Black Spots On My Tongue: Causes & Treatment Options

Having a black tongue, or black spots on your tongue, can be pretty concerning. Not only is it visually unappealing, but it can connect to various potential conditions. Many of those conditions are harmless and simply a reaction to different states of your body. However, in some cases, a black tongue can indicate a severe condition. This article will give you options on what it could mean and how to remove those spots in some cases.

8 min readCauses and Treatment for Black Spots On My Tongue

Anytime your tongue takes an odd discoloration, it can be pretty concerning. But it's important not to panic, as that can lead you to make rash decisions.

Knowledge will be your power when it comes to treatment and prevention. While it's best to consult your dentist about something like this, you can also do some research to get started.

In this article, you'll learn more about what causes black spots on your tongue, how to prevent them going forward, and the steps you can take for treatment.

What Do Black Spots On A Tongue Mean? Overview

Black spots on your tongue can mean various things. Below, you'll find an overview of those different causes:

  • Chemical reactions (with drugs or food)
  • Injuries
  • Tongue piercings
  • Tattoos
  • The presence of heavy metals (mainly bismuth or lead)
  • Addison's disease
  • Posttraumatic pigmentation (after tongue trauma)
  • Tuberculosis Tobacco use
  • Prescription drugs
  • Pregnancy leading to hyperpigmentation
  • Post-inflammatory pigmentation
  • Labial melanotic macule (spotted through lesions)
  • Oral melanoacanthoma (also spotted through lesions)

While blackness can signify something serious, it can also come from something harmless. The best way to find out is by scheduling an appointment with your dentist.

What Is The Natural Appearance Of Your Tongue?

Before you go to your dentist, it helps to know what a "normal" tongue looks like. While there are some slight variations, they should all be pink and covered in tiny bumps known as papillae.

Sometimes, a normal tongue has a white film on top of it. This is a sign of a build-up of bacteria, which you can remove by brushing your tongue. You might also consider investing in some tongue scraper to remove this whiteness.

If your tongue has other colors, it might signify something else. Here are some alternative options and a short review of some of their potential causes:

  • Purple tongue - Caused by poor blood circulation or a unique heart condition.
  • Yellow tongue - Caused by bacteria growth, jaundice, eczema, or poor oral hygiene.
  • Red tongue - Caused by an allergic reaction, herpes on the tongue, a vitamin B deficiency, or scarlet fever.
  • Orange tongue - Caused by poor oral hygiene, dry mouth, or some antibiotics.
  • Green tongue - Caused by bacteria growth or fungal infection.
  • Blue tongue - Caused by a lack of oxygen in your blood or eczema.
  • White tongue - Caused by a fungal infection or leukoplakia.
  • Grey tongue - Caused by eczema or geographic tongue.

The discoloration of your tongue is a sign that you likely need to consult a dentist. These colors are often connected to other conditions, like tongue ulcers.

Can Injuries On My Tongue Cause Black Spots?

When you bite down on your tongue or it is pierced by something, it can cause a bruise. This can lead to bluish-black spots, which should naturally return to pink as the tongue heals.

If you've injured your tongue recently, it's one of the most easily identifiable causes. In this case, you'll go to a doctor to receive a treatment plan and some steps you can take to assist in healing.

One potential source of injury is a tongue piercing, although it shouldn't turn your tongue black if done correctly. Having a black tongue after a piercing is a sign of trapped bacteria.

In these cases, it's best to leave the piercing where it is and clean it out using a saline solution (a mixture of salt and water). However, you'll still want to see a doctor.

For piercings and other injuries, you can also suck on ice to help alleviate any pain and swelling. If you are experiencing uncomfortable warmth, ice is beneficial.

Alternatively, you can get a clean, damp towel and heat it in the microwave. Homemade warm compresses can help reduce swelling. Just be sure not to make it too hot, or you might end up with a burned tongue.

If you have a tingling tongue with your injury, that might signal nerve damage.

Can Chemical Exposure To My Tongue Cause Black Spots?

Chemical exposure to your tongue often comes from prescription drugs. The ingredients in some medications react to the surface of your tongue by discoloring it.

Bismuth, for example, is a heavy metal included in some medications. Taking it can discolor your tongue, but it can also cause black stools. Those who take medicines like Bismatrol or Diotame might experience this effect.

You are less likely to get a black tongue with a balanced diet when drinking or eating. However, if you eat a large amount of darker food or smoke cigarettes, they can stain your tongue.

Alongside bad oral health, this can lead to a harmless condition called "black hairy tongue," which comes from having too many dead skin cells on your tongue's surface. The cells take the color of what you consume.

The "hair" is a clump of dead cells. It can come from having a soft diet (like yogurt or protein shakes). Eating food that doesn't naturally scrape your tongue can cause this sort of build-up.

You can solve this problem through good oral hygiene and eating more solids. But if the condition continues, please consult a doctor for solutions.

What About Tongue Cancer?

Tongue cancer is uncommon, but it is one possibility if you have black spots on your tongue. These spots will almost always expand to your mouth and throat.

This cancer starts from cells on the surface of your tongue. If it stays in your mouth, this is known as oral tongue cancer, which is relatively easy to diagnose. It can eventually be removed through surgery.

Its complicated variant is hypopharyngeal tongue cancer, which starts at the base of your tongue. It is a rare form known of head and neck cancer.

This cancer is connected to tobacco, drinking excessive amounts of alcohol, or having plummer-vinson syndrome. Given that it's only diagnosed in 3,000 people in the US, it's pretty rare.

Other signs of this cancer include lumps in your throat or changes in your voice. You might also have a sore throat lasting much longer than it should.

When it comes to cancer or any medical condition, it's best not to self-diagnose. Go to your doctor if you have concerns regarding a spotty black tongue.

How To Get Rid Of Black Spots On A Tongue

Knowing more about what might cause the black spots on your tongue gives you an idea of where to start. But you'll need to take action if you want to eliminate those black spots.

Below, you'll find some steps you can take to help remove those black spots:

Improve Oral Hygiene

Above all, the best step to prevent and get rid of a black tongue (if it's dirty) is to improve your oral hygiene. Conditions like "black hairy tongue" come mainly from a lack of good dental care.

If you have trouble remembering to brush your teeth every night, try and connect it with an existing nighttime habit. For example, you can make it a rule that you must brush your teeth before removing your shirt or putting on pajamas.

To remind yourself to brush every morning, connect the habit to a post-breakfast activity. If you like to read the newspaper, make it a rule to brush your teeth before you start reading.

You can also connect these with activities you already do in the bathroom, like taking a shower or using the toilet. This is called habit stacking, and it makes it easier to remember small, important things.

Once you are confident in the habit, add flossing and mouthwash to your routine. You'll do better with oral hygiene by building new habits on top of old ones.

Brush Your Tongue Twice A Day

An often-forgotten part of oral hygiene is brushing your tongue. After all, your tongue isn't front and center, making it a less visible part of your mouth.

Because it's not visible, it's natural to forget about it. Think of it like a guitar you have in storage. While you keep telling yourself that you'll eventually learn, you won't learn anything if you don't take it out of the box.

This creates an interesting (and slightly weird) question, how do you take your tongue out of storage?

You can start by telling yourself to make a goofy face before brushing your teeth. Ideally, this goofy face involves you sticking your tongue out. It won't be hidden anymore, making it easier to remember to clean it.

You can also purchase a tool for cleaning your tongue: a scraper. By placing the scraper alongside your other cleaning tools (toothbrush, floss, and mouthwash), you'll more likely recognize it as a vital part of your oral care routine. When you clean your tongue, it also has the added benefit of improving your breath.

Visit Your Oral Care Provider

If regular cleaning isn't helping you, now might be the time to visit your oral care provider. If you have a regular dentist you see twice a year; they'll have your record of past visits.

Your dentists might know the right questions from the information gathered during prior visits. This helps you reach a concrete conclusion faster.

You'll also want to let the dentist know of any recent changes. Dietary changes, medication changes, and other recent events might help your dentist solve the problem faster.

Pictures Of A Black Tongue

Below, you'll see pictures of different black tongue conditions you can use for reference. Remember that your condition might not look exactly like this, and you should still see a medical professional:

Black Hairy Tongue:

Tongue Injury:


Tongue Cancer:

How Do You Remove Black Spots On A Tongue Naturally?

To remove black spots on your tongue naturally, follow an oral care routine that involves brushing your tongue or using a scraper. These black spots are often caused by oral hygiene issues, meaning they can be solved by improving your habits. Alternatively, it might be related to an injury or medication, which is when you should consult a doctor.

Should I Worry About Black Spots On My Tongue?

Whenever you have black spots on your tongue, it's best not to worry. Often, these black spots can be removed through professional tongue cleanings or at-home dental care. Knowledge will be essential when finding black spots, so you should consult a dentist for steps you can take to remove them. Knowing the problem and having the plan to fix it will help you feel much better.

What Are The Risks Of Having Black Spots On My Tongue?

The risks of having black spots on your tongue depend on the condition's cause. Left untreated, those black spots can risk everything from bad breath to death. Knowing the reason, you won't have to wonder about the risks because you'll know the most likely outcomes. You can also use this knowledge to take steps toward healing.

Do Black Spots On A Tongue Mean I Have An Infection?

Black spots on your tongue do not usually mean you have an infection. Instead, it's most likely caused by your diet or medications and how your body reacts to them. Infection is just one of the many causes of a black tongue, so it's best to educate yourself by speaking with a medical professional.

Wrapping Up

So, while it might be concerning, a black tongue doesn't always mean something serious. In many cases, it's just the result of an injury, a response to a medication, or a harmless medical condition.

Of course, it could also be something serious. So, if you want to be safe, it's best to consult a medical professional.

To avoid many of these causes, remember to follow a good dental care routine and contact your dentist. Remember your tongue when you brush your teeth.