Dr. Hoang Quoc Tuan, from the Dermatology Department of the Dermatology - Allergy Center at the 108 Military Central Hospital, says he sees many patients daily with tongue-related issues. Among them, a significant number express worry about their unusually black tongues. Two recent cases involved young men who sought consultation because their tongues had turned black over the past one to two weeks. Anxious, they requested full cancer screenings.
Clinical examinations revealed that the black discoloration was concentrated in the central area of the middle and back two-thirds of their tongues, with no ulcers, cracks, or bleeding. No other abnormalities were found. Their medication history showed that both men had taken metronidazole and bismuth three weeks prior to treat H. pylori-positive peptic ulcers.
"Although the exact mechanism isn't fully understood, it's hypothesized that changes in the oral microbiome and local immunity due to medication may be responsible," Dr. Tuan said.
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Images of unusually black tongues in two patients. Photo: Hospital provided |
Images of unusually black tongues in two patients. Photo: Hospital provided
Black hairy tongue is characterized by the elongation and enlargement of the filiform papillae on the tongue's surface. This leads to an accumulation of keratin, food debris, bacteria, or fungi, causing the tongue to appear black, brown, or dark yellow, depending on the accumulated substance.
Common symptoms of black hairy tongue include: black, brown, or dark yellow discoloration; a feeling of fullness or altered taste; bad breath; and typically no pain or ulcers. This condition can be caused by medications like tetracycline, metronidazole, linezolid, and bismuth, or habits such as smoking tobacco or cigarettes, drinking coffee or strong tea, chewing betel nut, or poor oral hygiene.
Therefore, those with this condition should discontinue or replace the suspected medication and brush their teeth and tongue daily. They should also avoid smoking and limit dark-colored drinks.
Dr. Tuan emphasizes that most cases of black hairy tongue are benign and reversible. However, maintaining good oral hygiene and changing lifestyle habits are crucial. Consult a specialist if the tongue discoloration is accompanied by pain, ulcers, bleeding, swollen lymph nodes, or weight loss.
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