Hairy Tongue, Bumpy Tongue

Question:

I have been diagnosed with hairy tongue (long term antibiotic use) by both my dentist and regular doctor. Until recently, it didn`t bother me, it only looked strange. Now, my tongue feels bumpy when it rubs the roof of my mouth and the affected area appears bumpy as well. Its not white, just bumpy under the "hairy" area. The dentist said it was fine, that it would go away but I`m still nervous since I can feel it. Today I woke up with a sore throat, could it just be a virus on top of the hairy tongue? Thank you.

Answer:

This is probably normal, but since I can only go on your written self-report, I am limited on giving you a more definitive answer.

As you know by now “Hairy tongue” or Black Hairy tongue” is the result of the filiform papilla that covers the dorsal aspect of the tongue, becoming elongated. The papilla are normally small finger-like projections that are somewhat uniform in length. Under certain conditions, these keratinized epithelial projections become elongated (generally as a result of antibiotic usage, or smoking or loss of salivary flow) and the loss of normal sloughing occurs. The build up of keratin results in the elongation of this specialized mucosal covering of the tongue and the “hairy “appearance results.

The discoloration is related to the filiform projections acting as a scaffold for bacteria and yeasts to adhere. Some of these microbes have the ability to produce pigmentation (also referred to as chromatogenic bacteria) and the black/brown discoloration occurs.

Now, in response to your concerns about the rough bumps that were underneath the initial problem; these may be nothing more than fungiform papilla, another normal anatomic feature of the dorsum of the tongue. You probably notice them more because the previous covering acted as a blanket for the normal papilla. They may appear to be more reddened and very pebbly, but that may be the result of irritation and/or treatment to get rid of the hairy filiform papilla.

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