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You know that icky feeling of finding a random hair in your mouth? We’ve all been there. Usually, it’s just hair from our head, body, or pet. Gross, but easy enough to pull out and forget about. In other cases, “hairy tongue” is the cause. We’re not kidding. As strange as it sounds, hairy tongue is a legitimate medical condition.
Before you panic, we can assure you that despite its unpleasantness, this condition is generally harmless.
Hairy tongue, medically known as lingua villosa, develops when the tiny bumps on your tongue’s surface grow longer than normal and fail to shed as they should. These bumps, called filiform papillae, measure about 1 millimeter in length. When you have hairy tongue, the papillae can grow up to 18 millimeters long. That’s almost three-quarters of an inch!
The “hair” you see isn’t actually hair. It’s the papillae, which are made of the same keratin protein found in your hair and nails. This might explain why they look strand-like when abnormally long.
The tongue’s papillae are constantly shedding and regenerating. When this natural process slows or stops, the papillae continue growing. The result is a furry, rough, or hair-like coating on your tongue. As the papillae elongate and overlap with each other, the tongue may feel carpet-like, with a thicker and more fibrous texture.
Except for black, white, and sometimes brown, most of the colors below, including yellow, green, and any other “colorful” shade, occur due to external factors such as food dyes, spices, smoking, or medication byproducts.
Unless you notice hair-like growths on your tongue, most color changes are temporary. If the discoloration doesn’t improve with regular brushing and tongue cleaning, you should discuss it with your Chandler dentist or physician to rule out a health- or medication-related cause.
Black hairy tongue is the most common variation. It forms when dead cells and an excess of keratin accumulate on the papillae, which then trap bacteria, fungi, yeast, and pigments from food, tobacco, and other substances. Porphyromonas gingivalis and other chromogenic (pigment-producing) bacteria in the oral cavity can also turn the elongated papillae black or dark brown.
White hairy tongue typically indicates an overgrowth of yeast, particularly Candida albicans. This condition appears as a thick, white coating across the tongue’s surface. Unlike thrush, which leaves cottage cheese-like patches on the tongue that can be wiped or scraped off, white hairy tongue affects the filiform papillae themselves. The white coating is a combination of dead cells and debris trapped between the elongated papillae.
In some cases, white patches on your tongue may not be hairy tongue but oral hairy leukoplakia. This condition develops when the Epstein-Barr virus infects the tongue. It mostly affects people with impaired immune systems, such as those with HIV or undergoing certain medical treatments.
A brown tongue is a common effect of long-term tobacco use, excessive coffee, tea, or red wine consumption, or exposure to mouthwashes containing chlorhexidine. Eating foods high in tannins, which include chocolate, legumes, beans, pomegranates, and berries, can also leave a brown stain on your tongue. The color deepens gradually, as the elongated papillae absorb more and more of these pigments.
If you smoke, the tar and nicotine in tobacco can stain your papillae yellow. Some prescription medications, such as those that contain bismuth for treating gastrointestinal conditions, may also cause a yellow or black coating to form when they interact with sulfur in your saliva.
Although less common, Candida species sometimes produce a greenish-black tinge, particularly when mixed with other microorganisms in your mouth. Some antibiotics, including tetracyclines and penicillins, may also disrupt the balance of your oral microbiome, allowing organisms linked to green pigmentation to flourish.
If your tongue looks and feels like it’s growing hair, you’re not imagining things. Here are the top ten causes of hairy tongue:
When you brush your teeth and tongue irregularly, bacteria, dead cells, and traces of sugar, salt, and acids from your meals will naturally accumulate. As the buildup thickens, it could block the normal shedding of papillae.
Brushing your teeth removes food sources that fuel microbial growth, and brushing your tongue stimulates the papillae to shed and regenerate.
Saliva washes away bacteria and debris from your tongue’s surface. Reduced saliva flow or dry mouth syndrome, whether due to medication side effects, dehydration, or health conditions, can cause the papillae to elongate and discolor.
Smoking is one of the leading causes of black hairy tongue. The 7,000+ chemicals in tobacco smoke, as well as the sticky, brown, toxic residue (tar) coating your lips, teeth, and tongue, can spread and promote keratin buildup on the papillae. Tobacco also changes the oral microbiome toward more chromogenic species that discolor the elongated papillae.
If you smoke or chew tobacco, you’re giving the “hairs” in your tongue more reasons to grow and discolor. Dropping this habit is one of the fastest ways to tame a hairy tongue.
Keep in mind that tobacco use, combined with any of the other causes mentioned in this article, makes you twice as vulnerable to this condition. Point in case, this man developed green hairy tongue due to smoking, poor oral hygiene, and intake of certain antibiotics.
Broad-spectrum antibiotics can alter the balance of good and bad bacteria in your oral cavity. Since antibiotics don’t always pick and choose what to eliminate, they can reduce the beneficial bacteria in your mouth, and, in turn, allow microbes and yeast to thrive. This imbalance and overgrowth of harmful organisms can trigger hairy tongue.
Some antipsychotics and anticholinergics can also cause dry mouth syndrome, which can then lead to hairy tongue.
Coffee and tea contain tannins and chromogens that stain the papillae. If you prefer to drink them hot, be warned that regular exposure to hot beverages can further irritate the papillae and encourage abnormal growth. Drinking multiple cups a day without adequate water intake raises your risk even more.
Oral rinses that contain oxidizing agents, such as peroxide or astringents like witch hazel, can irritate the tongue and other soft tissues. At high concentrations or with prolonged use, they can erode enamel, damage gums, and stimulate papillae overgrowth.
Avoid hydrogen peroxide mouthwashes and astringent-based formulas if you have open wounds or ulcers, recently had oral surgery, or have a sensitivity or allergy to these chemicals. Consult your dentist to determine whether your mouth really needs such a potent rinse, or if there are better and safer alternatives.
Chlorhexidine mouthwash is another example. This broad-spectrum antimicrobial biguanide is highly effective against gingivitis; however, it can contribute to or exacerbate hairy tongue. As discussed, overusing topical antiseptics can alter the mouth’s flora and lead to the papillae’s elongation and discoloration. It can also stain your teeth.
If you have gum disease and your dentist prescribes chlorhexidine dental treatments, swish it in your mouth for 30 seconds only, and avoid using it for more than four weeks. For mouth ulcers and thrush, continue using the medication for two days after you’re symptom-free.
Soft foods like yogurt, mashed potatoes, and smoothies glide over the tongue without friction. Although delicious and easier to digest, they reduce the stimulation and abrasion necessary for the papillae to shed. A diet of primarily soft foods can also weaken jaw muscles, stunt jawbone growth, and contribute to malocclusion.
If you have digestive problems or are recovering from illness or surgery, follow your physician’s guidance on how long to eat soft foods, then transition back to varied foods when cleared to do so.
On the other hand, if you can’t eat solid foods due to missing teeth, modern dental solutions like dentures and dental implants can restore your smile and ability to eat a diet with varied textures. At Kyrene Family Dentistry, our advanced tooth replacement options in Chander are customized based on each patient’s needs and budget. Contact us to know more about our smile restoration procedures.
Some patients undergoing radiation therapy for head and neck cancers may develop black hairy tongue as a side effect, according to the American Academy of Oral Medicine.
Radiation therapy damages cells by breaking DNA bonds. When your head and neck, including your mouth, receive ionizing radiation’s beams of intense energy, the salivary glands can sustain collateral damage. You may incur severe xerostomia as a result. Furthermore, radiation can disrupt the tongue’s normal cell turnover process. These factors create ideal conditions for hairy tongue to develop.
Certain medical conditions increase the likelihood of having hairy tongue:
If you have any of these health issues, talk to your primary care physician and Chandler dentist about ways to treat or prevent secondary conditions like hairy tongue.
Cocaine abuse damages the teeth, gums, mouth, and jaw. Long-term use causes cavities, decay, tooth loss, bruxism, permanent perforation or holes in the roof of the mouth, and severe dry mouth. The latter, as we’ve mentioned repeatedly, is one of the leading causes of black hairy tongue.
You may experience some or all of the following, depending on the cause and severity of your condition:
A fuzzy, furry, or hairy-looking tongue is the most noticeable symptom. The color can range from white to black, with various shades in between. The coating is on the tongue’s top surface, often toward the back.
Your tongue might feel different to your own touch or when it grazes the roof of your mouth. Many people describe a rough, fuzzy, or velvet-like sensation. Some compare it to having a piece of carpet in their mouth.
You may notice that foods and drinks taste different. The thick coating can block the taste buds and interfere with normal flavor perception. Some people develop a metallic taste that persists even after brushing or gargling with mouthwash.
Bad breath or halitosis commonly accompanies hairy tongue. The bacteria and debris trapped in the elongated papillae produce sulfur compounds and other substances that cause unpleasant odors. This bad breath might persist despite regular brushing and mouthwash use.
Some people with hairy tongue experience a gagging sensation, particularly when the elongated papillae at the back of the tongue tickle the soft palate.
In severe cases, some patients develop a painful burning sensation on their tongue. The cause is likely an overgrowth of the pathogenic yeast Candida albicans, along with severe bacterial and debris buildup, within the elongated papillae.
Often, hairy tongue goes away on its own with improved oral hygiene. Schedule an appointment with your dentist if:
Most dentists and doctors can diagnose the condition just by looking at your tongue. To identify the cause, they may ask about your medical history, current medications, dietary habits, and oral hygiene routine. They may also use an illuminated tongue depressor to get a closer look at your tongue. In rare cases, they might take a small sample (biopsy) if they suspect another condition.
Hairy tongue is highly treatable. Most cases resolve on their own within a week or two, or with simple interventions.
Brush your tongue once or twice a day using a soft-bristled toothbrush. Start at the back of your tongue and brush forward. Be gentle to avoid damaging its delicate surface and to desensitize your gag reflex. Rinse thoroughly with water after brushing.
Tongue scrapers are superior to toothbrushes for eliminating stubborn coating. To use, position the scraper at the back of your tongue, then pull it toward the tip in one smooth motion. Repeat 2-3 times, ensuring to rinse the scraper before each pass. Do this once or twice daily, preferably after brushing your teeth.
To avoid gagging when brushing or scraping your tongue, don’t force yourself to reach the back of your tongue right away. Start cleaning near the tip, then gradually move further back. Being consistent may help desensitize your gag reflex over time.
Add more raw fruits and vegetables to your diet. While not a replacement for brushing, scraping, and flossing, munching on apples, carrots, and celery, for example, stimulates saliva production, which naturally cleanses your teeth and tongue. Also, increase your water intake to at least eight glasses per day. Water helps rinse away debris and maintains adequate saliva production.
If medications are causing dry mouth and hairy tongue, your doctor might adjust your dosages or recommend alternatives with fewer side effects on oral health. Do not stop taking prescribed medication without your doctor’s guidance.
In stubborn cases, your dentist might perform professional tongue debridement. This procedure eliminates biofilm and debris from the tongue’s surface, which improves oral hygiene and reduces bad breath.
Conventional techniques involve manually removing the coating with a plastic or metal scraper. More advanced tongue debridement uses low-level laser therapy, often as a last resort for severe or persistent cases. The latter is a minimally invasive surgical procedure.
If yeast overgrowth is present, your dentist may prescribe antifungal medications through oral rinses, lozenges, or systemic drugs that circulate through your bloodstream to address deeper infections. Common prescriptions include nystatin rinse or fluconazole tablets.
If you develop hairy tongue, remember that it’s temporary and curable. The majority of patients see improvement within a few days to a week of starting treatment. It rarely causes serious complications.
Hairy tongue is a relatively common condition. It affects about 13% of the population at some point, though its prevalence varies by age and lifestyle factors. It’s more common in men, people over 65, and individuals with poor oral hygiene or who use tobacco products.
No, hairy tongue is not contagious. You can’t transmit it to others through kissing, sharing food, or any other form of contact. Still, maintaining good oral hygiene benefits your overall health and the health of those around you.
Most cases of hairy tongue resolve within two weeks without medical intervention, especially with good oral hygiene practices. Some people see improvement within days.
Hairy tongue can recur if you return to the habits or aggravate the conditions that caused it.
No. Hairy tongue is not cancerous and does not increase your cancer risk. However, any unusual changes in your mouth should be evaluated by a healthcare professional. If you have concerns about oral cancer, discuss them with your local dentist or doctor, who can perform appropriate examinations and tests.
Once the papillae return to normal, so should your sense of taste. If taste changes persist after the visible signs of hairy tongue resolve, consult your healthcare provider.
If you’re experiencing symptoms, Kyrene Family Dentistry can identify the cause and provide effective treatments for hairy tongue in Chandler, Arizona. Call us at 480-705-9005 to restore your confident smile, including your tongue’s normal appearance.