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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Black Spot On Tongue, Tooth Pain, Have A Crown Done. Eaten Altoids. What Is It?

hello,

i have noticed a black sport on tongue (upper left side, size of a peanut) and similar, but small spots, in the neighborhood (only on left side). After couple of weeks of thorough tongue washing and dental hygiene, it is still there.

May be a coincidence but I ate 8 boxes!! of altoids over a period of 2 weeks prior to noticing this spot. I used to crunch alotids on the left side primarily (because i was suffering from tooth ache on the right side). I got crown done on a tooth to the right side of my mouth around the same time frame.

My dentist looked at it and thought it was just pigmentation but not sure why it would develop all of a sudden.

My doctor did a blood test and found me slightly anemic (didn't find any cancer). He put me on iron tablets but primarily because he thought my 2 week altoid craving was result of pica (i think).

I have taken couple of cipro 500mg few weeks before noticing the spot just to get rid of cold. This may have killed good bacteria, so I started taking probiotics (bayer truebiotic).

All of this happened in a period of 1-2 months. I am giving all these details because I am not sure (and neither are my dentist and MD) as to which of those may have caused these black spots to appear. My MD mentioned that after taking iron tablets for couple of months, if it still doesn't go away, i should see an ENT specialist.
Thu, 12 Sep 2013
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Dentist, Pedodontics 's  Response
Hello, welcome to HCM forum. There are several reason that can cause black spots on the tongue. Practically without inspecting visually it is almost impossible to predict the correct diagnosis. A good picture may also help. But most common black spot on tongue which is of a pea size along with similar spot around it could be suggestive of "black hairy tongue". It is simply the elongated growth of the papillae present over the tongue and discolored by food stain and bacterial growth. Some times the elongation is so much that it looks like a bunch of hair over the tongue, hence its name. it is generally caused by some illness, some medicine intake and mostly due to some local constant irritation. Interestingly intake or using mouth wash containing MENTHOL for long time is one of the local factor of developing such condition. Which could happen in your case as you were taking Altoids (peppermint/menthol) for long time with one side. Doctor prescribed iron tablets because iron deficiency is also sometimes blamed for this kind of condition. Antibiotics generally does not cause this condition until taken for long time at a stretch. Anyway, the condition is self limiting but may take time to regress. Continue your iron tablet, stop Altoids. Maintain your oral hygiene with proper brushing. keep your tongue clean gently using a tongue scraper or using your tooth brush. Do not use any commercial mouthwash, warm salt water mouth wash can be used instead. Hope your problem will be relieved soon. Good luck.
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Dentist Dr. Bhavin Jain's  Response
hello, i m trying to anser ur question but it is very difficult to daignose without inspecting. but according to ur history i can say it could be coz of long term use of altoids(menthol).it ll be more clear if u put some clear pic. of ur tongue.
i need to ask some questions regarding this.
1)do u smoke?
2)do u have a less salivation?
3)is there any hairy appearence on the tongue??
4)long term use of mouth wash like chlorhexidine???
if some of these u have then it could be black hairy tongue.iit is painless. no particular treatment is required for that.but u do one thing just scraping & brushing ur tongue before sleep or u can use sodium bicarbonate mouth rinses.
u can use keratolytic agents like podophyllin,but carry safty concern.
hope this would help.
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Black Spot On Tongue, Tooth Pain, Have A Crown Done. Eaten Altoids. What Is It?

Hello, welcome to HCM forum. There are several reason that can cause black spots on the tongue. Practically without inspecting visually it is almost impossible to predict the correct diagnosis. A good picture may also help. But most common black spot on tongue which is of a pea size along with similar spot around it could be suggestive of black hairy tongue . It is simply the elongated growth of the papillae present over the tongue and discolored by food stain and bacterial growth. Some times the elongation is so much that it looks like a bunch of hair over the tongue, hence its name. it is generally caused by some illness, some medicine intake and mostly due to some local constant irritation. Interestingly intake or using mouth wash containing MENTHOL for long time is one of the local factor of developing such condition. Which could happen in your case as you were taking Altoids (peppermint/menthol) for long time with one side. Doctor prescribed iron tablets because iron deficiency is also sometimes blamed for this kind of condition. Antibiotics generally does not cause this condition until taken for long time at a stretch. Anyway, the condition is self limiting but may take time to regress. Continue your iron tablet, stop Altoids. Maintain your oral hygiene with proper brushing. keep your tongue clean gently using a tongue scraper or using your tooth brush. Do not use any commercial mouthwash, warm salt water mouth wash can be used instead. Hope your problem will be relieved soon. Good luck.