The black tongue is a disorder that can be caused by various diseases, medicines or foods, while the red tongue means that it is inflamed or that there is a deficiency of vitamins. 
Many people believe that the black color is caused by a liver problem, but this organ can cause only the yellow tongue.


Causes of black tongue

hygiene Poor oral hygiene can cause black tongue. Bacteria can grow between the taste buds, causing a black appearance.

For good oral hygiene, it is recommended:

  • Brush the tongue twice a day with toothpaste,
  • Clean the interdental spaces every day with dental floss,
  • Limit snacks between meals,
  • Go to the dentist regularly,
  • It is also recommended to replace the toothbrush every 3-4 months.

One of the main causes of black spots on the tongue is hyperpigmentation (pronounced pigmentation of the skin or mucous membranes). 
Hyperpigmentation can occur in isolation, but in most cases it is caused by a genetic feature that keeps the color on the surface of the tongue. 
It may just be an aesthetic problem, but in some cases it is caused by a more complex and serious illness. 
In most cases, these spots are very small and appear on the lower part of the tongue.

Treatment:  Apply rosehip oil, potato puree juice, aloe vera , lemon juice or cucumber juice. 
Non-prescription medicines that contain the following ingredients may decrease melanin production and remove melanin from the skin:

  • Soy milk,
  • Hydroquinone,
  • Cucumber,
  • Calcium,
  • Kojic acid,
  • Azelaic acid.

A dermatologist can easily remove these stains for aesthetic reasons.

Oral Cancer
Description: A patient with oral cancer usually has small bumps that grow in the oral cavity and do not pass. 
In some cases, the mass may appear with altered pigmentation and dark spots are visible on the underside of the tongue or on the surface. 
There are other signs and symptoms of oral cancer, for example:

  • An unexplained bleeding in the mouth,
  • Swelling,
  • Numbness or tingling,
  • Sore throat ,
  • Earache ,
  • Important weight loss ,
  • Difficulty in swallowing, chewing and speech disorders.

There are several risk factors for oral cavity cancer, such as heredity, excessive alcohol consumption, and cigarette smoke . 
Treatment for oral cancer: The most appropriate treatment for oral cancer is surgery to remove the cancerous mass. 
Then radiotherapy and chemotherapy can be done to destroy any remaining cancer cells.

Piercing the tongue
In some cases, after a piercing remains a dark mark on the surface of the tongue. 
This is because the pigment that gives color to the tongue is lost. When the pigmentation of the tongue returns, black disappears, but if that does not happen on its own, further treatments may be necessary. 
The symptoms that occur after a tongue piercing are just aesthetic. 
Therapy : If the black spots do not disappear, it is necessary to go to a dermatologist for a consultation. Therapy involves medications and surgery.

Reaction to certain medicines
The tongue may be dyed black because of some medicines like antibiotics and medicines that contain bismuth salicylate. 
The antibiotics are among the most frequent causes of black tongue in children. 
Therapy : Regular brushing of the tongue should remove these blemishes.

Mouthwash, Bismuth, and Tobacco
Regular use of mouthwashes containing peroxide or oxidizing agents can cause black tongue. 
Even mouthwashes with witch hazel, menthol, or other astringents can cause this symptom. 
Bismuth tablets can cause black tongue. 
Smoking too many cigarettes can cause black tongue. 
The reason the tongue changes color is that these medicines alter the chemical composition of the tongue.

Some foods such as licorice and coffee may give the central part of the tongue a brown-black color.


Why does a black hairy or villous tongue occur?

A hairy black tongue and is caused by an infection bacterial or fungal. 
Bacteria accumulate in small rounded formations called papillae. 
They are located along the surface of the tongue, in the middle and on the sides. 
If the papillae grow excessively and stretch, they may be as long as 15 times normal. 
These structures become very long as hairs and can capture bacteria and fungi that cause brown or black (sometimes also greenish) tongue. 
The black hairy tongue can also affect babies who may have candidiasis .

Certain diseases and habits can increase the chances of developing a black hairy tongue.

Among them are:

  • Poor oral hygiene
  • Tobacco
  • Drink lots of coffee or tea.
  • Take antibiotics that may alter the normal balance of bacteria in the mouth, such as amoxicillin or azithromycin.
  • Dehydration
  • Take medications that contain chemical bismuth (used in some medicines for digestion)
  • Not producing enough saliva
  • Regularly use mouthwashes containing peroxide, witch hazel, or menthol.
  • Do radiotherapy on the head and neck
  • Black hairy tongue is more common in men, in people who use intravenous drugs and in people who have HIV .


What are the symptoms of hairy tongue?

Besides the aspect of the tongue, most people with black hairy tongue have no symptoms and do not feel discomfort. 
The only symptomatic case is caused by the growth of yeast Candida albicans that can cause a burning sensation in the tongue .

Some people complain of a tickling sensation on the back of the palate, an unpleasant metallic taste in the mouth or nausea . 
In severe cases, the black hairy tongue may be accompanied by a feeling of suffocation. 
Sometimes food can remain inside the long papillae and can cause bad breath .


Black or red tongue

How is it possible to solve black hairy tongue?

In some cases, the disease resolves by itself, but practicing good oral hygiene is the best way to treat the problem. 
Wash your teeth gently twice a day with a soft brush and brush your tongue. 
You can use a tongue scraper to clean the area. 
Drink plenty of water during the day to help keep your mouth clean.

Other suggestions include:


Treatment for black tongue

For the black and hairy (or villous) tongue therapy is generally not necessary. 
Although unattractive, it is a temporary and harmless disease. 
To solve this problem, you need to do a good oral hygiene and eliminate the factors that cause the disorder, such as cigarette smoke or medicines containing bismuth.


Natural remedies for black spots on the tongue

1. Good Oral Hygiene Good oral
hygiene is essential for overall mouth health and can help prevent and remove black lumps or tongue blemishes. 
Cleaning the tongue with a spatula and using mouthwash twice a day is essential for the prevention and treatment of black patina.

2. A healthy diet and lifestyle
Follow a healthy diet  with plenty of cereals, fruits and vegetables.

3. Pineapple
Suck some small pieces of pineapple and hold them near the base of the tongue for about forty seconds. 
Then chew the pineapple for eight minutes. 
Repeating this natural treatment twice a day for seven to ten days, the black spots should disappear. 
Patients with irritable bowel syndrome should not perform this procedure.


Red tongue

Possible causes of red tongue (varies from pink to red-purple)

1. Deficiency of folic acid and vitamin B12
2. Pellagra 
3. Pernicious anemia
4. Plummer-Vinson syndrome 
5. Celiac disease .

There are several systemic diseases that can cause red tongue.

  • Autoimmune diseases such as Kawasaki syndrome can cause a bright red tongue with swollen lips, vertical fissures and bleeding.
  • People who suffer from scarlet fever are more likely to have a reddening of the tongue and also the formation of red dots. 
    In this case, the organ looks like a strawberry. 
    White spots on the tongue may also be noted with red lumps.
  • The allergies such as  eczema cause redness by excessive irritation of the tongue surface. 
    In this case, the red tongue is the consequence of the attack of bacteria to the taste buds.
  • The asthma is another cause redness. Red spots on the tongue occur due to the reaction of the respiratory tract to allergens.
  • The red tongue can also be a sign of acne .


Other causes of red tongue
A deficiency of niacin (another type of vitamin B) may cause reddening of the tongue. 
A deficiency of niacin causes a condition known as pellagra. 
The symptoms of pellagra are mouth pain, strawberry-colored tongue, mental disorders and diarrhea .

We can not forget the most obvious causes of the reddish tongue. 
It can be caused by the food that the person ingests. 
It can occur after eating a good amount of strawberries or a chewing gum with a red food coloring. 
Some acidic foods can cause pain and temporary tongue redness.

The Chinese herbalist says: in Chinese medicine, a red tongue indicates the heat. 
The color of the tongue may be darker in some parts relative to the organs of the body. 
For example, the root of the tongue may indicate excess heat in the intestine. It is necessary to adjust the heat with soft foods like cucumber, melon and green tea.

Bright red
tongue Bright red tongue can be caused by deficiency of vitamins. 
Deficiency of vitamin B12 or iron is a frequent cause of red and sore tongue, in addition to causing bitter mouth . 
Some people with vitamin B12 deficiency suffer from pernicious anemia, a disease in which red blood cells become very large and immature. 
People with pernicious anemia do not absorb enough vitamin B12 because they lack the intrinsic factor that serves for absorption in the gut.

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