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Figure 1.An example of

“Black hairy tongue” 

Figure 2. Patient was asked to use

a tongue scraper

Jose Mendez#1714

DH 153

Hairy/coatedTongue

Patient Information

Jose Mendez #1714

DH 153

"Black Hairy Tongue: Causes andTreatment." WebMD. WebMD.

Web. 19 May 2016.Darby, M. L., & Walsh, M. M.

(2015). Dental hygiene: Theoryand practice (4th ed.). St. Louis,

MO: Elsevier.DeLong, L., & Burkhart, N. W.

(2013). General and oral pathologyfor the dental hygienist  (2nd ed.).Philadelphia, PA: Wolters Kluwer

Health/Lippincott Williams &Wilkins.

8/16/2019 Brochure Hairy Tongue

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WHAT IS HAIRY OR COATEDTONGUE?

“Hairy” or “coated” tongue is a harm-less, but sometimes annoying problem that is

seen rather frequently. People whocomplain of this condition are almostalways adults, and it can affect men orwomen. 

WHAT CAUSES COATEDTONGUE?

Basically, the top surface of the tongueis an area that is typically subjected to alot of irritation on a daily basis. This

irritation is often due to hot drinks orrough foods (tortilla chips, etc.). For thisreason, humans have been designed to

have the tops of their tongues produce alayer of protective dead cells called“keratin”. This is the same material thatforms our hair and fingernails. It is alsothe same material that forms when we,for example, use a rake in the yard, andcalluses develop on the palms of ourhands. The calluses are made up ofkeratin. The keratin formed on the topof our tongues is knocked off andswallowed when we eat our meals.

 Normally the amount of keratin produced is equal to the amountknocked off, and our tongues appear

normal. Sometimes this balance is upset,however, and the condition called“coated tongue” results.

This may be due to the keratin not beingknocked off as quickly, as seen with peoplewho are eating a softer, less abrasive diet

(denture wearers especially). On the other hand,some people will develop this problem when

the keratin is produced more quickly than it can be knocked off and swallowed. This increased production of keratin is usually due to irritation

of the top of the tongue due to drinking hot beverages or smoking tobacco. Theaccumulation of keratin on the filiform papillae(“taste buds”) of the tongue gives the tongue akind of “hairy” appearance. 

IS THIS CONTANGEOUS?

 No, absolutely not. While several medi-caltextbooks suggest that this is due to some sortof infection, very little evidence supports thattheory. In fact, we have seen numerous cases ofcoated or hairy tongue that have been treatedwith a variety of antibiotics that had no effectwhatsoever.

WHAT IS THE DIFFERENCEBETWEEN COATED AND HAIRYTONGUE?

The difference between these two terms is basically that of the degree of keratinaccumulation. With coated tongue, theaccumulation is not severe. With hairy tongue,

the amount of keratin is such that hair-like projections of the keratin material form on the

top of the tongue. 

WHAT ABOUT THE COLOROF MY TONGUE?SOMETIMES IT SEEMS BLACKOR BROWN

Because the keratin is composed of deadcells, this material can act as a place for

the normal bacteria found in the mouth toaccumulate and grow. Some of these

 bacteria can produce pigments while theygrow, resulting in a brown or black colorto the top of the tongue (Figure 1).The

 bacteria are harmless and cannot beeliminated from the mouth (regardless ofwhat the mouthwash advertisements

suggest!)

IS THERE A CURE?

Generally the most effective treatment forthis condition is the daily use of a tonguescraper, which removes the dead

keratinized cells from the top of the tongue(Figure 2). Stopping or reducing any habitsthat might cause irritation to the top of thetongue also usually helps reduce the

 problem. Of course it is important to realizethat this is harm-less condition, and if itdoesn’t cause too many symptoms, it reallydoesn’t require treatment. 

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