condition may result from alterations in the normal oral environment, leading to excessive elongation of filiform papillae or impaired normal shedding. The black coloration may be caused by changes in salivary composition or contamination from melanin produced by spores of the black root mold.

bubble_chart Clinical Manifestations

The middle and posterior parts of the tongue's dorsum are densely covered with black tufted hairs. The hairs along the midline are longer, denser, and darker in color, while they become sparser toward the edges, ranging in length from a few millimeters to over 1 cm, with possible food residue on the surface. Most cases present no subjective symptoms, but may also be accompanied by fetid mouth odor, dry mouth, and a bitter taste in the mouth.

bubble_chart Treatment Measures

Strengthen oral hygiene, stop breathing, and avoid suspected foods or medications. For fungal infections, you can take nystatin orally or apply it as a suspension.