Is Your Baby's Tongue Black? What Parents Need to Know

• Written by Leena Khowal

  Reviewed by Ritika Malik

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Imagine being born with a unique black spot on your tongue, simply called “Black Tongue” - also known as Congenital Melanotic Macule [a harmless dark spot present at birth].

Ever wondered what causes some babies' tongues to appear black or dark brown in colour? It's not just a matter of poor oral hygiene or diet. It’s a condition known as Black Tongue, or Black Hairy Tongue, which is rare and affects a small number of people worldwide. Despite its name, it is not a disease, but rather a harmless condition that can be caused by various factors. In this article, we'll explore what Black Tongue is, its causes, symptoms, and treatment options.

What is Black Tongue?

Black Hairy Tongue, popularly known as Black Tongue, is a condition where the tongue appears black or dark brown in colour due to an overgrowth of papillae (small bumps) on its surface.

These papillae can trap bacteria, debris, and other substances, leading to discolouration. This rare and harmless condition is often overlooked, with very few documented cases in the medical literature. Characterised by solitary or multiple dark spots on the tongue, these lesions [abnormal tissue growths] can vary in size and colour, but they can grow in proportion to the rest of the body.

What's fascinating is that this condition can affect anyone, regardless of skin tone, although it's more common in individuals with darker skin.

Research suggests that these melanotic macules are simply a result of increased melanin [skin pigment] deposits in the tongue's basal cell layer [the deepest layer of skin cells], without any underlying systemic issues [health problems affecting the whole body].

Visible Symptoms of Black Tongue

If you’ve noticed an unusual black spot on your baby’s tongue, you’re not alone. Let’s examine the common signs to help you recognise what to look for.

• Discolouration: The most noticeable symptom is the black or dark brown colouration of the tongue.
• Hairy Appearance: The papillae on the tongue can become elongated, giving it a hairy or fuzzy appearance.
• Bad Breath: The trapped bacteria and debris can cause bad breath (halitosis).
• Difficulty Swallowing: In rare cases, the condition can cause difficulty swallowing.
• Dry Mouth: If there is a decrease in saliva production, this decrease can contribute to the development of black tongue.
• Visible Papillae: The papillae on the tongue may become more visible, giving it a rough texture.

Causes of Black Tongue

A black tongue can be caused by various factors, ranging from harmless to potentially severe.

Non-Medical Causes

• Food and drink stains: Consuming foods or drinks with intense colours, such as blackberries or dark-coloured candies, can temporarily cause a stain.
• Artificial Dyes: Some foods or drinks with artificial dyes can also cause staining.

Medical Causes

• Bacterial Overgrowth: An overgrowth of bacteria in the mouth, particularly those that produce sulfur compounds [chemicals that can cause bad breath and tongue discolouration], can lead to a black tongue.
• Black Hairy Tongue (Lingua Villosa Nigra): A condition characterised by an overgrowth of yeast or bacteria on the tongue, causing discolouration and a hairy appearance.
• Pigmented Nevus: A birthmark that can cause a black tongue in some babies.
• Antibiotics and Medications: Certain antibiotics, such as tetracycline, and medications, including antacids and anti-diarrheal agents, can cause tongue discolouration.
• Vitamin Deficiencies: Deficiencies in vitamins such as B12 or iron can cause changes in tongue colour.
• Oral Thrush: A yeast infection that can cause a black tongue, especially in newborns. It’s usually treated with antifungal medication.

Helping your little one: Treating and managing Black tongue

Don’t worry if your baby’s tongue has turned black! Because in most cases, it’s a harmless condition that can be easily prevented and treated. Here are the steps to follow.

Treatment options

• Wait it out: If the discolouration is caused by food. It will likely disappear on its own within a short time.
• Stop the Medication: If a medication is a culprit, stop taking that medicine for a while to disappear the mark.
• Dental Care: If the discolouration persists, a dentist can gently scrape the tongue to remove the pigmentation.
• Underlying Illness: If an underlying illness causes the black tongue, treatment would focus on addressing the underlying condition. This may involve the prescription of antifungal or antibiotic medications.

Prevention Methods

• Scrape Away: Introduce a tongue scraper into their oral hygiene routine to prevent skin cell buildup on their taste buds.
• Regular Dental Cleanings: Schedule regular dental cleanings for your baby to maintain good oral health.
• Stay Hydrated: Ensure your baby drinks enough water to keep their mouth moisturised and to help them swallow dead skin cells.
• Balanced Diet: Encourage a balanced diet rich in fruits, lean proteins, vegetables, and whole grains to promote a healthy balance of bacteria in the mouth.

By following these tips and treatment options, you can help manage your black tongue and maintain good oral health.

Should you worry if your baby has a black tongue?

No, black tongue, also known as black hairy tongue, is a common and harmless condition in babies, caused by a buildup of keratin on the tongue's surface or an overgrowth of bacteria or fungi. It may appear alarming, but it typically resolves on its own or with improved oral hygiene practices.

When to Consult Your Healthcare Provider

However, if you're concerned about your baby's condition, or if the following occur (it’s better to Seek Medical Attention) :

• Persistent symptoms: If symptoms persist despite self-care measures, schedule an appointment with your healthcare provider.
• Medication concerns: If you suspect that one of your medications is causing black hairy tongue, consult your doctor before stopping or changing your medication.
• Severe symptoms: If the baby is experiencing severe symptoms, such as difficulty swallowing, breathing, or speaking, seek immediate medical attention.

Prioritising Your Baby's Health

As a parent, it's natural to worry about your baby's health. To ensure your baby receives the best possible care, consider investing in a comprehensive Health Insurance Plan, which shall offer:

- E-consultation services.

- Extensive coverage for various medical expenses.

- Wellness benefits and cumulative bonus super.

If you prioritise your baby's health and invest in a comprehensive health insurance plan, you can have peace of mind knowing your baby is protected and receives the best possible care.

Case Study: Black Hairy Tongue (BHT) in a 3-Month-Old Baby

A 3-month-old baby girl was admitted who had a persistent, dark tongue lesion that didn't respond to initial treatment for thrush. Further examination then revealed blackish, elongated tongue papillae, characteristic of Black Hairy Tongue (BHT). Notably, the baby had been receiving vitamin C supplements since 28 days old, which likely contributed to the development of Black Hairy Tongue.

To address the condition, the baby's vitamin C and antifungal medications were discontinued, and gentle tongue brushing with a soft-bristled toothbrush was initiated.

After 4 weeks, the lesion showed significant improvement, and there was no recurrence after 4 months.

>> Also Read: Quick Ways to Maintain Oral Hygiene

Final Thoughts for Parents!!

While black tongue in babies can seem alarming, it's often harmless and temporary. It’s essential to understand the causes—ranging from harmless buildup to the effects of medication—that can help alleviate your concerns. With good hygiene and timely pediatric guidance, most cases resolve without serious intervention. However, unusual symptoms should never be ignored. Every baby is different, and staying informed helps you respond with care and confidence. If in doubt, always consult your paediatrician for clarity and peace of mind.

Disclaimer: The above information is for reference purposes only. Kindly consult your general physician for verified medical advice. The health insurance benefits are subject to policy terms and conditions. Refer to your policy documents for more information.