Black Spots on Tongue

Black spots on tongue may be small or medium in size at their beginning, and dark in color. They could cover a large area of your tongue, or just a bit of the surface. They may be on the underside of your tongue or on its tip. Children and adults can both get these tongue spots. Their intensity varies, from lighter to gray to black.

Dark tongue spots may begin from the sides and go toward the center of your tongue. They may be bumpy and raised, or more flat. You could have only one or two spots, since they can be caused by various things, and you may also have some lip discoloration.


It will no doubt alarm you the first time you see black spots on your tongue, but quite often, the cause is not serious. Take time to narrow down the reason for the spots, and then you’ll know whether they’re serious or not, and how to get rid of them. Note any other symptoms you’re experiencing at the same time, to get to the root of the problem.

What do Black Spots on Tongue Look Like?

Black spots may vary in appearance, depending on what caused them. They may be specks or patches, and appear gray, brown or black. They do not usually cause pain or discomfort.

What Causes Black Spots on the Tongue?

Hairy Tongue

This condition may cause almost your entire tongue to become dark or black. Small black spots appear first, often caused by antibiotics, tobacco or alcohol, used in excess. The spots are brought on by a fungus that grows in patches. If you keep using these products, the spots may spread to the whole tongue.

Oral Piercings

If you’ve recently gotten an oral piercing, you may experience black pigmentation around that site. The tongue may have gotten bruised while the piercing was done, or the discoloration could be caused by the metal of the stud that was inserted.

Biting your tongue, having a cut on your tongue or bumping it may cause it to bruise, as well.

Physical Ailments

There are various physical problems that may lead to black spots on tongue. One common cause is oral fibroma or hyper-pigmentation.  This is somewhat like a birthmark on your tongue, and as time passes, it may become more prominent.

Exposure to Medical Chemicals

If your tongue is over-exposed to chemicals like bismuth, they react with the natural acids on your tongue and can cause a temporary blackening of the tongue. Among the most common of chemical sources are chewable Pepto-Bismol tablets.

Oral Cancer

Don’t worry – this is rare. However, in extreme cancer cases, your tongue may blacken due to oral cancer development. It’s an uncommon side effect, so don’t panic and jump to the conclusion that cancer is the cause for your black spots on tongue.

If you have black tongue spots as well as difficulty swallowing or lumps in your mouth, this MAY indicate a growth of cancer, but usually you’ll be dealing with one of the less serious conditions mentioned.

Treating Black Spots on Tongue

Follow your physician’s instructions.

If you recently had oral surgery or had your tongue pierced, this makes the likely cause of your dark pigmentation a bruise. Follow specific instructions of your piercing artist or oral surgeon and keep your mouth very clean, so that you don’t develop an infection.

If your black spots don’t go away, or at least lesson in color, after a week or two, you may want to consult with an ear, nose & throat specialist or your regular physician. They will be able to tell you whether the coloring of your tongue is a symptom of serious mouth damage, or not.

Alter your oral habits.

If you have hairy tongue, the entire mouth must be cleaned, to remove the fungus that causes the discoloration. You also must remove the root cause of this problem, so that the black spots on tongue do not return.

Cut down on drinking, quit smoking and eat a healthy diet, to avoid black tongue symptoms. Otherwise you may deal with ongoing fungal infections of the mouth.

If you have noticed that you’re developing a lot of fungus areas in the mouth, or if they are quickly spreading, consult with your physician to get additional treatment that will help you to get rid of the fungus. Your physician may also have some tips that can be used to clean your mouth and keep it clean.

Change your brushing & flossing routine.

Changing your oral hygiene is an important step to take, when you’re getting rid of those unsightly black spots on your tongue. Brush your teeth twice a day or more. This will aid in the removal of particles in your mouth that will otherwise contribute to the darker pigmentation on your tongue or elsewhere in the mouth.

Brush your tongue gently and use a clean tongue cleaner to help remove any buildup that is making your tongue turn black. Be particularly careful when you brush your tongue, so that you don’t damage it further. You don’t want to bruise the tongue, just get it fully clean. Sanitize your tongue cleaner and toothbrush so that no bacteria will grow on them.

Additional treatments that may help

If you have black spots on your tongue, you may also note difficulty or pain in swallowing or growths within your mouth. Together, these signs could indicate that you’re developing a more serious condition, like oral cancer. This needs more intense treatment. Your physician will help you in determining if you need these intense treatments to help in removing the spots and growths.