Dark spots on the tongue – Symptoms, Causes, and Treatments

Dark spots on the tongue can range in size from tiny flecks to significant noticeable marks. Spots, patches and discolouration occasionally form on the tongue and may not be harmful, but they may be a sign of more significant problems. 

On noticing such symptoms, it is advisable to consult a doctor so they can make proper diagnosis. 

Why do black spots appear on the tongue? 

The tongue is the muscular part of the mouth. There are several tiny tastes and sensation receptors on the tongue. Dark spots on the tongue typically go unnoticed. However, they could be a sign of a health issue if they have a particular hue or itch or are accompanied by other symptoms. 

Causes of dark spots on the tongue 

Tongue Injury 

Black spots can result from tongue injuries and oral piercings. Pain may develop if the tongue is injured. When a person has had a recent oral piercing or cut, or other injuries, a black patch on the tongue may be a persistent symptom of injury.

Exposure to chemicals 

The acids on the tongue can occasionally cause them to turn black when certain chemicals interact with them. Exposure to bismuth, a chemical found in some medications, may cause a colour change. 

Despite the fact that the entire tongue becomes black, the change may first show up in patches. When an individual stops taking bismuth, the tongue usually regains its usual pink colour.

Tongue’s natural appearance 

Though a person never notices them before, black dots on the tongue can be a common occurrence. In essence, the tongue is a muscle that is covered in taste buds. 

The tongue moves the food around the mouth while the taste buds signal the flavour cues to the brain. When red wine or coffee stains them, these taste buds, which are visible to the human eye, may appear like dark spots.

The tongue may develop black patches or spots due to excessive pigmentation. Several weeks after the completion of treatment, the black areas arising due to hyperpigmentation and chemotherapy normally disappear.

Cracked tooth 

Black spots on the tongue may result from a cracked tooth. The teeth can also cut the tongue, which could lead to an infection or discolouration.

Tongue cancer 

Dark spots on the tongue may occasionally be a sign of severe disease, like cancer. The dark areas could also resemble unhealed wounds or scabs. Additional signs of tongue cancer include lumps, swelling and swallowing issues. 

While suffering from any of these symptoms, the individual must immediately consult a doctor. Even though tongue cancer is a crucial condition, early treatment has the best results.

Dark spots may be a sign of leukoplakia, which can indicate a precancerous stage.

The most typical type of tongue cancer is squamous cell carcinoma. Usually, it appears as an ulcer or a scab that won’t go away. These marks can occur anywhere on the tongue.

Hairy tongue 

The presence of dark, black or grey regions on the tongue that resemble tongue hairs is referred to as a black hairy tongue. The usual cause is dead skin cells that do not shed properly. 

The other causes of this might include bad oral habits, medications and tobacco use. The condition is more commonly seen in men than in women.

Maintaining oral hygiene by using a toothbrush and tooth scraper daily will help get rid of a black, hairy tongue. Dentists or medical professionals can use specialised tools to scrape the tongue if other methods are ineffective.

Black tongue with hairs needs attention. Papillary structures, which are not visible to the naked eye, exist all over our tongue. However, they become clearly visible when dead cells accumulate on top of them.

The papillae seem black and hairy because they pick up stains from the food and drink we consume. Most of the time, the problem resolves on its own, but in the following situations, the process doesn’t occur.

• Decrease in saliva
• Side effects of medication
• High fluid consumption
• Oxidising mouthwashes
• Drinking beverages such as tea or coffee.

Tongue piercing 

Black spots on the tongue are also more common among those who have had their tongues pierced. They develop as a result of the melanin loss that gives the tongue its natural colour. Over time, the tongue regains its colour, and if it doesn’t, one might require medical attention.

Other causes of black spots on tongue includes: 

When your tongue doesn’t get rid of old skin cells, it can get dirty and discoloured from things you eat or drink. 

Antibiotics : These are the medicines that can help you feel better when you’re sick. But they can also kill good and bad germs in your mouth. Sometimes, this can make some germs grow too much in your mouth and cause problems. It may result in dark spots on your tongues and bad breath. 

Tobacco: Smoking or chewing tobacco can also cause black tongue. Tobacco easily leaves stains in your teeth and tongue. 

Consuming Coffee or Tea: Intake of coffee and tea easily stain the papillae, if one consumes it too often. 

Mouthwashes: Harsh and strong mouthwashes which contain oxidising agents can also darken your tongue and cause bad breath. 

Medications: Some Gastrointestinal medicines that contain Pepto-Bismol (Bismuth Subsalicylate) react with Sulphur in your mouth and make it appear black.  

Symptoms of dark Spots on the tongue 

A dark tongue signifies that the tongue turns black, but the discolouration can also be brown, white or yellow. The centre of the tongue typically has the most discolouration.

Some individuals do not always have other symptoms. The following are some signs and symptoms of a black tongue.

• Stinking breath
• Nausea
• Burning sensation
• Alteration in food flavour
• Gagging sensation
• Tickling feeling

Other symptoms and signs the following are black tongue spots.

• Tongue pain
• Ear pain 
• A lump in the throat or neck
• Difficulty swallowing. 

How to diagnose dark spots on the tongue? 

Usually, a doctor can diagnose the black tongue just by physical examination. A doctor might request additional tests if they have any second thoughts about the diagnosis.

Additional testing that could be necessary include,

• Swab for bacterial culture
• Scraping of fungi

Dark spots that last for more than a few weeks and are unsure of the origin need medical attention.

Discussing the medications and nutritional supplements taken with the doctor is essential regardless of noticing symptoms such as pain or lumps in the mouth, neck or throat.

The patient should also tell the doctor about any personal or family history of cancer and smoking and alcohol habits.

While most lesions are benign and disappear on their own, some lesions and bumps on the tongue or anywhere else in the mouth could be cancerous.

The patient might require imaging tests like x-rays or PET scans if the doctor suspects them to have tongue cancer. The doctor can also evaluate whether or not the suspicious tissue is malignant by performing a biopsy on it.

Treating dark spots on the tongue 

The black tongue can be prevented by practising good dental hygiene. Cleaning the tongue with a brush or scraper can help keep food particles and bacteria off its surface. 

If the spots disappear after brushing, further treatment might not be necessary. Visit a dentist for an examination if the spots persist. When feasible, stay away from substances or treatments that tend to make the tongue black.

Dietary modifications, such as cutting back on alcohol, coffee or tea, can be helpful if the discolouration is brought on by something a person usually consumes or drinks.

A medical professional can suggest a patient to stop using mouthwashes that contain peroxide.

It’s possible that adjusting or avoiding these factors won’t always make the black tongue go away. A doctor might prescribe a retinoid or an antifungal in this situation. Laser surgery is necessary for a few rare instances to correct the problem.

How to prevent dark spots on the tongue? 

It is impossible to prevent tongue spots completely. There are, however, certain strategies to lower the risk, including

• Not smoking or using tobacco products
• Drinking alcohol sparingly
• Routine dental examinations
• Consulting doctor on noticing any new tongue and mouth symptoms
• Request specific oral care recommendations from the doctor on experiencing tongue spots.

Black patches can mostly be prevented by maintaining adequate oral hygiene. 

The following are examples of good everyday oral hygiene.

• Brush your teeth and use a tongue scraper to remove dead skin cells. 
• Brush teeth post-meal
• Rinse the mouth with mouthwash after consuming tea, coffee, etc.
• Reducing tobacco usage in all forms, including quitting smoking, is very beneficial for restoring dental health and reducing black spots.
• Floss every day.
• Extensive dental cleaning.
• Maintain fluid intake as water aids in absorbing the dead cells.

Conclusion 

A black spot on the tongue is not usually a severe issue. Sometimes, the only sign a patient has is a change in the appearance of the tongue. Improving oral hygiene should be a top priority if an individual wants to get rid of black spots. 

It is essential to remember that while brushing the teeth, it is recommended to brush the tongue as well. After washing the tongue, if those dark spots go away, they might not need any additional treatment.

However, pay attention to any unusual symptoms observed in the mouth. It is imperative to see a doctor if black spots on the tongue continue and are accompanied by additional symptoms like lumps or swellings.

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