Black Hairy Tongue Syndrome: Case Report and Review of the Literature

Black hairy tongue (BHT) syndrome is a benign condition characterized by dark discoloration and elongation of the tongue's papillae, often due to poor oral hygiene, smoking, certain foods and beverages, and medications. A case study of a 70-year-old woman with BHT highlighted contributing factors such as Sjogren’s syndrome, immune-modifying medication, and dietary habits. Despite treatment with antifungals and antibiotics, her condition persisted, improving only after dietary changes and enhanced oral hygiene. The study emphasizes the need for individualized management, as BHT can significantly impact quality of life, causing symptoms like taste disturbance and weight loss. The literature review identifies common BHT triggers, including antibiotics, malignancies, immunosuppressants, smoking, corticosteroids, autoimmune diseases, antidepressants, radiation therapy, proton pump inhibitors, and alcohol. Effective management typically involves discontinuing these factors and maintaining local hygiene.