Say Ahh…
4. A 60-year-old man, smelling of alcohol and tobacco, complained of a black discoloration of his tongue and occasional gagging sensation. He smoked one to 2 packs of cigarettes and drank 6 to 8 beers daily. On physical exam, his teeth were stained and his tongue shows elongated papillae with brown discoloration.
Diagnosis: This patient had a black hairy tongue (BHT), poor oral hygiene, and tobacco and alcohol addiction. BHT is a benign disorder of the tongue characterized by abnormally hypertrophied and elongated filiform papillae on the surface of the tongue. In addition, there is defective desquamation of the papillae on the dorsal tongue, resulting in a hair-like appearance. These papillae, which are normally about 1 mm in length, may become as long as 12 mm. The elongated filiform papillae can then collect debris, bacteria, fungus, or other foreign materials.
For more information, read “Discoloration of the tongue.” J Fam Pract. 2014.
