Black Tongue on Babies

Overview 

If your little one has a black tongue, it’s natural to feel concerned about their well-being. However, rest assured that it’s nothing serious and can be easily explained in most cases. Nevertheless, knowing specific indicators that may require medical attention is essential.

Black Tongue 

Black tongue, also known as black hairy tongue, is often the result of an overgrowth of bacteria or yeast in the mouth. Thankfully, it’s a harmless condition despite its intimidating name. So, there’s no need to worry about it causing significant issues. 

Various factors can lead to a black tongue, and one of them is poor dental hygiene. 

However, treating this condition is usually straightforward and uncomplicated. 

Factors that lead to a baby or child developing a black tongue 

There are various causes of a black tongue in children, some of which are medical and non-medical causes.

Food coloring 

Non-medical causes include consuming food or drinks with black dye, food colouring, and natural colours that can stain, like blackberries.  

On the other hand, medical causes can be related to illnesses or medications. Some diseases that can lead to a black tongue are the presence of bacteria in the mouth that produce sulfur compounds or a condition called black hairy tongue, where an excess of bacteria or yeast grows on the tongue.  

Possible birthmark 

Additionally, some children are born with a black tongue, which is considered a birthmark known as pigmented nevus. 

Over-the-counter medication Pepto-Bismol 

One common cause of a black tongue in kids is the over-the-counter medication Pepto-Bismol. This medication treats conditions such as upset stomach, acid indigestion, diarrhoea, and symptoms of Helicobacter pylori infection. Pepto-Bismol contains bismuth subsalicylate, which can result in a black tongue when mixed with sulfur in saliva. Fortunately, this discolouration usually disappears within a few days after stopping the medication. 

Pepto-Bismol and children 

Regular Pepto-Bismol isn’t recommended for kids under 12 due to the risk of Reye’s syndrome. However, other medications are available for treating children’s digestive problems and H. pylori infections. 

Children’s Pepto-Bismol, on the other hand, is safe for kids as young as 2.8 and doesn’t contain bismuth subsalicylate. If your baby or toddler is experiencing diarrhoea or digestive issues, it’s best to consult your paediatrician for the appropriate treatment. 

Sometimes, children are attracted to Pepto-Bismol because of its pink colour and minty flavour if you notice that your child has a black tongue and you’re unsure why, it might be worth asking them if they’ve consumed Pepto-Bismol or if any is missing from the bottle. 

Additionally, look for dark stool, as bismuth can cause this when it mixes with sulfur in the intestines. Remember to store Pepto-Bismol and all other medications in a place where children cannot access them. 

Bismuth and Reye’s syndrome in kids 

It’s important to note that children under the age of 12 should avoid taking Pepto-Bismol or any medications that contain bismuth subsalicylate. This ingredient has been associated with a condition called Reye’s syndrome, which can be very dangerous and even deadly for kids. Reye’s syndrome can lead to:

• Fatty deposits in the liver and other organs 

• Fluid buildup in the brain 

• High levels of ammonia and acidity 

• Low blood sugar 

Signs and symptoms include: 

– Irritability or aggression 

– Continuous or recurrent vomiting 

– Delirium 

– Seizures 

– Disorientation 

– Loss of consciousness 

– Lethargy 

This condition typically occurs shortly after a viral infection. If you notice any of these symptoms in your child during their recovery, seek immediate medical attention. 

Additionally, be cautious with other medications that contain salicylates, as they can also trigger Reye’s syndrome. It’s advisable to consult your healthcare provider before administering these drugs to a child. 

Examples of salicylate-containing drugs to be aware of are: 

– Kaopectate 

– Oil of wintergreen 

– Aspirin 

Symptoms of black tongue in children 

Kids often find the appearance of a black tongue quite unsettling. But sometimes, there can be additional symptoms accompanying it. 

 Some common signs that may accompany a black tongue are: 

• Black gums 
• Bad breath 
• Diarrhea 
• Bitter or unpleasant taste 
• Tongue irritation  
• Vomit – mainly if it contains blood 
• Discharge from or anywhere in the mouth 
• Swelling 
• Pain 
• Fever that doesn’t go away 
• Abdominal pain 

It’s worth noting that certain medications containing bismuth can temporarily darken stool due to the presence of sulfur in the gastrointestinal tract. 

Treatment 

The discolouration of the tongue due to food typically resolves spontaneously within a short period. In cases where medication is the culprit, the black tongue should disappear shortly after discontinuing the medication. However, if the discolouration persists despite these measures, a dentist can delicately scrape the tongue to eliminate the pigmentation. 

On the other hand, if the black tongue results from an underlying illness, it may persist until the condition is effectively treated. This may necessitate the use of prescription antifungals or antibiotics. 

Tips to take care of the condition 

Using tooth brush effectively 

Teach your child to clean their tongue with a soft toothbrush twice daily to remove dead skin cells and bacteria effectively. 

Try a tongue scraper

Incorporating a tongue scraper into their oral hygiene routine will prevent the accumulation of skin cells on their taste buds. 

Remind your child to brush after meals

To prevent food particles and bacteria from getting stuck in their taste buds. 

Prioritise your child’s flossing before bedtime

Flossing at least once a day can prevent the buildup of food debris and plaque in their mouth. 

Schedule regular dental cleanings for your child

Visiting their dentist for regular cleanings will greatly contribute to maintaining good oral health. 

Teach your child to consume water regularly

Drinking an adequate amount of water will help keep your mouth moisturised, allowing you to swallow dead skin cells.

Maintain a balanced diet

Including various fruits, lean proteins, vegetables, and whole grains in their diet will promote a healthy balance of bacteria in their mouth. 

Prevention 

To prevent black tongue, it is recommended to administer a baby version of peptic acid tablets to children starting from the age of 2. This is because peptic ulcer is the most common cause of black tongue in children. 

Unlike other forms of Pepto bismuth, children’s peptic acid tablets only contain calcium carbonate as the active ingredient. This means that it does not carry the risk of causing Ray’s syndrome or black tongue. 

It is important to note that malnutrition, particularly a deficiency in vitamin C, can potentially increase the risk of developing a black tongue infection. 

Summary 

A black tongue is generally not a cause for concern. If the discolouration is due to food or drink, it should fade away quickly. If it is caused by medication, it usually disappears within a few days after discontinuing it. However, if the black tongue persists, it is advisable to consult a dentist who can gently remove it. In the case of an infection, antibiotics or antifungal medications may be necessary to treat the black tongue.

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