Materiały źródłowe

• #1 Black hairy tongue syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/25152586/

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] BHT remains an important medical condition which may result in additional burden on the patient and health care system and requires appropriate prevention, recognition and treatment.

• #2 Black hairy tongue syndrome

  https://www.wjgnet.com/1007-9327/full/v20/i31/10845.htm

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] Review of the medical literature shows that BHT is not uncommon. A large cross-sectional study of 5150 Turkish dental outpatients has reported an overall prevalence of 11.3% with increased rates in men (18%) compared to women (6%). However, a cross-sectional study of 1901 Iranian dental patients only reported a prevalence of 1.2%. BHT occurred in 0.6% of Minnesota school-aged children in contrast to 8.4% patients in a young Finnish population. Discordance of the observed rates may stem from difference patients demographics (age, sex, ethnicity, practices and habits) and interobserver variability in defining lesions in corresponding study populations.

• #3 Black hairy tongue syndrome

  https://www.wjgnet.com/1007-9327/full/v20/i31/10845.htm

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] Review of the medical literature shows that BHT is not uncommon. A large cross-sectional study of 5150 Turkish dental outpatients has reported an overall prevalence of 11.3% with increased rates in men (18%) compared to women (6%). However, a cross-sectional study of 1901 Iranian dental patients only reported a prevalence of 1.2%. BHT occurred in 0.6% of Minnesota school-aged children in contrast to 8.4% patients in a young Finnish population. Discordance of the observed rates may stem from difference patients demographics (age, sex, ethnicity, practices and habits) and interobserver variability in defining lesions in corresponding study populations.

• #4 Black hairy tongue – Wikipedia

  https://en.wikipedia.org/wiki/Black_hairy_tongue

  Hairy tongue occurs in about 0.5% of adults. However, the prevalence is variable depending on the population studied.

• #5 Hairy Tongue

  https://www.aaom.com/hairy-tongue

  Hairy tongue is a relatively common, temporary, and harmless condition that occurs in as much as 13% of the population. […] It is found more commonly in males than females and equally among races. […] Certain types of bacteria and yeast can even give the tongue a black appearance, referred to as black hairy tongue. […] Patients who have had hairy tongue are at greater risk for recurrence.

• #6 Black hairy tongue syndrome

  https://www.wjgnet.com/1007-9327/full/v20/i31/10845.htm

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] Review of the medical literature shows that BHT is not uncommon. A large cross-sectional study of 5150 Turkish dental outpatients has reported an overall prevalence of 11.3% with increased rates in men (18%) compared to women (6%). However, a cross-sectional study of 1901 Iranian dental patients only reported a prevalence of 1.2%. BHT occurred in 0.6% of Minnesota school-aged children in contrast to 8.4% patients in a young Finnish population. Discordance of the observed rates may stem from difference patients demographics (age, sex, ethnicity, practices and habits) and interobserver variability in defining lesions in corresponding study populations.

• #7 Black hairy tongue syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4138463/

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] Review of the medical literature shows that BHT is not uncommon. A large cross-sectional study of 5150 Turkish dental outpatients has reported an overall prevalence of 11.3% with increased rates in men (18%) compared to women (6%). However, a cross-sectional study of 1901 Iranian dental patients only reported a prevalence of 1.2%. BHT occurred in 0.6% of Minnesota school-aged children in contrast to 8.4% patients in a young Finnish population. Discordance of the observed rates may stem from difference patients demographics (age, sex, ethnicity, practices and habits) and interobserver variability in defining lesions in corresponding study populations.

• #8 Black hairy tongue syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4138463/

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] Review of the medical literature shows that BHT is not uncommon. A large cross-sectional study of 5150 Turkish dental outpatients has reported an overall prevalence of 11.3% with increased rates in men (18%) compared to women (6%). However, a cross-sectional study of 1901 Iranian dental patients only reported a prevalence of 1.2%. BHT occurred in 0.6% of Minnesota school-aged children in contrast to 8.4% patients in a young Finnish population. Discordance of the observed rates may stem from difference patients demographics (age, sex, ethnicity, practices and habits) and interobserver variability in defining lesions in corresponding study populations.

• #9 Black hairy tongue syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4138463/

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] Review of the medical literature shows that BHT is not uncommon. A large cross-sectional study of 5150 Turkish dental outpatients has reported an overall prevalence of 11.3% with increased rates in men (18%) compared to women (6%). However, a cross-sectional study of 1901 Iranian dental patients only reported a prevalence of 1.2%. BHT occurred in 0.6% of Minnesota school-aged children in contrast to 8.4% patients in a young Finnish population. Discordance of the observed rates may stem from difference patients demographics (age, sex, ethnicity, practices and habits) and interobserver variability in defining lesions in corresponding study populations.

• #10 Drug-Induced Black Hairy Tongue: A Case Report – Mediterranean Journal of Infection Microbes and Antimicrobials

  https://mjima.org/articles/drug-induced-black-hairy-tongue-a-case-report/doi/416f29f7-a3c1-49ec-930f-5f2f5544de9f

  Black hairy tongue, also known as lingua villosa nigra, is a painless, benign clinical condition caused by defective desquamation and reactive hypertrophy of the filiform papillae of the tongue. Its estimated prevalence in a large series of Turkish dental outpatients is as high as 23.7%. The etiology of this condition is due most commonly to the side effects of certain drugs, including antibiotics, antihypertensives, psychotropics, and oxygenating oral mouth rinses. […] Although patients may be alarmed, black hairy tongue is completely harmless. In most cases, it does not require drugs for treatment. Elimination of any incriminating factors is usually sufficient to treat the lesions.

• #11 Black hairy tongue syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4138463/

  Selected populations are at a higher risk of developing BHT. Patients with oncological disorders, smokers, black tea drinkers, and those with poor oral hygiene are more likely to develop BHT. BHT also shows clear gender and age predilection. Men are about three times more commonly affected than women. This can be attributed to greater prominence of smoking and higher rates of poor oral hygiene in males. […] Finally, globally, there may also be geographic deviations in the prevalence of BHT due to differences in oral hygiene habits and dietary patterns, and variation in oral flora.

• #12 Hairy Tongue

  https://fpnotebook.com/ENT/Tongue/HryTng.htm

  Prevalence: 0.5 to 11% […] More common in older patients […] More common in males (3 fold more common than in females)

• #13 Black Hairy Tongue: A Rare Adverse Effect of Olanzapine

  https://www.psychiatrist.com/pcc/black-hairy-tongue-rare-adverse-effect-olanzapine/

  Prevalence ranges from 0.6% to 11.3% and is 3 times more common in men than in women, with elderly males being more prone to development. […] The exact mechanism behind olanzapine induced black hairy tongue is unknown. It has been suggested that the anticholinergic properties of olanzapine may play a role in its development.

• #14 Black hairy tongue syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4138463/

  Selected populations are at a higher risk of developing BHT. Patients with oncological disorders, smokers, black tea drinkers, and those with poor oral hygiene are more likely to develop BHT. BHT also shows clear gender and age predilection. Men are about three times more commonly affected than women. This can be attributed to greater prominence of smoking and higher rates of poor oral hygiene in males. […] Finally, globally, there may also be geographic deviations in the prevalence of BHT due to differences in oral hygiene habits and dietary patterns, and variation in oral flora.

• #15 Black hairy tongue syndrome

  https://www.wjgnet.com/1007-9327/full/v20/i31/10845.htm

  Selected populations are at a higher risk of developing BHT. Patients with oncological disorders, smokers, black tea drinkers, and those with poor oral hygiene are more likely to develop BHT. BHT also shows clear gender and age predilection. Men are about three times more commonly affected than women. This can be attributed to greater prominence of smoking and higher rates of poor oral hygiene in males. This difference is offset in Finland, where smoking rates have been declining among men and young women are slightly more likely to be affected with BHT. In addition, BHT is positively correlated with increasing age with some studies showing a prevalence of nearly 40% in patients over the age of 60, though cases have been reported in patients as young as 2-mo-old. Although uncommon, in elderly patients, additional tongue conditions associated with BHT may include fissured tongue (12%) and macroglossia (4%). Advanced age, poor general condition as well as selected neurological disorders affecting tongue movement and mastication place a patient at a higher risk of developing BHT, largely due to the limited effective friction that results in desquamation of the keratinized layers of the filiform papillae. Finally, globally, there may also be geographic deviations in the prevalence of BHT due to differences in oral hygiene habits and dietary patterns, and variation in oral flora.

• #16 Black hairy tongue syndrome

  https://www.wjgnet.com/1007-9327/full/v20/i31/10845.htm

  Selected populations are at a higher risk of developing BHT. Patients with oncological disorders, smokers, black tea drinkers, and those with poor oral hygiene are more likely to develop BHT. BHT also shows clear gender and age predilection. Men are about three times more commonly affected than women. This can be attributed to greater prominence of smoking and higher rates of poor oral hygiene in males. This difference is offset in Finland, where smoking rates have been declining among men and young women are slightly more likely to be affected with BHT. In addition, BHT is positively correlated with increasing age with some studies showing a prevalence of nearly 40% in patients over the age of 60, though cases have been reported in patients as young as 2-mo-old. Although uncommon, in elderly patients, additional tongue conditions associated with BHT may include fissured tongue (12%) and macroglossia (4%). Advanced age, poor general condition as well as selected neurological disorders affecting tongue movement and mastication place a patient at a higher risk of developing BHT, largely due to the limited effective friction that results in desquamation of the keratinized layers of the filiform papillae. Finally, globally, there may also be geographic deviations in the prevalence of BHT due to differences in oral hygiene habits and dietary patterns, and variation in oral flora.

• #17 Black hairy tongue syndrome

  https://www.wjgnet.com/1007-9327/full/v20/i31/10845.htm

  Selected populations are at a higher risk of developing BHT. Patients with oncological disorders, smokers, black tea drinkers, and those with poor oral hygiene are more likely to develop BHT. BHT also shows clear gender and age predilection. Men are about three times more commonly affected than women. This can be attributed to greater prominence of smoking and higher rates of poor oral hygiene in males. This difference is offset in Finland, where smoking rates have been declining among men and young women are slightly more likely to be affected with BHT. In addition, BHT is positively correlated with increasing age with some studies showing a prevalence of nearly 40% in patients over the age of 60, though cases have been reported in patients as young as 2-mo-old. Although uncommon, in elderly patients, additional tongue conditions associated with BHT may include fissured tongue (12%) and macroglossia (4%). Advanced age, poor general condition as well as selected neurological disorders affecting tongue movement and mastication place a patient at a higher risk of developing BHT, largely due to the limited effective friction that results in desquamation of the keratinized layers of the filiform papillae. Finally, globally, there may also be geographic deviations in the prevalence of BHT due to differences in oral hygiene habits and dietary patterns, and variation in oral flora.

• #18 Hairy Tongue: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1075886-overview

  The prevalence of hairy tongue varies widely, from 8.3% in children and young adults to 57% in persons who are addicted to drugs and incarcerated. Hairy tongue has been reported with greater frequency in males, those who use tobacco, those who heavily drink coffee and tea, patients infected with HIV, and those who are HIV-negative and use intravenous drugs. […] The incidence and the prevalence of hairy tongue increases with age, possibly because a higher percentage of the older population engages in activities (eg, using tobacco or drinking coffee or tea) that predispose to the condition. […] Although hairy tongue is reported more often in males, it is not uncommon in females, especially those who drink coffee or tea or who use tobacco. […] No racial predilection is associated with hairy tongue.

• #19 Black hairy tongue syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4138463/

  Selected populations are at a higher risk of developing BHT. Patients with oncological disorders, smokers, black tea drinkers, and those with poor oral hygiene are more likely to develop BHT. BHT also shows clear gender and age predilection. Men are about three times more commonly affected than women. This can be attributed to greater prominence of smoking and higher rates of poor oral hygiene in males. […] Finally, globally, there may also be geographic deviations in the prevalence of BHT due to differences in oral hygiene habits and dietary patterns, and variation in oral flora.

• #20 Black hairy tongue syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4138463/

  Selected populations are at a higher risk of developing BHT. Patients with oncological disorders, smokers, black tea drinkers, and those with poor oral hygiene are more likely to develop BHT. BHT also shows clear gender and age predilection. Men are about three times more commonly affected than women. This can be attributed to greater prominence of smoking and higher rates of poor oral hygiene in males. […] Finally, globally, there may also be geographic deviations in the prevalence of BHT due to differences in oral hygiene habits and dietary patterns, and variation in oral flora.

• #21 Hairy Tongue: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1075886-overview

  The prevalence of hairy tongue varies widely, from 8.3% in children and young adults to 57% in persons who are addicted to drugs and incarcerated. Hairy tongue has been reported with greater frequency in males, those who use tobacco, those who heavily drink coffee and tea, patients infected with HIV, and those who are HIV-negative and use intravenous drugs. […] The incidence and the prevalence of hairy tongue increases with age, possibly because a higher percentage of the older population engages in activities (eg, using tobacco or drinking coffee or tea) that predispose to the condition. […] Although hairy tongue is reported more often in males, it is not uncommon in females, especially those who drink coffee or tea or who use tobacco. […] No racial predilection is associated with hairy tongue.

• #22 Black hairy tongue syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4138463/

  Selected populations are at a higher risk of developing BHT. Patients with oncological disorders, smokers, black tea drinkers, and those with poor oral hygiene are more likely to develop BHT. BHT also shows clear gender and age predilection. Men are about three times more commonly affected than women. This can be attributed to greater prominence of smoking and higher rates of poor oral hygiene in males. […] Finally, globally, there may also be geographic deviations in the prevalence of BHT due to differences in oral hygiene habits and dietary patterns, and variation in oral flora.

• #23 Black hairy tongue syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4138463/

  Selected populations are at a higher risk of developing BHT. Patients with oncological disorders, smokers, black tea drinkers, and those with poor oral hygiene are more likely to develop BHT. BHT also shows clear gender and age predilection. Men are about three times more commonly affected than women. This can be attributed to greater prominence of smoking and higher rates of poor oral hygiene in males. […] Finally, globally, there may also be geographic deviations in the prevalence of BHT due to differences in oral hygiene habits and dietary patterns, and variation in oral flora.

• #24 Hairy Tongue: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1075886-overview

  The prevalence of hairy tongue varies widely, from 8.3% in children and young adults to 57% in persons who are addicted to drugs and incarcerated. Hairy tongue has been reported with greater frequency in males, those who use tobacco, those who heavily drink coffee and tea, patients infected with HIV, and those who are HIV-negative and use intravenous drugs. […] The incidence and the prevalence of hairy tongue increases with age, possibly because a higher percentage of the older population engages in activities (eg, using tobacco or drinking coffee or tea) that predispose to the condition. […] Although hairy tongue is reported more often in males, it is not uncommon in females, especially those who drink coffee or tea or who use tobacco. […] No racial predilection is associated with hairy tongue.

• #25 Levofloxacin-induced black hairy tongue (BHT) in a 30-year-old female COVID-19 infected patient – International Journal of Case Reports and Images (IJCRI)

  https://www.ijcasereportsandimages.com/archive/article-full-text/101264Z01TM2021

  Black hairy tongue (BHT) is a condition in which the filiform papillae on the dorsal surface of the tongue are elongated and hypertrophied. […] Xerostomia, smoking, coffee, poor oral hygiene and use of medication are risk factors for acquiring BHT. […] Black hairy tongue is also associated with various conditions that cause immune compromise, such as malignancies, human immunodeficiency virus (HIV), graft versus host disease (GVHD) and recent radiation therapy to the head and neck region. […] A lot of medications have been reported to induce hairy discoloration of the tongue like antibiotics, proton pump inhibitors, antipsychotics, chemotherapeutics drugs, methyldopa, and interferon. […] The association between microbial infections and development of BHT has been debated for many years and it seems that bacterial proliferation is secondary to antibiotic use, as well as the elongation of the filiform papillae.

• #26 Hairy Tongue: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1075886-overview

  The prevalence of hairy tongue varies widely, from 8.3% in children and young adults to 57% in persons who are addicted to drugs and incarcerated. Hairy tongue has been reported with greater frequency in males, those who use tobacco, those who heavily drink coffee and tea, patients infected with HIV, and those who are HIV-negative and use intravenous drugs. […] The incidence and the prevalence of hairy tongue increases with age, possibly because a higher percentage of the older population engages in activities (eg, using tobacco or drinking coffee or tea) that predispose to the condition. […] Although hairy tongue is reported more often in males, it is not uncommon in females, especially those who drink coffee or tea or who use tobacco. […] No racial predilection is associated with hairy tongue.

• #27 Black Hairy Tongue: Causes and Treatments For a Black or Coated Tongue

  https://www.webmd.com/oral-health/black-hairy-tongue

  Black hairy tongue is more common in men, people who use intravenous drugs, and those who are HIV-positive. […] Certain lifestyle habits and conditions can make people more likely to develop black hairy tongue. They include: poor oral hygiene, smoking tobacco, drinking a lot of coffee or tea, using antibiotics (which may disrupt the normal balance of bacteria in the mouth), being dehydrated, taking medications that contain the chemical bismuth (such as Pepto-Bismol for upset stomach), not producing enough saliva, regularly using mouthwash that contains peroxide, witch hazel, or menthol, getting radiation therapy to the head and neck.

• #28 Black hairy tongue syndrome

  https://www.wjgnet.com/1007-9327/full/v20/i31/10845.htm

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] Review of the medical literature shows that BHT is not uncommon. A large cross-sectional study of 5150 Turkish dental outpatients has reported an overall prevalence of 11.3% with increased rates in men (18%) compared to women (6%). However, a cross-sectional study of 1901 Iranian dental patients only reported a prevalence of 1.2%. BHT occurred in 0.6% of Minnesota school-aged children in contrast to 8.4% patients in a young Finnish population. Discordance of the observed rates may stem from difference patients demographics (age, sex, ethnicity, practices and habits) and interobserver variability in defining lesions in corresponding study populations.

• #29 Black hairy tongue syndrome

  https://www.wjgnet.com/1007-9327/full/v20/i31/10845.htm

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] Review of the medical literature shows that BHT is not uncommon. A large cross-sectional study of 5150 Turkish dental outpatients has reported an overall prevalence of 11.3% with increased rates in men (18%) compared to women (6%). However, a cross-sectional study of 1901 Iranian dental patients only reported a prevalence of 1.2%. BHT occurred in 0.6% of Minnesota school-aged children in contrast to 8.4% patients in a young Finnish population. Discordance of the observed rates may stem from difference patients demographics (age, sex, ethnicity, practices and habits) and interobserver variability in defining lesions in corresponding study populations.

• #30 Black hairy tongue syndrome

  https://www.wjgnet.com/1007-9327/full/v20/i31/10845.htm

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] Review of the medical literature shows that BHT is not uncommon. A large cross-sectional study of 5150 Turkish dental outpatients has reported an overall prevalence of 11.3% with increased rates in men (18%) compared to women (6%). However, a cross-sectional study of 1901 Iranian dental patients only reported a prevalence of 1.2%. BHT occurred in 0.6% of Minnesota school-aged children in contrast to 8.4% patients in a young Finnish population. Discordance of the observed rates may stem from difference patients demographics (age, sex, ethnicity, practices and habits) and interobserver variability in defining lesions in corresponding study populations.

• #31 Hair tongue black – Altmeyers Encyclopedia – Department Dermatology

  https://www.altmeyers.org/en/dermatology/hair-tongue-black-119584

  The prevalence data vary between 0-50% depending on the collective and size. […] The black hair tongue can be observed after: prolonged systemic antibiotic administration, stem cell transplantation, long-term therapy with systemic glucocorticoids, keratoplastic, chemical stimuli (smoking, spicy mouthwashes, chlorhexidine, sodium perborate, H2O2), continuous parenteral nutrition.

• #32 Black Hairy Tongue: Causes and Treatments For a Black or Coated Tongue

  https://www.webmd.com/oral-health/black-hairy-tongue

  Black hairy tongue is more common in men, people who use intravenous drugs, and those who are HIV-positive. […] Certain lifestyle habits and conditions can make people more likely to develop black hairy tongue. They include: poor oral hygiene, smoking tobacco, drinking a lot of coffee or tea, using antibiotics (which may disrupt the normal balance of bacteria in the mouth), being dehydrated, taking medications that contain the chemical bismuth (such as Pepto-Bismol for upset stomach), not producing enough saliva, regularly using mouthwash that contains peroxide, witch hazel, or menthol, getting radiation therapy to the head and neck.

• #33 Black hairy tongue associated with squamous cell carcinoma of the esophagus

  http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-99572021000500112

  Black hairy tongue (BHT) is a benign disorder characterized by dark coloration and hypertrophy with hyperkeratosis in filiform papillae on the surface of the tongue. Several intrinsic and extrinsic factors, including poor dental hygiene, smoking, drinking dark beverages, indiscriminate use of antibiotics, and some malignant diseases, have been proposed as potential causes. […] An association between BHT and systemic diseases such as HIV and malignancies has been described. […] Its prevalence is variable, although a prevalence as high as 11.3% has been described in some oral health studies, being more common in elderly men, heavy smokers, and black tea and coffee consumers, HIV positive people, edentulous individuals, people with prostate cancer or B-cell lymphoma, and in patients undergoing antibiotic treatment. […] No cases of BHT and esophageal cancer association were found in the literature review conducted by us, so this is an association that should be taken into account.

• #34 Black hairy tongue in a patient with chronic alcoholism (lingua villosa nigra)

  https://www.clinmedkaz.org/article/black-hairy-tongue-in-a-patient-with-chronic-alcoholism-lingua-villosa-nigra-8801

  Black Hairy Tongue (BHT) is a hereditary benign condition which is characterized by the appaerance of abnormally hypertrophied and elongated pilliform papilla on dorsal surface of tongue. Known predisposing factors include smoking, consumption of excessive coffee / black tea, bad oral hygiene, trigeminal neuralgia, poverty, xesrostomia, drugs and alcohol. Hairy tongue is especially seen in those who smoke intensively in high prevalance; however our case is associated with excessive alcohol consumption. […] As means of treatment, we made suggestions such as alcohol abstinence, mouthwash with antiseptic solution, frequent hygienic care, tooth brushing as his treatment.

• #35 Hairy Tongue: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1075886-overview

  The prevalence of hairy tongue varies widely, from 8.3% in children and young adults to 57% in persons who are addicted to drugs and incarcerated. Hairy tongue has been reported with greater frequency in males, those who use tobacco, those who heavily drink coffee and tea, patients infected with HIV, and those who are HIV-negative and use intravenous drugs. […] The incidence and the prevalence of hairy tongue increases with age, possibly because a higher percentage of the older population engages in activities (eg, using tobacco or drinking coffee or tea) that predispose to the condition. […] Although hairy tongue is reported more often in males, it is not uncommon in females, especially those who drink coffee or tea or who use tobacco. […] No racial predilection is associated with hairy tongue.

• #36 Hairy tongue

  https://dermnetnz.org/topics/hairy-tongue

  Hairy tongue most often occurs in adults over 40 years of age and is rare in infants. […] A range of medications have been linked to hairy tongue including penicillin, erythromycin, tetracycline, doxycycline, lansoprazole, olanzapine, bismuth, erlotinib, linezolid. […] Other factors that may cause, and/or aggravate hairy tongue include poor oral hygiene, smoking or chewing tobacco, drinking alcohol, cocaine, chlorhexidine or peroxidase-containing mouthwash, coloured beverages, including coffee, dehydration, hyposalivation (dry mouth), radiation therapy. […] Hairy tongue is due to defective shedding of surface cells. Abnormal filiform papillae prevent normal cleaning and debridement of the tongue, hence debris accumulates. Bacteria and yeasts then overgrow and make porphyrins (deeply coloured organic compounds), which may contribute to the discolouration. […] Hairy tongue is a clinical diagnosis. […] It is important to take a detailed history to establish possible contributing factors.

• #37 Hairy tongue

  https://dermnetnz.org/topics/hairy-tongue

  Hairy tongue most often occurs in adults over 40 years of age and is rare in infants. […] A range of medications have been linked to hairy tongue including penicillin, erythromycin, tetracycline, doxycycline, lansoprazole, olanzapine, bismuth, erlotinib, linezolid. […] Other factors that may cause, and/or aggravate hairy tongue include poor oral hygiene, smoking or chewing tobacco, drinking alcohol, cocaine, chlorhexidine or peroxidase-containing mouthwash, coloured beverages, including coffee, dehydration, hyposalivation (dry mouth), radiation therapy. […] Hairy tongue is due to defective shedding of surface cells. Abnormal filiform papillae prevent normal cleaning and debridement of the tongue, hence debris accumulates. Bacteria and yeasts then overgrow and make porphyrins (deeply coloured organic compounds), which may contribute to the discolouration. […] Hairy tongue is a clinical diagnosis. […] It is important to take a detailed history to establish possible contributing factors.

• #38

  https://journals.lww.com/md-journal/fulltext/2023/10270/black_hairy_tongue_treated_with_traditional.139.aspx

  A study reported that antibiotics such as cephalosporin, tetracycline, clarithromycin, penicillin, erythromycin, doxycycline, linezolid, and neomycin cause BHT. Our patient was prescribed 3 different cephalosporins for infection treatment, which may have caused her BHT. […] The 4 diagnostic methods of TCM can enable practitioners to perform a comprehensive assessment of a patient’s health status. In TCM, oral hygiene and imbalanced body constitution are considered to be associated with BHT. CHM treatment can effectively resolve BHT and its associated symptoms with few adverse events. […] Although most patients with BHT are asymptomatic, studies have reported that BHT is associated with gastrointestinal symptoms such as gagging, nausea, tickling sensation, dry mouth, dysgeusia, and halitosis. A case series of 179 patients with BHT reported that 57.5% of the patients had digestive disorders. The correlation between BHT and digestive disorders is consistent with TCM theory that the coating of the tongue is produced by stomach Qi. In our case study, we noted that our patient experienced digestive disorders such as constipation, bloating, dry mouth, and diarrhea after being hospitalized; these disorders may have been induced by the administered antibiotics, which caused spleen Qi deficiency.

• #39 Levofloxacin-induced black hairy tongue (BHT) in a 30-year-old female COVID-19 infected patient – International Journal of Case Reports and Images (IJCRI)

  https://www.ijcasereportsandimages.com/archive/article-full-text/101264Z01TM2021

  Black hairy tongue (BHT) is a condition in which the filiform papillae on the dorsal surface of the tongue are elongated and hypertrophied. […] Xerostomia, smoking, coffee, poor oral hygiene and use of medication are risk factors for acquiring BHT. […] Black hairy tongue is also associated with various conditions that cause immune compromise, such as malignancies, human immunodeficiency virus (HIV), graft versus host disease (GVHD) and recent radiation therapy to the head and neck region. […] A lot of medications have been reported to induce hairy discoloration of the tongue like antibiotics, proton pump inhibitors, antipsychotics, chemotherapeutics drugs, methyldopa, and interferon. […] The association between microbial infections and development of BHT has been debated for many years and it seems that bacterial proliferation is secondary to antibiotic use, as well as the elongation of the filiform papillae.

• #40 Hairy tongue

  https://dermnetnz.org/topics/hairy-tongue

  Hairy tongue most often occurs in adults over 40 years of age and is rare in infants. […] A range of medications have been linked to hairy tongue including penicillin, erythromycin, tetracycline, doxycycline, lansoprazole, olanzapine, bismuth, erlotinib, linezolid. […] Other factors that may cause, and/or aggravate hairy tongue include poor oral hygiene, smoking or chewing tobacco, drinking alcohol, cocaine, chlorhexidine or peroxidase-containing mouthwash, coloured beverages, including coffee, dehydration, hyposalivation (dry mouth), radiation therapy. […] Hairy tongue is due to defective shedding of surface cells. Abnormal filiform papillae prevent normal cleaning and debridement of the tongue, hence debris accumulates. Bacteria and yeasts then overgrow and make porphyrins (deeply coloured organic compounds), which may contribute to the discolouration. […] Hairy tongue is a clinical diagnosis. […] It is important to take a detailed history to establish possible contributing factors.

• #41 Pantoprazole Induced Black Hairy Tongue: A Case Report

  https://www.ijmrhs.com/medical-research/pantoprazole-induced-black-hairy-tongue-a-case-report-100944.html

  Black Hairy Tongue (BHT) is found in approximately 0.4% of the South Asian population. […] Drug induced BHT have been frequently associated with the use of psychotropic drugs, anticancer drugs and antibiotics. Pantoprazole is a widely used Proton Pump Inhibitor (PPI) for the treatment of gastroesophageal reflux disease and prophylaxis for drug-induced gastritis. […] In 2009, 6 cases and 87 cases of PPI-induced BHT were reported in the database of the Netherlands Pharmacovigilance Centre Lab and WHO database respectively. […] Hence, these reports show that BHT due to Pantoprazole is less frequently encountered as compared to other PPIs. […] Among the PPI induced BHT cases in the 2009 WHO database, 24 cases were associated with concomitant therapy with antibiotics. […] BHT can be successfully managed by stopping the offending agent, mechanical debridement like tongue scraping, maintaining good oral hygiene and adequate hydration. […] Pantoprazole induced BHT is a benign condition and can be successfully managed by stopping the medication, good oral hygiene and hydration.

• #42 Hairy tongue

  https://dermnetnz.org/topics/hairy-tongue

  Hairy tongue most often occurs in adults over 40 years of age and is rare in infants. […] A range of medications have been linked to hairy tongue including penicillin, erythromycin, tetracycline, doxycycline, lansoprazole, olanzapine, bismuth, erlotinib, linezolid. […] Other factors that may cause, and/or aggravate hairy tongue include poor oral hygiene, smoking or chewing tobacco, drinking alcohol, cocaine, chlorhexidine or peroxidase-containing mouthwash, coloured beverages, including coffee, dehydration, hyposalivation (dry mouth), radiation therapy. […] Hairy tongue is due to defective shedding of surface cells. Abnormal filiform papillae prevent normal cleaning and debridement of the tongue, hence debris accumulates. Bacteria and yeasts then overgrow and make porphyrins (deeply coloured organic compounds), which may contribute to the discolouration. […] Hairy tongue is a clinical diagnosis. […] It is important to take a detailed history to establish possible contributing factors.

• #43 Black Hairy Tongue: A Rare Adverse Effect of Olanzapine

  https://www.psychiatrist.com/pcc/black-hairy-tongue-rare-adverse-effect-olanzapine/

  Prevalence ranges from 0.6% to 11.3% and is 3 times more common in men than in women, with elderly males being more prone to development. […] The exact mechanism behind olanzapine induced black hairy tongue is unknown. It has been suggested that the anticholinergic properties of olanzapine may play a role in its development.

• #44 Hairy tongue

  https://dermnetnz.org/topics/hairy-tongue

  Hairy tongue most often occurs in adults over 40 years of age and is rare in infants. […] A range of medications have been linked to hairy tongue including penicillin, erythromycin, tetracycline, doxycycline, lansoprazole, olanzapine, bismuth, erlotinib, linezolid. […] Other factors that may cause, and/or aggravate hairy tongue include poor oral hygiene, smoking or chewing tobacco, drinking alcohol, cocaine, chlorhexidine or peroxidase-containing mouthwash, coloured beverages, including coffee, dehydration, hyposalivation (dry mouth), radiation therapy. […] Hairy tongue is due to defective shedding of surface cells. Abnormal filiform papillae prevent normal cleaning and debridement of the tongue, hence debris accumulates. Bacteria and yeasts then overgrow and make porphyrins (deeply coloured organic compounds), which may contribute to the discolouration. […] Hairy tongue is a clinical diagnosis. […] It is important to take a detailed history to establish possible contributing factors.

• #45 Levofloxacin-induced black hairy tongue (BHT) in a 30-year-old female COVID-19 infected patient – International Journal of Case Reports and Images (IJCRI)

  https://www.ijcasereportsandimages.com/archive/article-full-text/101264Z01TM2021

  Black hairy tongue (BHT) is a condition in which the filiform papillae on the dorsal surface of the tongue are elongated and hypertrophied. […] Xerostomia, smoking, coffee, poor oral hygiene and use of medication are risk factors for acquiring BHT. […] Black hairy tongue is also associated with various conditions that cause immune compromise, such as malignancies, human immunodeficiency virus (HIV), graft versus host disease (GVHD) and recent radiation therapy to the head and neck region. […] A lot of medications have been reported to induce hairy discoloration of the tongue like antibiotics, proton pump inhibitors, antipsychotics, chemotherapeutics drugs, methyldopa, and interferon. […] The association between microbial infections and development of BHT has been debated for many years and it seems that bacterial proliferation is secondary to antibiotic use, as well as the elongation of the filiform papillae.

• #46 Pantoprazole Induced Black Hairy Tongue: A Case Report

  https://www.ijmrhs.com/medical-research/pantoprazole-induced-black-hairy-tongue-a-case-report-100944.html

  Black Hairy Tongue (BHT) is found in approximately 0.4% of the South Asian population. […] Drug induced BHT have been frequently associated with the use of psychotropic drugs, anticancer drugs and antibiotics. Pantoprazole is a widely used Proton Pump Inhibitor (PPI) for the treatment of gastroesophageal reflux disease and prophylaxis for drug-induced gastritis. […] In 2009, 6 cases and 87 cases of PPI-induced BHT were reported in the database of the Netherlands Pharmacovigilance Centre Lab and WHO database respectively. […] Hence, these reports show that BHT due to Pantoprazole is less frequently encountered as compared to other PPIs. […] Among the PPI induced BHT cases in the 2009 WHO database, 24 cases were associated with concomitant therapy with antibiotics. […] BHT can be successfully managed by stopping the offending agent, mechanical debridement like tongue scraping, maintaining good oral hygiene and adequate hydration. […] Pantoprazole induced BHT is a benign condition and can be successfully managed by stopping the medication, good oral hygiene and hydration.

• #47 Black hairy tongue syndrome

  https://www.wjgnet.com/1007-9327/full/v20/i31/10845.htm

  Selected populations are at a higher risk of developing BHT. Patients with oncological disorders, smokers, black tea drinkers, and those with poor oral hygiene are more likely to develop BHT. BHT also shows clear gender and age predilection. Men are about three times more commonly affected than women. This can be attributed to greater prominence of smoking and higher rates of poor oral hygiene in males. This difference is offset in Finland, where smoking rates have been declining among men and young women are slightly more likely to be affected with BHT. In addition, BHT is positively correlated with increasing age with some studies showing a prevalence of nearly 40% in patients over the age of 60, though cases have been reported in patients as young as 2-mo-old. Although uncommon, in elderly patients, additional tongue conditions associated with BHT may include fissured tongue (12%) and macroglossia (4%). Advanced age, poor general condition as well as selected neurological disorders affecting tongue movement and mastication place a patient at a higher risk of developing BHT, largely due to the limited effective friction that results in desquamation of the keratinized layers of the filiform papillae. Finally, globally, there may also be geographic deviations in the prevalence of BHT due to differences in oral hygiene habits and dietary patterns, and variation in oral flora.

• #48 Black hairy tongue syndrome

  https://www.wjgnet.com/1007-9327/full/v20/i31/10845.htm

  Selected populations are at a higher risk of developing BHT. Patients with oncological disorders, smokers, black tea drinkers, and those with poor oral hygiene are more likely to develop BHT. BHT also shows clear gender and age predilection. Men are about three times more commonly affected than women. This can be attributed to greater prominence of smoking and higher rates of poor oral hygiene in males. This difference is offset in Finland, where smoking rates have been declining among men and young women are slightly more likely to be affected with BHT. In addition, BHT is positively correlated with increasing age with some studies showing a prevalence of nearly 40% in patients over the age of 60, though cases have been reported in patients as young as 2-mo-old. Although uncommon, in elderly patients, additional tongue conditions associated with BHT may include fissured tongue (12%) and macroglossia (4%). Advanced age, poor general condition as well as selected neurological disorders affecting tongue movement and mastication place a patient at a higher risk of developing BHT, largely due to the limited effective friction that results in desquamation of the keratinized layers of the filiform papillae. Finally, globally, there may also be geographic deviations in the prevalence of BHT due to differences in oral hygiene habits and dietary patterns, and variation in oral flora.

• #49

  https://journals.lww.com/md-journal/fulltext/2023/10270/black_hairy_tongue_treated_with_traditional.139.aspx

  A study reported that antibiotics such as cephalosporin, tetracycline, clarithromycin, penicillin, erythromycin, doxycycline, linezolid, and neomycin cause BHT. Our patient was prescribed 3 different cephalosporins for infection treatment, which may have caused her BHT. […] The 4 diagnostic methods of TCM can enable practitioners to perform a comprehensive assessment of a patient’s health status. In TCM, oral hygiene and imbalanced body constitution are considered to be associated with BHT. CHM treatment can effectively resolve BHT and its associated symptoms with few adverse events. […] Although most patients with BHT are asymptomatic, studies have reported that BHT is associated with gastrointestinal symptoms such as gagging, nausea, tickling sensation, dry mouth, dysgeusia, and halitosis. A case series of 179 patients with BHT reported that 57.5% of the patients had digestive disorders. The correlation between BHT and digestive disorders is consistent with TCM theory that the coating of the tongue is produced by stomach Qi. In our case study, we noted that our patient experienced digestive disorders such as constipation, bloating, dry mouth, and diarrhea after being hospitalized; these disorders may have been induced by the administered antibiotics, which caused spleen Qi deficiency.

• #50 Black hairy tongue associated with squamous cell carcinoma of the esophagus | DocMode Health Technologies Limited

  https://docmode.org/black-hairy-tongue-associated-with-squamous-cell-carcinoma-of-the-esophagus/

  Black hairy tongue is a relatively uncommon condition characterized by a black or brown discoloration of the tongues dorsum, accompanied by a hairy or furry appearance due to elongation of the papillae. […] Several case reports and case-control studies have suggested an association between black hairy tongue and SCC of the esophagus. In a case-control study conducted in the United States, researchers found that patients with black hairy tongue were more likely to develop SCC of the esophagus than those without black hairy tongue. […] The odds ratio for SCC of the esophagus in patients with black hairy tongue was 7.4, indicating a significant association between the two conditions. Another case-control study conducted in Iran also found a significant association between black hairy tongue and SCC of the esophagus.

• #51 Black hairy tongue associated with squamous cell carcinoma of the esophagus

  http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-99572021000500112

  Black hairy tongue (BHT) is a benign disorder characterized by dark coloration and hypertrophy with hyperkeratosis in filiform papillae on the surface of the tongue. Several intrinsic and extrinsic factors, including poor dental hygiene, smoking, drinking dark beverages, indiscriminate use of antibiotics, and some malignant diseases, have been proposed as potential causes. […] An association between BHT and systemic diseases such as HIV and malignancies has been described. […] Its prevalence is variable, although a prevalence as high as 11.3% has been described in some oral health studies, being more common in elderly men, heavy smokers, and black tea and coffee consumers, HIV positive people, edentulous individuals, people with prostate cancer or B-cell lymphoma, and in patients undergoing antibiotic treatment. […] No cases of BHT and esophageal cancer association were found in the literature review conducted by us, so this is an association that should be taken into account.

• #52 Levofloxacin-induced black hairy tongue (BHT) in a 30-year-old female COVID-19 infected patient – International Journal of Case Reports and Images (IJCRI)

  https://www.ijcasereportsandimages.com/archive/article-full-text/101264Z01TM2021

  Black hairy tongue (BHT) is a condition in which the filiform papillae on the dorsal surface of the tongue are elongated and hypertrophied. […] Xerostomia, smoking, coffee, poor oral hygiene and use of medication are risk factors for acquiring BHT. […] Black hairy tongue is also associated with various conditions that cause immune compromise, such as malignancies, human immunodeficiency virus (HIV), graft versus host disease (GVHD) and recent radiation therapy to the head and neck region. […] A lot of medications have been reported to induce hairy discoloration of the tongue like antibiotics, proton pump inhibitors, antipsychotics, chemotherapeutics drugs, methyldopa, and interferon. […] The association between microbial infections and development of BHT has been debated for many years and it seems that bacterial proliferation is secondary to antibiotic use, as well as the elongation of the filiform papillae.

• #53 Black Hairy Tongue and Other Causes of Black Tongue

  https://www.verywellhealth.com/black-tongue-5190133

  Black hairy tongue syndrome (BHT) is a benign condition in which the small bumps on the surface of the tongue, called papillae, become elongated and take on a black or brownish color. The elongated papillae give BHT its characteristically hairy appearance. […] There are many risk factors associated with BHT. These include lifestyle, medications, and medical conditions that predispose individuals to this otherwise benign (non-cancerous) condition. […] For reasons that are not entirely clear, males are affected by BHT three times more often than females. While BHT can affect any age group, older adults are more commonly affected. […] Although BHT is considered harmless, it can lead to certain complications if left untreated. One study suggested that BHT is linked to an increased risk of oral, throat, and lung cancer not so much because it „causes” cancer but because BHT is linked to heavy smoking (which is a risk factor for cancer). […] Similarly, because BHT is strongly linked to poor oral hygiene, a person may be at far greater risk of periodontal disease if oral hygiene practices don’t improve.

• #54 Black Hairy Tongue: Causes and Treatments For a Black or Coated Tongue

  https://www.webmd.com/oral-health/black-hairy-tongue

  Black hairy tongue is more common in men, people who use intravenous drugs, and those who are HIV-positive. […] Certain lifestyle habits and conditions can make people more likely to develop black hairy tongue. They include: poor oral hygiene, smoking tobacco, drinking a lot of coffee or tea, using antibiotics (which may disrupt the normal balance of bacteria in the mouth), being dehydrated, taking medications that contain the chemical bismuth (such as Pepto-Bismol for upset stomach), not producing enough saliva, regularly using mouthwash that contains peroxide, witch hazel, or menthol, getting radiation therapy to the head and neck.

• #55 Black tongue: Causes, treatments, and home remedies

  https://www.medicalnewstoday.com/articles/327163

  There are two main types of black tongue: black hairy tongue and pseudo-black hairy tongue. Each has a different cause, which the following sections will cover in more detail. […] The following factors increase the risk of keratin building up on the tongue: poor oral hygiene, which may result from not regularly brushing or scraping the tongue; drinking coffee or black tea; smoking and other forms of tobacco use; recent or prolonged use of antibiotics; having a weak immune system due to a medical condition, such as diabetes or HIV; a condition called trigeminal neuralgia, which affects the facial nerves; radiation therapy. […] Black tongue can be alarming, but it is not a medical emergency. […] A person should see a doctor or dentist if their symptoms persist or worsen, or if they are accompanied by pain and swelling. The doctor or dentist will work to diagnose the cause of black tongue and will provide appropriate medical treatments.

• #56 Hairy tongue

  https://dermnetnz.org/topics/hairy-tongue

  Hairy tongue most often occurs in adults over 40 years of age and is rare in infants. […] A range of medications have been linked to hairy tongue including penicillin, erythromycin, tetracycline, doxycycline, lansoprazole, olanzapine, bismuth, erlotinib, linezolid. […] Other factors that may cause, and/or aggravate hairy tongue include poor oral hygiene, smoking or chewing tobacco, drinking alcohol, cocaine, chlorhexidine or peroxidase-containing mouthwash, coloured beverages, including coffee, dehydration, hyposalivation (dry mouth), radiation therapy. […] Hairy tongue is due to defective shedding of surface cells. Abnormal filiform papillae prevent normal cleaning and debridement of the tongue, hence debris accumulates. Bacteria and yeasts then overgrow and make porphyrins (deeply coloured organic compounds), which may contribute to the discolouration. […] Hairy tongue is a clinical diagnosis. […] It is important to take a detailed history to establish possible contributing factors.

• #57 Hairy tongue

  https://dermnetnz.org/topics/hairy-tongue

  Hairy tongue most often occurs in adults over 40 years of age and is rare in infants. […] A range of medications have been linked to hairy tongue including penicillin, erythromycin, tetracycline, doxycycline, lansoprazole, olanzapine, bismuth, erlotinib, linezolid. […] Other factors that may cause, and/or aggravate hairy tongue include poor oral hygiene, smoking or chewing tobacco, drinking alcohol, cocaine, chlorhexidine or peroxidase-containing mouthwash, coloured beverages, including coffee, dehydration, hyposalivation (dry mouth), radiation therapy. […] Hairy tongue is due to defective shedding of surface cells. Abnormal filiform papillae prevent normal cleaning and debridement of the tongue, hence debris accumulates. Bacteria and yeasts then overgrow and make porphyrins (deeply coloured organic compounds), which may contribute to the discolouration. […] Hairy tongue is a clinical diagnosis. […] It is important to take a detailed history to establish possible contributing factors.

• #58 Black tongue: What is it, and how is it treated? | Perio Implant Advisory

  https://www.perioimplantadvisory.com/clinical-tips/article/14294685/black-tongue-what-is-it-and-how-is-it-treated

  Studies have shown that black hairy tongue can occur in 1%11% of the population. It occurs in males at three times the rate of females due to higher smoking rates and poor oral hygiene in males. The rate of this condition also increases in those older than 60.5 […] Black hairy tongue should be differentiated from fake black tongue (pseudoblack hairy tongue), which can occur when the tongue becomes stained from coffee/tea, food coloring, or medications that contain bismuth subsalicylate (Pepto-Bismol).

• #59 Black tongue: Causes, treatments, and home remedies

  https://www.medicalnewstoday.com/articles/327163

  There are two main types of black tongue: black hairy tongue and pseudo-black hairy tongue. Each has a different cause, which the following sections will cover in more detail. […] The following factors increase the risk of keratin building up on the tongue: poor oral hygiene, which may result from not regularly brushing or scraping the tongue; drinking coffee or black tea; smoking and other forms of tobacco use; recent or prolonged use of antibiotics; having a weak immune system due to a medical condition, such as diabetes or HIV; a condition called trigeminal neuralgia, which affects the facial nerves; radiation therapy. […] Black tongue can be alarming, but it is not a medical emergency. […] A person should see a doctor or dentist if their symptoms persist or worsen, or if they are accompanied by pain and swelling. The doctor or dentist will work to diagnose the cause of black tongue and will provide appropriate medical treatments.

• #60 Black Hairy Tongue: Causes, What It Is & Treatment

  https://my.clevelandclinic.org/health/diseases/17918-black-hairy-tongue

  Black hairy tongue affects about 13 % of people at some point in their lives, according to the American Academy of Oral Medicine. It happens in all population groups, but is more common in men and in people over the age of 65. […] The two most common causes of black hairy tongue include poor oral hygiene and a diet of soft foods. This is because the shedding process requires stimulation and abrasion to the top of your tongue. Common black hairy tongue causes include: […] Black hairy tongue treatment usually involves improving your oral hygiene at home. If that doesnt help, then your healthcare provider may prescribe medications or in severe cases, recommend surgery. […] Once you figure out what caused black hairy tongue, you can take steps to treat it and reduce the risk of it happening again. Often, this just involves making minor lifestyle changes, such as cleaning your tongue daily.

• #61 Levofloxacin-induced black hairy tongue (BHT) in a 30-year-old female COVID-19 infected patient – International Journal of Case Reports and Images (IJCRI)

  https://www.ijcasereportsandimages.com/archive/article-full-text/101264Z01TM2021

  Black hairy tongue is a self-limiting, usually asymptomatic condition which resolves after withdrawing the considered causative agent and performing oral hygiene. […] Multiple factors can contribute to this condition, but the pathophysiology is not yet fully understood. […] Clinicians should be aware about this benign condition which requires only visual inspection and often follows antibiotic administration, of equal importance is patient education about this condition, as it is an unusual one, and it may be erroneously attributed to a malignancy.

• #62 Black Hairy Tongue | Verified Learning

  https://www.verifiedlearning.com/black-hairy-tongue

  BHT is more common in older adults, smokers, and individuals with poor oral hygiene. […] This section focuses on educating patients about the condition, its benign nature, and the importance of regular oral hygiene practices to prevent recurrence.

• #63 Hairy Tongue

  https://www.aaom.com/hairy-tongue

  Hairy tongue is a relatively common, temporary, and harmless condition that occurs in as much as 13% of the population. […] It is found more commonly in males than females and equally among races. […] Certain types of bacteria and yeast can even give the tongue a black appearance, referred to as black hairy tongue. […] Patients who have had hairy tongue are at greater risk for recurrence.

• #64 Black hairy tongue: What to know about disease

  https://www.denver7.com/lifestyle/black-hairy-tongue-disease

  Black hairy tongue has been linked with certain medications, conditions and poor oral health. […] Black hairy tongue is an uncommon and harmless side effect of some drugs, but it can also be linked to smoking, poor oral hygiene and certain medical conditions. […] It’s unclear exactly how uncommon this is, Hamad said, but it’s the first case he’s seen in 10 years of practicing.

• #65 Black Hairy Tongue: This Missouri woman’s tongue turned black and hairy, study says – The Washington Post

  https://www.washingtonpost.com/health/2018/09/06/black-hairy-tongue-is-an-actual-medical-condition-it-looks-weird-it-sounds/

  Do not panic, but there is a medical condition in which a person’s tongue can take on a dark, woolly appearance — and it is appropriately called “black hairy tongue.” […] Yasir Hamad, lead author of the study and an assistant professor in the Department of Internal Medicine at the Washington University School of Medicine in St. Louis, said the condition is relatively rare. It affects anywhere from .06 percent to 13 percent of the population, according to official estimates, and varies by region. […] Hamad said the case in St. Louis was the “classic, textbook case of black hairy tongue.” […] The Mayo Clinic says the condition is sometimes caused by antibiotics — which can alter the bacteria and yeast in the mouth — tobacco, certain diets and excessive quantities of coffee, tea and alcohol as well as poor oral hygiene. […] Hamad advised physicians to be aware of it and to be sure to pay attention to patients’ mouths during examinations “so that they can recognize it.”

• #66 Black hairy tongue syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/25152586/

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] BHT remains an important medical condition which may result in additional burden on the patient and health care system and requires appropriate prevention, recognition and treatment.

• #67 Black hairy tongue syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4138463/

  Selected populations are at a higher risk of developing BHT. Patients with oncological disorders, smokers, black tea drinkers, and those with poor oral hygiene are more likely to develop BHT. BHT also shows clear gender and age predilection. Men are about three times more commonly affected than women. This can be attributed to greater prominence of smoking and higher rates of poor oral hygiene in males. […] Finally, globally, there may also be geographic deviations in the prevalence of BHT due to differences in oral hygiene habits and dietary patterns, and variation in oral flora.

• #68 Black hairy tongue syndrome

  https://www.wjgnet.com/1007-9327/full/v20/i31/10845.htm

  Selected populations are at a higher risk of developing BHT. Patients with oncological disorders, smokers, black tea drinkers, and those with poor oral hygiene are more likely to develop BHT. BHT also shows clear gender and age predilection. Men are about three times more commonly affected than women. This can be attributed to greater prominence of smoking and higher rates of poor oral hygiene in males. This difference is offset in Finland, where smoking rates have been declining among men and young women are slightly more likely to be affected with BHT. In addition, BHT is positively correlated with increasing age with some studies showing a prevalence of nearly 40% in patients over the age of 60, though cases have been reported in patients as young as 2-mo-old. Although uncommon, in elderly patients, additional tongue conditions associated with BHT may include fissured tongue (12%) and macroglossia (4%). Advanced age, poor general condition as well as selected neurological disorders affecting tongue movement and mastication place a patient at a higher risk of developing BHT, largely due to the limited effective friction that results in desquamation of the keratinized layers of the filiform papillae. Finally, globally, there may also be geographic deviations in the prevalence of BHT due to differences in oral hygiene habits and dietary patterns, and variation in oral flora.

• #69

  https://www.ijbcp.com/index.php/ijbcp/article/view/5392

  Black hairy tongue (BHT) is characterized by abnormally hypertrophied and elongated filiform papillae, appearing as blackish discoloration on the dorsal surface of the tongue. […] BHT has been reported as an adverse drug reaction to different categories of drugs. […] Suspecting BHT as an adverse drug reaction to pantoprazole, it was stopped, while clarithromycin was continued for the full course. […] WHO-UMC causality assessment scale showed a probable association of the adverse drug reaction with pantoprazole. […] Physicians should be aware of the possibility of BHT with the use of pantoprazole and that it completely resolves on stoppage of the drug, mechanical debridement and good oral hygiene.

• #70

  https://www.ijbcp.com/index.php/ijbcp/article/view/5392

  Black hairy tongue (BHT) is characterized by abnormally hypertrophied and elongated filiform papillae, appearing as blackish discoloration on the dorsal surface of the tongue. […] BHT has been reported as an adverse drug reaction to different categories of drugs. […] Suspecting BHT as an adverse drug reaction to pantoprazole, it was stopped, while clarithromycin was continued for the full course. […] WHO-UMC causality assessment scale showed a probable association of the adverse drug reaction with pantoprazole. […] Physicians should be aware of the possibility of BHT with the use of pantoprazole and that it completely resolves on stoppage of the drug, mechanical debridement and good oral hygiene.

• #71

  https://www.ijbcp.com/index.php/ijbcp/article/view/5392

  Black hairy tongue (BHT) is characterized by abnormally hypertrophied and elongated filiform papillae, appearing as blackish discoloration on the dorsal surface of the tongue. […] BHT has been reported as an adverse drug reaction to different categories of drugs. […] Suspecting BHT as an adverse drug reaction to pantoprazole, it was stopped, while clarithromycin was continued for the full course. […] WHO-UMC causality assessment scale showed a probable association of the adverse drug reaction with pantoprazole. […] Physicians should be aware of the possibility of BHT with the use of pantoprazole and that it completely resolves on stoppage of the drug, mechanical debridement and good oral hygiene.

• #72 Black hairy tongue syndrome

  https://www.wjgnet.com/1007-9327/full/v20/i31/10845.htm

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] Review of the medical literature shows that BHT is not uncommon. A large cross-sectional study of 5150 Turkish dental outpatients has reported an overall prevalence of 11.3% with increased rates in men (18%) compared to women (6%). However, a cross-sectional study of 1901 Iranian dental patients only reported a prevalence of 1.2%. BHT occurred in 0.6% of Minnesota school-aged children in contrast to 8.4% patients in a young Finnish population. Discordance of the observed rates may stem from difference patients demographics (age, sex, ethnicity, practices and habits) and interobserver variability in defining lesions in corresponding study populations.

• #73 Black hairy tongue syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4138463/

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] Review of the medical literature shows that BHT is not uncommon. A large cross-sectional study of 5150 Turkish dental outpatients has reported an overall prevalence of 11.3% with increased rates in men (18%) compared to women (6%). However, a cross-sectional study of 1901 Iranian dental patients only reported a prevalence of 1.2%. BHT occurred in 0.6% of Minnesota school-aged children in contrast to 8.4% patients in a young Finnish population. Discordance of the observed rates may stem from difference patients demographics (age, sex, ethnicity, practices and habits) and interobserver variability in defining lesions in corresponding study populations.

• #74 Black hairy tongue syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/25152586/

  Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. […] BHT remains an important medical condition which may result in additional burden on the patient and health care system and requires appropriate prevention, recognition and treatment.

• #75 Levofloxacin-induced black hairy tongue (BHT) in a 30-year-old female COVID-19 infected patient – International Journal of Case Reports and Images (IJCRI)

  https://www.ijcasereportsandimages.com/archive/article-full-text/101264Z01TM2021

  Black hairy tongue is a self-limiting, usually asymptomatic condition which resolves after withdrawing the considered causative agent and performing oral hygiene. […] Multiple factors can contribute to this condition, but the pathophysiology is not yet fully understood. […] Clinicians should be aware about this benign condition which requires only visual inspection and often follows antibiotic administration, of equal importance is patient education about this condition, as it is an unusual one, and it may be erroneously attributed to a malignancy.

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