A recent report highlighted the bizarre medical condition known as black hairy tongue or BHT. The case came to light when a man visited a dermatology clinic after the top of his tongue became covered in a dense mat of hair-like fibers. However, as rare as it may seem, BHT is a fairly common condition. The report published in Jama Dermatology on March 9 reveals that the man who is in his 50s was diagnosed with BHT, medically known as lingua villosa nigra.
Three months before his diagnosis, the man had suffered a stroke which caused paralysis on the left side of his body. After the stroke, the man was put on a diet of pureed foods and liquids, and about two and a half months later his caretakers noticed how black pigmentation covered the surface of his tongue.
JAMA Dermatology described the thick, black coating as tinged with “yellowish” streaks near the midline and back of the tongue. However, the authors noted that the outer edges, tip, and dead center of the tongue were free of black gunk. upon closer examination of the pigmentation, doctors discovered that the black coating was made up of long, thin fibers, with bright yellow deposits, likely trapped food particles, scattered throughout.
Doctors also scraped samples of mucus from her tongue to check for abnormal bacterial or fungal growth, but found no such growth in their tests.
It was then that he was diagnosed with BHT. According to the Mayo Clinic, BHT is a temporary, harmless oral condition that causes the tongue to look dark and hairy. The peculiar appearance of the tongue usually results from an accumulation of dead skin cells on the many small projections on the surface of the tongue which contain taste buds.
Mayo Clinic mentions that although black hairy tongue may seem alarming, in most cases it does not cause any health problems and is usually painless. Black hairy tongue can be treated by eliminating possible causes or contributing factors and practicing good oral hygiene.
According to the Cleveland Clinic, BHT can be caused by poor oral hygiene and/or a soft food diet, as the excretion process is facilitated by stimulation and abrasion of the top of the tongue. The condition can also occur from excessive consumption of coffee, tea, tobacco, or alcohol, certain medications, radiation therapy, dry mouth, and certain types of mouthwash.
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