Seeing black spots in your mouth can be alarming, but these are not necessarily a cause for alarm. Taking the time to narrow down what is causing the black spots will help you determine whether or not your condition is serious and what kind of treatment is necessary to help get rid of them. It's important to make note of the other symptoms you are experiencing along with the black spots on the tongue to help narrow down the cause of your ailment.

What Do Black Spots on Tongue Look Like?

Black spots may vary based on what is causing them to appear. In some cases they can literally be small black specks across the tongue. In other cases black patches may appear across the tongue, which typically start at the sides of the tongue and spread up to the center. The darkness of the spots may also vary from client to client. Some can be light and gray, some may appear more brown and others may be very dark. In some cases the black spots on the tongue may also be slightly raised, but this should not cause discomfort or pain.

What Cause Black Spots on Tongue?

• Ailment. There are a number of ailments that can lead to black pigmentation on the tongue. One of the most common causes of this ailment is hyper-pigmentation or oral fibroma. This is essentially a birthmark on the tongue that may become more prominent over time.
• Oral piercing. If you have recently had an oral piercing put in, black pigmentation may appear around the site. This may be caused by the tongue becoming bruised from the piercing process, but it can also be due to the exposure to the metal in the stud. Biting the tongue, causing a cut or bumping the tongue can cause the tongue to become bruise in a similar fashion.
• Exposure to chemicals. Sometimes the entire tongue will turn black. Excessive exposure to chemicals such as bismuth can react with acids naturally found on the tongue and cause the tissue to temporarily turn black. One of the most common sources of these chemicals includes chewable Pepto-Bismol tablets.
• Hairy tongue. A condition such as hairy tongue can cause the entire tongue to turn black as well. Tiny black spots will start to appear across the tongue due to excessive use of tobacco, alcohol or antibiotics. This is caused by a fungus that grows across in small black patches across the tongue. If you continue to expose yourself to these products, the black spots can continue to spread until the entire tongue turns black.
• Oral cancer. In extreme cases the tongue can turn black due to the development of oral cancer. This is a very rare side effect of this condition, so it is important not to panic or jump to conclusions if black patches begin to develop on the tongue. If these black spots are combined with lumps in the mouth or difficulty swelling then you may be dealing with a cancerous growth, but otherwise it is likely that you are dealing with one of the conditions listed above.

How to Deal With Black Spots on Tongue

• Change oral hygiene routine. The first step you should take when trying to get rid of unsightly black spots on the tongue is to alter your oral hygiene routine. Brush your teeth at least twice a day to help remove particles throughout the mouth that might be contributing to the dark pigmentation throughout your mouth. Be sure to gently brush the tongue or use a tongue cleaner to help remove the buildup that is turning your tongue black. Be careful to do this gently to avoid causing damage to the tongue and keep the toothbrush and tongue cleaner you use sanitized so that the bacteria does not grow on these devices.
• Alter your habits. When you are suffering from hairy tongue syndrome, you can clean your mouth to help remove the fungus causing the coloring, but you will need to get rid of the root cause of the problem if you do not want the black growths to return. Quitting smoking, cutting down on drinking and altering your diet can help you avoid these symptoms so that you are not dealing with a constant fungal infection in your mouth. If you notice that you are developing a great deal of fungus in your mouth or that the fungus is growing quickly, contact your doctor to see if you need additional treatment to get rid of the fungus. Your doctor may also have tips that you can use to help clean up your mouth.
• Follow doctors' instructions. If you have recently had a tongue piercing or oral surgery it is likely that the black pigmentation in your mouth is just a bruise. Follow any instructions given to you by your doctor or piercing artist regarding keeping your mouth clean to avoid infection. If the pigmentation does not lessen or go away after one or two weeks you can consult with a dermatologist to help ensure that the coloring in your mouth is not a symptom of serious damage to your mouth.
• Other treatments. Black spots on tongue that are accompanied by other symptoms such as growths in the mouth, pain or difficulty swallowing should be checked by your doctor as soon as possible. This could be a sign that you are developing a more serious condition such as oral cancer that will require more serious treatment. Your doctor can help you determine if you will need additional treatment to help remove these spots.