Black Spots on the Tongue: Causes and When to Seek Help

Tongue issues?

Hello Dr.
Lin, I suddenly noticed a small black spot on the side of my tongue while brushing my teeth.
I would like to ask what this could be.
I don't remember having it this morning...
Is it possible for a mole to appear suddenly? Do I need to go to the hospital for any examinations? I'm a bit worried, so I would appreciate your help.
Thank you.
Image: https://ibb.co/fpNZnyY

Ho, 20~29 year old female. Ask Date: 2023/10/03

Dr. Lin Wufu reply Internal Medicine

Hello, it is recommended to see an otolaryngologist to find out what it is! The most common issue might be minor bleeding, which could appear as a bruise if it was accidentally scratched.
However, it's safer to have a doctor confirm it.
You can observe it for another week, and if it doesn't go away, then you should see a doctor.

Reply Date: 2023/10/03

More Info

Hello! Thank you for reaching out with your concern regarding the sudden appearance of a black spot on your tongue. It's understandable to feel worried when you notice something unusual about your body, especially in such a visible area. Let's explore the potential causes of this phenomenon and when it might be necessary to seek medical attention.

Firstly, the appearance of a black spot on the tongue can be attributed to several benign conditions. One common cause is black hairy tongue (lingua villosa), which occurs when the filiform papillae on the tongue become elongated and discolored, often due to poor oral hygiene, smoking, or certain medications. This condition is generally harmless and can be improved with better oral care.

Another possibility is melanotic macules, which are small, flat, brown or black spots that can appear on the mucous membranes, including the tongue. These spots are usually benign and can occur due to various factors, including genetics or sun exposure. They are not typically a cause for concern unless they change in size, shape, or color.

Additionally, oral thrush (a fungal infection) can sometimes lead to dark spots or patches on the tongue, although this is usually accompanied by other symptoms such as discomfort or a white coating.
In some cases, the black spot could be a result of trauma or irritation, such as biting your tongue or irritation from dental appliances. If you have recently experienced any injury to your mouth, this could explain the sudden appearance of the spot.

However, while many causes of black spots on the tongue are benign, there are also some conditions that warrant further investigation. For instance, oral melanoma, although rare, is a serious condition that can present as a dark spot in the mouth. If the spot is irregular in shape, has an uneven color, or is accompanied by other symptoms such as pain or bleeding, it is crucial to seek medical attention promptly.

Given your description of the sudden appearance of the spot without prior notice, it would be wise to monitor it closely. If the spot persists for more than a couple of weeks, changes in appearance, or if you experience any discomfort, it would be advisable to consult a healthcare professional, preferably an oral surgeon or a dentist. They can perform a thorough examination and, if necessary, conduct a biopsy to rule out any serious conditions.

In summary, while many causes of a black spot on the tongue are benign and related to lifestyle factors, it is essential to remain vigilant. If you have any concerns or if the spot does not resolve, do not hesitate to seek medical advice. Regular dental check-ups can also help catch any oral health issues early on. Thank you for your question, and I hope this information helps alleviate some of your concerns!

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