On call: Black hairy tongue

On call

Black hairy tongue

Q. The top of my tongue has taken on a dark brown color and a fuzzy look. I don't have a sore throat and I can taste everything, but I'm a bit worried. I am 67, and my only medications are Timoptic and Xalatan — drops for glaucoma. Can you tell me what's wrong and what to do about it?

A. It's likely that you have a condition called black hairy tongue — but it's not as bad as it sounds.

The top of the tongue is covered with millions of filiform papillae, which are normally invisible to the naked eye (they are less than 1 mm long). The papillae don't get a chance to grow bigger because the flow of saliva, the movement of food, and good oral hygiene knock them off and allow the tongue to replace them with new papillae. But if oral conditions change, the papillae can remain in place and continue to grow, sometimes to nearly 18–20 mm. The long papillae can trap food particles and bacteria, which produce the dark color you've noticed.

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