14 Causes of Black Spots on Tongue

Black Spots on Tongue

Black Spots on Tongue

Some spots on the tongue, might signal a serious underlying problem that needs prompt medical attention. Spots are usually temporary and not harmful. Black spots on tongue could range from tiny dots to conspicuous black areas, which look especially alarming. Single spot or may be a cluster small dots may appear on the surface of the tongue.

  • Appear on a particular part of the tongue such as the side, tip, etc.
  • Cover the entire surface of the tongue
  • Spread to the cheeks, lips and the rest of the mouth


Causes of Black Spots on Tongue

Some causes black spots on the tongue is:


Hyperpigmentation is when your tongue is producing too much pigment. The melanocytes are the cells that responsible for producing pigment. This cell secretes a molecule called melanin, which is gives skin color. There are many factors that can lead to someone developing hyperpigmentation, including stress, trauma, anemia, and hormonal changes. Patients with hyperpigmentation on tongue are usually accompanied by stress and fatigue that may result from a lack of appetite, insomnia, and lack the spirit of doing daily activities.

Tongue Injuries

Another relatively common cause of black tongue spots is physical trauma, either caused by biting or oral devices.

Oral Fibroma

Oral fibromas are hard masses that form on the tongue that can be accompanied by black specks. Oral fibromas are benign, meaning they don’t lead to anything serious.

Chemical Exposure to your Tongue

Certain chemicals react with acids on the surface of the tongue and turn it black. Exposure to the chemical bismuth, which is an ingredient in some medications, may cause the color change.

Tongue Cancer

Dark patches on the tongue are a sign of a serious condition like cancer. The dark spots may also appear as scabs or sores that don’t heal. Other signs ofblack spot on tongue cancer include lumps, swelling and problems with swallowing. Other risk factors for tongue cancer include:

  • smoking
  • drinking alcohol
  • having the human papillomavirus (HPV)
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In the early stages, clinically tongue cancer may manifest in various forms, can be patchy leukoplakia (black spots on the tongue), thickening, exophytic or endophytic growth ulcer forms.

Causes of tongue cancer:

  • Repeated trauma to the tongue, for example, the tongue is often bitten
  • Consuming old betel
  • Chewing tobacco

Fungal Infections

Candida albicans oral or oral fungal infections are infections of the tongue caused by fungal growth on the tongue. As the fungus overtakes your mouth, it can cause your tongue to develop a dark, moldy appearance. This can be caused by drinking, smoking, or not brushing daily.

Certain Medications

A side effect of some medications includes black tongue spots. Typically, drugs that can cause black spots on the tongue are a medicine that contains bismuth salicylate, an asthma drug, and some kinds of antibiotics. Consumption of certain drugs such as antibiotics, antidepressants, and drugs containing iron salt can also lead to dark spots.


Some women experience black spots on the tongue during pregnancy. It’s due to all the hormonal changes that a woman goes through whenever she’s pregnant.

Drinking Alcohol or Smoking

Alcohol consumption and smoking can cause black spots on the tongue if done too often. Alcohol consumption and smoking too much can lead to bad breath; tongue tasted bitter and sour, and can also cause the condition of the appearance of dark spots on the tongue.

Tongue Piercing

a tongue piercing can also increase the risk of fungal infections of the tongue. This can then lead to the development of black spots on the tongue. Healing period after piercing the tongue may develop black spots on the tongue area.

Hairy Black Tongue

The most common causes are black spots of fur on the tongue. The fur is located on the tongue, at the pink side. A black hairy tongue is a common reason for having a large collection of black spots at the back and middle of your tongue. Although the dark patches on the surface of your tongue look worrisome, it is usually caused by harmless conditions.

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Sometimes those dark spots on the tongue are freckles which are really harmless. They can affect different parts of the tongue causing uneven discoloration on it.

Oral Mucocele

Oral mucoceleare lumps that are dark blue almost black that form a bump under the tongue. They can form in other parts of the mouth as well.

Other Causes

There are several other possible causes, especially related to our consumption, include:

  • consumption of certain foods and beverages, such as coffee and tea
  • black spots on the tongue can also occur if you have anemia
  • Effect of chemotherapy: black or brown spots on tongue by pigmentation patches on the tongue are sometimes seen in patients undergoing chemotherapy treatment.
  • HIV (although rarely)
  • mother’s milk allergy in infants


Black Spots on Tongue Dangerous or Not?

In order to make an accurate diagnosis, the doctor must be informed about the following:

  • Consumption of any supplements or medications
  • Personal and family medical history
  • Smoking and alcohol consumption
  • Conditions of compromised immune system
  • Experience of symptoms such as lumps or pain in the throat, neck or mouth

The following medical tests could be prescribed:

  • X-rays
  • Positron emission tomography scans
  • Biopsy


Treatment for Black Spots on Tongue

  • Maintaining Oral Hygiene: Keeping the mouth clean is the best way in how to remove black spots on tongue.
    • Brushing twice a day
    • rinsing the mouth after every meal
    • flossing the teeth
    • Using an antibacterial mouthwash.
  • Changes in Life Style: People must stop alcohol consumption, smoking and chewing of tobacco in order to avoid dark spots on the tongue.
  • Clean mouth after consuming tea or coffee.
  • Drinking plenty of water (Keep Hydrate)
  • Routine Dental Examination
  • Surgery: In certain cases warts may appear on the tongue or in the mouth. They need to be removed surgically. In case of oral fibroma too, a surgery can be conducted to remove the unwanted mass.
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Tips for Prevention Black Spots on Tongue

There are some ways to cut down on your risk for having tongue spots, including:

  • Not smoking or chewing tobacco
  • Avoid Excess alcohol
  • Getting regular dental checkups
  • Avoid foods that can cause irritation of the mouth, such as chewing, chewing tobacco.

Maintaining good daily oral hygiene includes:

  • Brushing your teeth
  • Rinsing
  • Flossing
  • Gentle brushing of your tongue


Black Spots on Tongue: When to See a Doctor?

Normally, black spots or discolored patches on your tongue should go away by themselves or when the underlying cause is addressed. Visit your doctor immediately if this symptom persist, include:

  • You have discolored patches on your tongue, the roof of your mouth, or inside of your cheeks that don’t go away.
  • Swelling of the tongue, especially if it affects your breathing.
  • You have pain in your tongue that doesn’t go away.
  • You have difficulty chewing or swallowing food because of mucoceles or other lesions in your mouth.
  • Your taste buds and sense of taste has altered.

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