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Tongue Pigmentations: Causes And Treatment

"What is that discolored spot on my tongue?" There are a variety of reasons for unusual tongue pigmentation. Whether it's disease or a normal physiological reaction, your dental professional can tell you what is causing the strange coloring on your tongue.

Color Change: Exogenous vs. Endogenous

The surface of the tongue sometimes changes color. This change may occur as a result of outside factors that discolor the surface of the tongue (exogenous pigmenting) or as the by-product of an oral or systemic condition discoloring the tongue from the inside (endogenous pigmenting).

The most common endogenous pigment in the human body is melanin, notes the Journal of Pharmacy and Bioallied Sciences. Melanin is produced by epithelial cells and gives natural color to skin, the inside of the mouth and the tongue. Variations in melanin or the addition of a different cellular pigments, such as carotenoids and hemoglobin, can result in a visible tongue pigmentations, including white, gray, black, red, brown or yellow hues. Here are some of the common discolorations, along with why they generally appear:

  • Black or brown tongue. A brown or black hairy tongue can result from the use of chewing or smoking tobacco. These pigmentations often subside if tobacco use is discontinued. Black spots on the tongue can also occur if a small amount of amalgam (silver) filling material makes contact with the tongue during a filling procedure. This process can create an amalgam tattoo, notes the Journal of Pharmacy and Bioallied Sciences. Other metals, such as graphite, can also cause discoloration if the patient has trace elements in the blood that are viewed through transparent blood vessels.
  • Blue or purple tongue. An increase of blood vessels just below the tongue surface can contribute to the tongue looking blue or purple. The hemoglobin in the blood vessels causes this discoloration. Tongue varicosities are common and appear much like varicose veins in other parts of the body. These are even more common on the underside of the tongue.
  • Bright red tongue. Glossitis may result in a bright red or shiny tongue. Glossitis has many causes and symptoms. Patients who have tongue pain or trauma should seek care from a dental professional to see if treating their condition is necessary.
  • Spotted tongue. Certain conditions in the mouth exist where portions of the small knob-like tongue projections, called papillae, can wear away at an inconsistent rate. Geographic tongue, also called benign migratory glossitis, is a condition where the tongue begins to look spotted due to inconsistent shedding of cells where the tongue starts to appear white and spotted.

Tongue discoloration can also come from a wide range of infections (such as thrush and HIV), disorders (such as endocrine problems and chronic irritation) and even pregnancy.

Treating Tongue Pigmentation

Whatever the cause of your tongue discoloration, your dental professional can help determine the necessary treatment. Proper cleaning of the tongue on a daily basis helps prevent bad breath by removing dead skin cells and harmful bacteria and plaque. You should already be brushing your teeth twice daily. While you're at it, brush your tongue too to improve your oral health and counteract preventable tongue pigmentation.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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