(Black) Hairy Tongue |
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Long brown/black "hairs" cover the posterior tongue. |
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Quick Review |
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Hairy tongue, or black hairy tongue (brown, yellow, green, etc. hairy tongue) is a benign change of the top surface of the tongue. It is characterized by elongation of the many small nodules (filiform papillae) of the surface to that they resemble stubby hairs. They can become stained, usually black from coffee, tea, cokes or colored bacteria. Cause is unknown but it is usually seen during antibiotic use, in smokers, in persons using stomach antacids, or in hospitalized or debilitated patients. Usually it is asymptomatic but may produce bad breath and may cause a burning sensation. Treatment is to scrape the tongue. It may recur. |
Introduction
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References (Chronologic Order)
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General references:
Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and maxillofacial pathology. Philadelphia, W. B. Saunders; 1995.
Elder D, Elenitsas R, Jaworsky C, Johnson B Jr. Lever's Histopathology of the skin, 8th edition. Philadelphia; Lippincott-Raven, 1997.
Sapp JP, Eversole LR, Wysocki GP. Contemporary oral and maxillofacial pathology. Mosby; St. Louis, 1997.
Odell EW, Morgan PR. Biopsy pathology of the oral tissues. London; Chapman & hall Medical, 1998.
Specific references:
S
Table 1: Gender-specific prevalence rates per 1,000 population for selected oral masses and surface alterations in U.S. adults, ranked by total frequency. Modified from Bouquot JE. Common oral lesions found during a mass screening examination. J Am Dent Assoc 1986; 112:50-57, and Bouquot JE, Gundlach KKH. Oral exophytic lesions in 23,616 white Americans over 35 years of age. Oral Surg Oral Med Oral Pathol 1986; 62:284-291.
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Diagnosis |
Number of lesions per 1,000 population* |
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Males |
Females |
Total |
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Leukoplakia |
43.2 |
20.9 |
28.9 |
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Torus palatinus |
13/2 |
21.7 |
18.7 |
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Irritation fibroma |
13.0 |
11.4 |
12.0 |
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Fordyce granules |
17.7 |
5.2 |
9.7 |
| Torus mandibularis | 9.6 | 7.9 | 8.5 |
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Hemangioma |
8.4 |
4.1 |
5.5 |
| Erythema, inflammatory | 4.5 | 4.8 | 4.7 |
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Papilloma |
5.3 |
4.2 |
4.6 |
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Epulis fissuratum |
3.5 |
4.4 |
4.1 |
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Varicosities, lingual |
3.5 |
3.4 |
3.5 |
| Fissured tongue | 3.5 | 3.1 | 3.2 |
| Benign migratory glossitis | 3.4 | 3.0 | 3.1 |
| Aphthous ulcer | 3.3 | 3.0 | 3.1 |
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Papillary hyperplasia |
1.7 |
3.8 |
3.0 |
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Mucocele |
1.9 |
2.6 |
2.5 |
| Herpes labialis (herpes simplex) | 2.4 | 2.6 | 2.5 |
| Traumatic ulcer | 2.1 | 2.1 | 2.1 |
| Angular cheilitis | 1.8 | 1.9 | 1.9 |
| Smokeless tobacco keratosis | 4.3 | 0.2 | 1.7 |
| Hematoma or ecchymosis | 2.0 | 1.4 | 1.6 |
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Enlarged lingual tonsil |
2.4 |
1.2 |
1.6 |
| Chronic cheek bite | 0.7 | 1.4 | 1.2 |
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Lichen planus |
1.2 |
1.1 |
1.1 |
| Squamous cell carcinoma | 2.5 | 0.1 | 0.9 |
| Amalgam tattoo | 0.6 | 1.0 | 0.9 |
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Buccal exostosis |
0.9 |
0.9 |
0.9 |
| Leaf-shaped fibroma | 0.4 | 1.2 | 0.9 |
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Median rhomboid glossitis |
0.8 |
0.5 |
0.6 |
| Hairy tongue | 1.2 | 0.3 | 0.6 |
| Nicotine palatinus | 1.2 | 0.2 | 0.6 |
| Atrophic glossitis (smooth tongue) | 0.6 | 0.5 | 0.6 |
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Epidermoid cyst |
0.7 |
0.4 |
0.5 |
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Oral melanotic macule |
0.5 |
0.3 |
0.4 |
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Oral tonsils (except lingual) |
0.5 |
0.3 |
0.4 |
| Leukoedema | 0.4 | 0.3 | 0.3 |
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Lipoma |
0.2 |
0.1 |
0.2 |
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Non-lingual oral tonsils |
0.2 |
0.1 |
0.2 |
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Ranula |
0.2 |
0.1 |
0.2 |
| Gingival hyperplasia | 0.1 | 0.1 | 0.1 |
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Buccinator node, hyperplastic |
0.1 |
0.1 |
0.1 |
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Pyogenic granuloma |
0.0 |
0.07 |
0.04 |
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Nasoalveolar cyst |
0.0 |
0.07 |
0.04 |
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Neurofibroma |
0.0 |
0.07 |
0.04 |
* total examined population = 23,616 adults over 35 years of age
