Synonym: lingua villosa nigra
Risk factors:
(1) poor oral hygiene
(2) heavy smoking
(3) antibiotic use (which alters normal oral flora)
(4) chronic use of Pepto-Bismol (bismuth turns other things black)
Clinical features:
(1) hyperplasia of the filiform papillae, resulting in a "hairy" appearance to the dorsal tongue
(2) proliferation of bacteria and accumulation of pigmented metabolites (porphyrins, other) among the papillae, imparting a dark (black, brown) appearance
(3) variable presence of halitosis
(4) variable presence of abnormal taste
Management involves:
(1) improving oral hygiene, which includes brushing and cleaning the tongue.
(2) stopping use of tobacco products
(3) discontinuation of antibiotic and Pepto-Bismol therapy
