causes of black pigmentation on tongue
Once the damaged tissue heals, the discoloration might fade away by itself. According to Mayo Clinic, when your papillae grow longer instead of shedding, a black tongue can appear. 
Such color changes are often attributed to the deposition, production, or increased accumulation of various endogenous or exogenous pigmented substances. Nonetheless, it is advised that all oral nevi, regardless of histologic type, should be completely removed.31. Human Immunodeficiency Virus (HIV) Infection, multisystem inflammatory syndrome in children (MIS-C), ENDUR-ACIN, ENDUR-AMIDE, Niacor, Niaspan, NiaVasc, Nicomide-T, Slo-Niacin. To be considered for publication, submissions must meet these guidelines. WebExamples of color changes in the mouth include the following: The mouth may have dark blue or black areas due to silver amalgam from a dental filling, graphite from falling with a pencil in the mouth, or a mole. WebA small blue-black discoloration on the underside of the tongue may be a tattoo caused by a fragment of dental amalgam filling material, which contains silver, becoming stuck in the
Figure 56 Melanoacanthoma. Recently, two noninvasive tests, which were originally developed to study cutaneous pigmentation, have been applied to evaluate oral melanosis. These papillae begin to trap food remnants and bacteria, Normally, papillae are pinkish or white, but food, beverages, bacteria, and yeast causes them to change color. Laser and intense pulse light therapies have been used successfully for the treatment of cutaneous nevi.32 However, their value in the treatment of oral nevi is unknown. Clinically presentation of melanotic macules are typically a brown, black, blue or grey area that is well circumscribed, lesions are usually less than 10mm in diameter but can be larger in some cases. Thus, surgical intervention may be necessary. To stage oral melanoma, the TNM clinical staging system is used. Anemia develops, causing paleness, weakness, fatigue, and, if severe, shortness read more . The differential diagnosis includes melanocytic nevus, malignant melanoma, amalgam tattoo, and focal ecchymosis. These lifestyle tweaks can be the deciding factor of getting rid of your black tongue. You might also need to see your dentist. Table 53 lists additional lesions that may be associated with oral mucosal discoloration. No further treatment is indicated. You may be wondering, "why is my tongue black?" Pigmented fungiform papillae of the tongue is a benign oral pigmentation variant that occurs most often in individuals with darker skin tones. It's important to make note of the other symptoms you are experiencing along with the black spots on the tongue to help narrow down the cause of your ailment. 
Unlike the cutaneous variant, which has distinct and wellrecognized risk factors associated with its development, the etiology of oral melanoma remains unknown. Diabetes is another potential cause of a black tongue. Melanin is then transferred to keratinocytes in melanosomes. In rare cases, multifocal lesions have been described. Chromogenic bacteria can produce discoloration of the dorsal tongue. It may cause embarrassment or discomfort for some, particularly when smiling or talking. How to Deal With Those Annoying Sunspots on Your Skin, Pain in the Roof of Mouth: Causes and Treatments, Pain After Whitening Teeth: Causes, Treatment and Prevention, Toothache and Jaw Pain: Causes and Best Ways to Help, Tips on Soothing Swollen Gum Around Those Wisdom Teeth, What Causes Bumps to Appear in Your Mouth? Microscopically, oral melanoacanthomas are characterized by a proliferation of benign, dendritic melanocytes throughout the full thickness of an acanthotic and spongiotic epithelium (Figure 57).14 A mild lymphocytic infiltrate with exocytosis is also characteristic. [26], Many different diseases can cause melanin pigmented lesions in the mouth through, Melanin is an endogenous pigment synthesized by melanocytes that are located in the basal layer of epithelium. These junctional nevi are usually small (<5 mm), macular, and tan to brown in color. Source: Courtesy of Dr. Christine Chu, private practice, New York, USA. Sometimes, avoiding these things or making changes might not help the black tongue go away. Microscopically, physiologic pigmentation is characterized by the presence of increased amounts of melanin within the basal cell layer. Melanocytic nevi include a diverse group of clinically and/or microscopically distinct lesions.18 Unlike ephelides and melanotic macules, which result from an increase in melanin pigment synthesis, nevi arise as a consequence of melanocytic growth and proliferation.11 In the oral cavity, the intramucosal nevus is most frequently observed, followed by the common blue nevus.19 Compound nevi are less common, and the junctional nevus and combined nevus (a nevus composed of two different cell types) are infrequently identified. Cutaneous melanoacanthoma represents a pigmented variant of seborrheic keratosis and typically occurs in older Caucasian patients. Oral melanocytic pigmentation in Caucasians is almost always considered pathologic in origin, although the pathology or pigment itself may be of no clinical significance. Cryotherapy damages the tissue by freezing its internal components thereby jeopardising the cells' optimum temperature; leading to denaturation of enzymes and proteins required for cell function. Several reasons can cause a black spot on the side of the tongue. Patients with Peutz-Jeghers syndrome have a much higher risk of developing intestinal cancers. People may be weak, short of breath read more or by pernicious anemia, which is caused by a deficiency of vitamin B12 Vitamin B12 Deficiency Vitamin B12 deficiency can occur in vegans who do not take supplements or as a result of an absorption disorder. "Black tongue" is a blanket term for the protein known as keratin building up. However, lasers allow for controlled cutting with a limited depth of necrosis. This stands for 'Tumor Nodes Metastasis'. If you've recently looked in the mirror and found a strange-colored substance covering your tongue, don't panic! Other areas, appearing white or yellow and rough, may resemble psoriasis Psoriasis Psoriasis is a chronic, recurring disease that causes one or more raised, red patches that have silvery scales and a distinct border between the patch and normal skin. Sometimes it can take some trial and error to figure out what works best in getting rid of it. Microscopic findings such as surface ulceration, vascular or lymphatic invasion, neurotropism, high mitotic index, and absence of lymphocytes infiltrating the tumor are all associated with a poor prognosis.6 Additionally, various clinical parameters, including tumor site, age of the patient (>60 years), sex (male), and regional or distant metastasis, also are predictive of poor prognosis. WebCauses of Black Spots on the Tongue. Generalized patchy hyperpigmentation of tongue and oral mucosa, Lingua villosa nigra (black hairy tongue), Elongated filiform papillae and yellow to brown discoloration of tongue surface, Hyperpigmented mucocutaneous macules that are flat and blue-gray to brown; typically on the vermilion border of the lips; around the nostrils; and on fingers, toes, and the perianal area, Pigmented fungiform papillae of the tongue, Pink, red, or dark hyperpigmented spots, typically on the anterior and lateral aspects of the tongue, Primary adrenal insufficiency (Addison disease), Generalized, patchy hyperpigmentation of the inner surface of lips and buccal mucosa, tongue, and gingival border; bronze diffuse hyperpigmentation and darkening of skin may occur over areas exposed to light, chronic friction, or pressure. Black tongue is often related to poor dental hygiene, but there are also other risk factors including: Drinking a lot of coffee or tea Tobacco use Excessive alcohol If you have a black tongue, then you could have a fungus called Aspergillus niger growing on the surface of your tongue. If you have too much bacteria growing in your mouth, it could cause your tongue to appear black and hairy, according to the Mayo Clinic. [17], Smoker's Melanosis, benign melanocytic pigmentation of the oral mucosa,[18][19] most commonly seen in the lower labial gingiva and interdental papillae[19] of smokers. [1] Management of such lesions is typically by close clinical monitoring, photographs and measuring tools. Surgical resection[37] is most commonly carried out. However, the adverse effects associated with BRAF and MEK inhibitors are extensive, ranging from inflammatory to malignant conditions. Your doctor can perform a biopsy to make a diagnosis. [9] Due to this, dark pigmentation may be visible on the oral mucosa or skin. The average Caucasian adult may have several nevi; some individuals may have dozens. The hyperpigmented spots are due to the melanin deposition in the tips of the fungiform papillae and appear around 20 to 30 years of age.4,6. It is composed of eumelanin, a brownblack pigment, and pheomelanin, a pigment of redyellow color.4 The term melanosis is used to describe diffuse hyperpigmentation. 
It highlights the three stages: stage I is a primary tumor; stage II is a metastatic tumor which has spread to regional lymph nodes and; stage III is a metastatic tumor which has spread to distant sites. Melanin is synthesized within specialized structures known as melanosomes. A biopsy is always warranted to confirm the diagnosis, but once rendered, no further treatment is required. Oral pigmentation is found in the following places: Oral pigmentation affects about 3% of the population[4] and is most likely seen in those with dark skin;[5] however people with light skin have, on average, 30 local pigmented areas and in some circumstances will present intra-orally. This technique has been successfully used for the evaluation of selected oral pigmented lesions.7 The second, reflectance confocal microscopy (RCM), allows the in vivo microscopic visualization of the skin and mucosa, which provides highresolution horizontal views with an approximate depth of 200300 m.8 This procedure can assist in the diagnosis and management of benign and malignant pigmented lesions of the lips.9 Because prospective and controlled studies detailing the predictive value and efficacy of dermoscopy and RCM for the diagnosis of oral pigmented lesions have not been performed, the practitioner should be wary of their use in common clinical dental practice.