Black Spots on Your Tongue: When to Seek Dental Advice

Tongue issues

Hello, doctor.
I have noticed some black spots on my tongue, specifically on the tip, which are distributed over approximately 12 to 13 papillae (it seems like the tips of the papillae have turned black without any protrusion).
This condition has persisted for about two years.
Initially, when I first discovered it, it seemed like a burn, and then it transformed into these black spots (I'm not sure if they are directly related).
I initially thought they would eventually fall off on their own, but they are still there and seem to have increased in number compared to my initial impression.
I would like to know if it is necessary to seek medical attention for this condition.
Thank you.

PL, 20~29 year old female. Ask Date: 2016/07/12

Dr. Zeng Guanghui reply Dentistry

There are black spots on the tip of the tongue that have persisted for two years.
Although there is no protruding sensation, it may be a lesion due to inflammation of the lingual papillae.
It is advisable to consult a dentist or an oral surgeon for further examination.

Reply Date: 2016/07/12

More Info

When it comes to the presence of black spots on your tongue, especially if they have persisted for two years and have increased in number, it is advisable to seek dental or medical advice. While some changes in the coloration of the tongue can be benign, such as those caused by certain foods, smoking, or poor oral hygiene, persistent changes warrant a closer examination.

The black spots you describe could be due to a variety of reasons. One possibility is a condition known as "black hairy tongue," which is characterized by an accumulation of dead cells and bacteria on the tongue's surface, leading to a dark appearance. This condition is often harmless and can be improved with better oral hygiene practices, including regular brushing of the tongue. However, if the spots are associated with pain, discomfort, or changes in taste, it could indicate an underlying issue that needs to be addressed.

Another potential cause could be a benign condition known as "melanotic macules," which are flat, brown to black spots that can occur on the oral mucosa, including the tongue. These are usually harmless but should be monitored for any changes in size, shape, or color. In some cases, they may require a biopsy to rule out more serious conditions.

In your case, since you mentioned that the spots began after what you believe was a burn, it is essential to consider that trauma to the tongue can lead to changes in pigmentation. However, if the spots have not resolved and have increased in number, this could indicate a need for further investigation.

It is also important to consider other factors that could contribute to changes in the tongue's appearance, such as nutritional deficiencies (e.g., vitamin B12, folate, or iron deficiency), oral infections, or even systemic conditions that may manifest in the oral cavity.
Given the duration and progression of your symptoms, I recommend scheduling an appointment with a dentist or an oral health specialist. They can perform a thorough examination, possibly including a visual inspection and diagnostic tests, to determine the exact cause of the black spots. If necessary, they may refer you to a specialist for further evaluation.

In summary, while some changes in the coloration of the tongue can be benign, persistent and increasing black spots should not be ignored. Seeking professional dental advice is the best course of action to ensure that any underlying issues are identified and appropriately managed. Regular dental check-ups are crucial for maintaining oral health and addressing any concerns before they develop into more significant problems.

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