Table of ContentsView AllTable of ContentsCausesConcerning SymptomsTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Causes
Concerning Symptoms
Treatment
Frequently Asked Questions
If your child has ablack tongue, you might be worried that something is really wrong. While it can be frightening, it’s usually harmless and easy to explain. Still, you should know certain warning signs to look for.
This article will go over what can cause black tongue in children, when you should get medical care for it, and how to get rid of it if it doesn’t go away on its own.
KidStock / Blend Images / Getty Images
Anatomy of Your Tongue
Causes of a Black Tongue in Children
Some causes of a black tongue in children are medical, while others aren’t. Non-medical causes include:
Among medical causes, they can either be related to illnesses or medications. Some illnesses that can cause a black tongue are:
Possible BirthmarkSome children are born with a black tongue. It’s considered a birthmark and is called pigmented nevus.
Possible Birthmark
Some children are born with a black tongue. It’s considered a birthmark and is called pigmented nevus.
Pepto-Bismol
The most common cause of a black tongue in kids is the popular over-the-counter (OTC) medicationPepto-Bismol. This drug is used to treat:
Pepto-Bismol contains an ingredient calledbismuth subsalicylate. When bismuth mixes with sulfur (a natural component of saliva) it forms bismuth sulfide. This substance can make your tongue look black.
This discoloration typically goes away on its own a few days after you stop taking the medication.
Bismuth and Reye’s Syndrome in Kids
Kids under 12 shouldn’t take Pepto-Bismol or other drugs containing bismuth subsalicylate.The ingredient has been linked to a condition calledReye’s syndromein kids.
Reye’s syndrome is a serious—and potentially fatal—illness. It causes:
Symptoms include:
This illness usually comes on soon after a viral illness. If you see these symptoms in your child when they’re recovering from something, get medical treatment right away.
Other Salicylate-Containing DrugsThese medications also can cause Reye’s syndrome. Ask your healthcare provider before giving them to a child.KaopectateAspirinOil of wintergreen
Other Salicylate-Containing Drugs
These medications also can cause Reye’s syndrome. Ask your healthcare provider before giving them to a child.KaopectateAspirinOil of wintergreen
These medications also can cause Reye’s syndrome. Ask your healthcare provider before giving them to a child.
Pepto-Bismol and Children
Due to the risk of Reye’s syndrome, regular Pepto-Bismol isn’t approved or recommended for kids under 12. Alternate medications are used for treating digestive problems andH. pyloriinfections in children.
With its distinctive pink color and minty flavor, some children decide to drink Pepto-Bismol. If your child has a black tongue and you don’t know why, it may be wise to ask them if they’ve drunk Pepto-Bismol or check to see if some is missing from the bottle.
Also, watch fordark stool(poop). Bismuth causes that when it mixes with sulfur in the intestines.
Be sure to keep Pepto-Bismol and all other medicines where children can’t get to them.
Adult Causes of a Black TongueIn adults, causes of a black tongue include smoking,cancer,side effects of chemotherapy, or bleeding. These causes are rare in children.
Adult Causes of a Black Tongue
In adults, causes of a black tongue include smoking,cancer,side effects of chemotherapy, or bleeding. These causes are rare in children.
What Causes Tongue Infections?
When to Call a Healthcare Provider
Usually, most causes of black tongue are harmless, and the only concern is how it looks.However, watch for warning signs of a medical condition, including:
Get urgent medical care if your child has a black tongue plus:
Call your healthcare provider if you notice any of these symptoms along with a black tongue.
Why Is My Tongue White?
Treatment for a Black Tongue
An Overview of Tongue Diseases
Summary
A black tongue is usually harmless. If your child eats or drinks something with a dark color (such as candy or berries), it might make their tongue black for a short time.
Yes. The Pepto-Bismol that’s made for adults can turn your tongue black.The children’s version of Pepto should not turn your tongue black because it does not contain bismuth, the ingredient that causes the discoloration.
Yes. The Pepto-Bismol that’s made for adults can turn your tongue black.
The children’s version of Pepto should not turn your tongue black because it does not contain bismuth, the ingredient that causes the discoloration.
That depends on what is causing it. If it’s from a medication, the color should go away within days of when they stop taking it.
A severe niacin (vitamin B3) deficiency can cause a condition often referred to as Black Tongue, also calledpellagra. It’s uncommon due to the modern diet’s niacin content.Learn MoreNiacin: Uses, Benefits, Side Effects
A severe niacin (vitamin B3) deficiency can cause a condition often referred to as Black Tongue, also calledpellagra. It’s uncommon due to the modern diet’s niacin content.
Learn MoreNiacin: Uses, Benefits, Side Effects
What is Geographic Tongue?
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Madhushankari GS, Yamunadevi A, Selvamani M, Mohan Kumar KP, Basandi PS.Halitosis—an overview: Part-I—classification, etiology, and pathophysiology of halitosis.J Pharm Bioallied Sci. 2015;7(Suppl 2):S339–S343. doi:10.4103/0975-7406.163441Owczarek-Drabińska JE, Radwan-Oczko M.A case of lingua villosa nigra (black hairy tongue) in a 3-month-old infant.Am J Case Rep. 2020;21:e926362. doi:10.12659/AJCR.926362Goldman RD.Bismuth salicylate for diarrhea in children.Can Fam Physician. 2013;59(8):843–844.Pacifico L, Osborn JF, Anania C, Vaira D, Olivero E, Chiesa C.Review article: bismuth-based therapy forHelicobacter pylorieradication in children.Aliment Pharmacol Ther.2012;35(9):1010-1026. doi:10.1111/j.1365-2036.2012.05055.xNational Institute of Neurological Disorders and Stroke.Reye’s syndrome.National Library of Medicine: MedlinePlus.Bismuth subsalicylate.National Library of Medicine: MedlinePlus.Methyl salicylate overdose.National Library of Medicine: DailyMed.Pepto Kids—calcium carbonate tablet, chewable.Cecchi C, Mariniello A, Carnio S, Delcuratolo MD, Novello S.Black hairy tongue after immune checkpoint inhibitors in NSCLC: a case report and review of the literature.Clin Lung Cancer.2021:S1525-7304(21)00062-0. doi:10.1016/j.cllc.2021.03.008Gurvits GE, Tan A.Black hairy tongue syndrome.World J Gastroenterol.2014;20(31):10845-50. doi:10.3748/wjg.v20.i31.10845Harvard University T.H. Chan School of Public Health.Niacin - Vitamin B3.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Madhushankari GS, Yamunadevi A, Selvamani M, Mohan Kumar KP, Basandi PS.Halitosis—an overview: Part-I—classification, etiology, and pathophysiology of halitosis.J Pharm Bioallied Sci. 2015;7(Suppl 2):S339–S343. doi:10.4103/0975-7406.163441Owczarek-Drabińska JE, Radwan-Oczko M.A case of lingua villosa nigra (black hairy tongue) in a 3-month-old infant.Am J Case Rep. 2020;21:e926362. doi:10.12659/AJCR.926362Goldman RD.Bismuth salicylate for diarrhea in children.Can Fam Physician. 2013;59(8):843–844.Pacifico L, Osborn JF, Anania C, Vaira D, Olivero E, Chiesa C.Review article: bismuth-based therapy forHelicobacter pylorieradication in children.Aliment Pharmacol Ther.2012;35(9):1010-1026. doi:10.1111/j.1365-2036.2012.05055.xNational Institute of Neurological Disorders and Stroke.Reye’s syndrome.National Library of Medicine: MedlinePlus.Bismuth subsalicylate.National Library of Medicine: MedlinePlus.Methyl salicylate overdose.National Library of Medicine: DailyMed.Pepto Kids—calcium carbonate tablet, chewable.Cecchi C, Mariniello A, Carnio S, Delcuratolo MD, Novello S.Black hairy tongue after immune checkpoint inhibitors in NSCLC: a case report and review of the literature.Clin Lung Cancer.2021:S1525-7304(21)00062-0. doi:10.1016/j.cllc.2021.03.008Gurvits GE, Tan A.Black hairy tongue syndrome.World J Gastroenterol.2014;20(31):10845-50. doi:10.3748/wjg.v20.i31.10845Harvard University T.H. Chan School of Public Health.Niacin - Vitamin B3.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Madhushankari GS, Yamunadevi A, Selvamani M, Mohan Kumar KP, Basandi PS.Halitosis—an overview: Part-I—classification, etiology, and pathophysiology of halitosis.J Pharm Bioallied Sci. 2015;7(Suppl 2):S339–S343. doi:10.4103/0975-7406.163441Owczarek-Drabińska JE, Radwan-Oczko M.A case of lingua villosa nigra (black hairy tongue) in a 3-month-old infant.Am J Case Rep. 2020;21:e926362. doi:10.12659/AJCR.926362Goldman RD.Bismuth salicylate for diarrhea in children.Can Fam Physician. 2013;59(8):843–844.Pacifico L, Osborn JF, Anania C, Vaira D, Olivero E, Chiesa C.Review article: bismuth-based therapy forHelicobacter pylorieradication in children.Aliment Pharmacol Ther.2012;35(9):1010-1026. doi:10.1111/j.1365-2036.2012.05055.xNational Institute of Neurological Disorders and Stroke.Reye’s syndrome.National Library of Medicine: MedlinePlus.Bismuth subsalicylate.National Library of Medicine: MedlinePlus.Methyl salicylate overdose.National Library of Medicine: DailyMed.Pepto Kids—calcium carbonate tablet, chewable.Cecchi C, Mariniello A, Carnio S, Delcuratolo MD, Novello S.Black hairy tongue after immune checkpoint inhibitors in NSCLC: a case report and review of the literature.Clin Lung Cancer.2021:S1525-7304(21)00062-0. doi:10.1016/j.cllc.2021.03.008Gurvits GE, Tan A.Black hairy tongue syndrome.World J Gastroenterol.2014;20(31):10845-50. doi:10.3748/wjg.v20.i31.10845Harvard University T.H. Chan School of Public Health.Niacin - Vitamin B3.
Madhushankari GS, Yamunadevi A, Selvamani M, Mohan Kumar KP, Basandi PS.Halitosis—an overview: Part-I—classification, etiology, and pathophysiology of halitosis.J Pharm Bioallied Sci. 2015;7(Suppl 2):S339–S343. doi:10.4103/0975-7406.163441
Owczarek-Drabińska JE, Radwan-Oczko M.A case of lingua villosa nigra (black hairy tongue) in a 3-month-old infant.Am J Case Rep. 2020;21:e926362. doi:10.12659/AJCR.926362
Goldman RD.Bismuth salicylate for diarrhea in children.Can Fam Physician. 2013;59(8):843–844.
Pacifico L, Osborn JF, Anania C, Vaira D, Olivero E, Chiesa C.Review article: bismuth-based therapy forHelicobacter pylorieradication in children.Aliment Pharmacol Ther.2012;35(9):1010-1026. doi:10.1111/j.1365-2036.2012.05055.x
National Institute of Neurological Disorders and Stroke.Reye’s syndrome.
National Library of Medicine: MedlinePlus.Bismuth subsalicylate.
National Library of Medicine: MedlinePlus.Methyl salicylate overdose.
National Library of Medicine: DailyMed.Pepto Kids—calcium carbonate tablet, chewable.
Cecchi C, Mariniello A, Carnio S, Delcuratolo MD, Novello S.Black hairy tongue after immune checkpoint inhibitors in NSCLC: a case report and review of the literature.Clin Lung Cancer.2021:S1525-7304(21)00062-0. doi:10.1016/j.cllc.2021.03.008
Gurvits GE, Tan A.Black hairy tongue syndrome.World J Gastroenterol.2014;20(31):10845-50. doi:10.3748/wjg.v20.i31.10845
Harvard University T.H. Chan School of Public Health.Niacin - Vitamin B3.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
