ISSN 0975-8437 INTERNATIONAL JOURNAL OF DENTAL CLINICS 2011:3(3):75-76

CASE REPORT

Hairy Tongue (Linguavillosa Nigra): A Case Report

Sumanth.M.Shetty, Rashmi Shetty
Abstract
Hairy tongue or black tongue is a benign condition characterized by hypertrophy of the filiform
papillae that give the dorsum of the tongue a furry appearance. The color of the elongated papillae varies from
yellowish white to brown. This paper reports a black hairy tongue in a 5 year old child.
Key Words: Hairy Tongue; Linguavillosa Nigra
Received on: 13/08/2010 Accepted on: 13/11/2010

Introduction
Black hairy tongue, also known as
Linguavillosa Nigra, is a painless, benign disorder
caused by defective desquamation and reactive
hypertrophy of the filiform papillae of the tongue.
The hairy appearance is due to elongation of
keratinized filiform papillae, which may have
different colors, varying from white to yellowish
brown to black depending on extrinsic factors (eg,
tobacco, coffee, tea, food) and intrinsic factors (ie,
chromogenic organisms in normal flora).(1,2)
Hairy tongue, was first described by Lusitanus in
1557.(3,4) It is also known as lingua villosa nigra, Discussion
hyperkeratosis of the tongue, nigrities linguae, Black hairy tongue is characterized by an
keratomycosis linguae, and melanotrichia abnormal coating of the dorsal surface of the
linguae.(1,4) The etiology of this condition is tongue.(5) Although the cause is unknown, several
unknown and the common predisposing factors precipitating factors may be implicated in the
were the side effects of certain drugs i.e., a broad- pathogenesis of this disorder, including the
spectrum antibiotic such as erythromycin or use of administration of topical or systemic antibiotics,
the antipsychotic drug olanzapine etc. This paper poor oral hygiene, smoking, alcohol and the use of
reports a black hairy tongue in a 5 year old child. mouth washes.(6) Often there are no symptoms
Case Report other than the aesthetic or anxiety over its etiology.
A 5 year old male child patient was Some patients complain of gagging, nausea,
reported to the Department of Pedodontics and alteration of taste or halitosis.(1) Hairy tongue is a
Preventive dentistry with a chief complaint bad benign condition of the tongue which affects both
breath. The medical history was noncontributory. sexes but more often males than females. The
Intraoral examination shows poor oral hygiene prevalence is about 0.5% of the population(4) but
with generalized stains on the teeth and a black varies widely from 8.3% in children and young
coloration of the tongue that appears as an adults to 57% in drug addicts and prisoners.(7)
elongation of the filiform papillae on the dorsal Hairy tongue is localized on the anterior two thirds
surface, with no other abnormalities (Figure 1). of the dorsal tongue rarely; black hairy tongue can
The physical examination was otherwise normal. be unilateral.(7)
The diagnosis is based on filiform papillae that are The prognosis of hairy tongue is excellent.
elongated more than 3 mm on the dorsal surface of The precipitating factors (mainly smoking and
the tongue. Culture of the dorsal surface of the coffee) have to be suppressed. The patient will
tongue shows no bacterial or fungal overgrowth. have to improve their oral hygiene with a soft tooth
Oral prophylaxis was done and stains and calculus brush which is enhanced by the prior application of
were removed. A simple treatment consisting of a 40% solution of urea, scraping, topical
brushing the tongue daily with a soft toothbrush triamcinolone acetonide, gentian violet, thymol,
was advised for the management of hairy tongue. salicylic acid, vitamin B complex, and surgical
Child and parents were educated on correct oral excision of the papillae.(5, 6) or topical application
hygiene and the fact that black hairy tongue is of solution of 0.1% tretinoïn can be applied daily
completely harmless. and rinsed after five minutes. (6)

©INTERNATIONAL JOURNAL OF DENTAL CLINICS VOLUME 3 ISSUE 3 JULY- SEPTEMBER 2011 75

ISSN 0975-8437 INTERNATIONAL JOURNAL OF DENTAL CLINICS 2011:3(3):75-76

In the cases where there is an overgrowth 2. Tamam L, Annagur BB. Black hairy tongue
of candida albica, oral and topical anti-candidiasis associated with olanzapine treatment: a case report.
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if not associated with brushing of the tongue. The 2006;73(6):891-4.
3. Lawoyin D, Brown R. Drug-induced black hairy
only indication of such treatment is when tongue: diagnosis and management challenges. Dent
overgrowth of candida albica is responsible of a Today. 2008;27(1):62-3.
glossopyrosis. In rare cases, surgical removal of the 4. Waggoner W, Volpe A. lingua villosa nigra--a
papillae scissors, electrodessication, carbon dioxide review of black hairy tongue. J Oral Med.
laser) may need to be performed.(2, 5, 7) In our 1967;22(1):18-21.
case the child and parents were motivated to 5. Heymann W. Psychotropic agent-induced black
improve the oral hygiene and the outcome was hairy tongue. Cutis. 2000;66(1):25-6.
successful. 6. Langtry J, Carr M, Steele M, Ive F. Topical
tretinoin: a new treatment for black hairy tongue
Conclusion
(lingua villosa nigra). Clinical and experimental
In conclusion, even though there were no dermatology. 1992;17(3):163-4.
symptoms other than the aesthetic or anxiety over 7. Newman CC, Wagner RF. Images in clinical
its etiology, the black hairy tongue should be medicine. Black hairy tongue. The New England
managed with patient education and proper oral journal of medicine. 1997;337(13):897.
hygiene instructions to improve the patients overall Address for Correspondence
well-being . Dr. Sumanth.M.Shetty, MDS,
Authors Affiliations: 1. Dr. Sumanth. M. Shetty, MDS, Associate Professor,
Associate Professor, Department of Pedodontics, 2. Dr. Department of Pedodontics,
Rashmi Shetty, MDS, Dept. of Conservative Dentistry New Horizon Dental College,
and Endodontics, New Horizon dental college, Bilaspur, Bilaspur, Chhattisgarh, India.
Chattisgarh, India. Ph.+0091.9886644249
References E mail: [email protected]
1. Vano-Galvan S, Jaen P. Black hairy tongue.
Cleveland Clinic Journal of Medicine.
2008;75(12):847-8.

Source of Support: Nil, Conflict of Interest: None Declared

©INTERNATIONAL JOURNAL OF DENTAL CLINICS VOLUME 3 ISSUE 3 JULY- SEPTEMBER 2011 76