Black Spots on Tongue: Causes & Treatment Options

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The spots, patches and discolouration that sometimes develop on tongues may be harmless, but occasionally they're a sign of something serious. Black spots on the tongue could range from tiny dots to conspicuous dark areas, which look especially alarming. If you notice black spots, tell a dentist or physician about them and get a proper diagnosis.

Natural Appearance of Your Tongue

Though it may be the first time you notice black spots on your tongue, they could be part of your tongue's natural appearance. The human tongue is a muscle covered in taste buds. It moves food around the mouth as you chew, and the taste buds send the brain signals about flavour. Taste buds are visible to the human eye; they can stand out and look like dark spots when red wine or coffee stains them.

Alternatively, black spots on the tongue could signal a condition called hyperpigmentation, according to a case study published by the Journal of Community Hospital Internal Medicine Perspectives. Pigmentation is what gives skin, hair and eyes their colour, and excessive concentrations of pigment in the tongue can result in harmless dark patches or spots, sometimes as a result of chemotherapy. In the case of hyperpigmentation and chemotherapy, the black spots usually clear up a few weeks after the treatment stops.

Injury and your Tongue

Oral piercings and tongue injuries may result in black spots. MedlinePlus explains that damage to the tongue can leave a sore. If you got an oral piercing recently or have bitten, cut or otherwise injured your tongue, a black spot could be a lingering sign of injury.

Chemical Exposure to your Tongue

Certain chemicals react with acids on the surface of the tongue and turn it black. Exposure to the chemical bismuth (an ingredient in some medications) may cause the colour change, notes the Mayo Clinic. Though it's often the entire tongue that turns black, the change could initially occur in patches. Once you stop taking bismuth, your tongue should return to its normal pink hue.

Tongue Cancer

In rare cases, dark patches on the tongue are a sign of a serious condition like cancer. The dark spots may also appear as scabs or sores that don't heal. Other signs of tongue cancer include lumps, swelling and problems with swallowing. If you have any of these symptoms, see a doctor immediately. Though tongue cancer is a serious disease, treatment is most effective when it begins in the early stages.

If the spots are grey, they could indicate a medical condition called leukoplakia, which is sometimes precancerous.

Treating Black Spots on the Tongue

The first step in trying to remove black spots on the tongue is improving oral hygiene. Brush your tongue when you brush your teeth.

If the spots disappear after brushing, they may not need any further treatment. However, if the spots remain, go see your dentist for a check-up. He or she can determine the cause and appropriate treatment.

Black spots on the tongue can be worrying. Though the spots, marks or patches are harmless in some cases, only a dentist or physician can make an accurate diagnosis of their cause. Book an appointment if you have black spots that don't go away or are accompanied by other symptoms like lumps or swelling.


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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