Black hairy tongue treated with traditional Chinese medicine: A case report.

RATIONALE: Black hairy tongue (BHT) is a rare condition that is conventionally managed by discontinuing associated medications or habits and practicing good oral hygiene, including tongue brushing. Previous studies have indicated that black tongue coating is often associated with gastrointestinal discomfort, which traditional Chinese medicine (TCM) could be a potentially effective option for treating this condition with minimal side effects. We present a case of BHT diagnosed and treated within 2 weeks by using TCM methods. PATIENT CONCERNS: A 73-year-old woman presented with a chief concern of a black tongue that had persisted for 2 weeks and was accompanied by thirst and diarrhea. These symptoms were initially observed during her hospitalization for the treatment of staghorn calculi, xanthogranulomatous pyelonephritis, and urosepsis. Using the "four diagnostic methods" of TCM, we observed that her tongue had a thick black coating surrounded by a thick white coating; her tongue was of medium size with tooth marks, and its body color was light red. DIAGNOSES, INTERVENTIONS, AND OUTCOMES: On the basis of TCM theory, we made a clinical diagnosis of BHT and "spleen Qi deficiency with turbid dampness," which may have been caused by the antibiotic treatment during hospitalization. Subsequently, we administered a Chinese herbal medicine (CHM) formula comprising a combination of Wu-Ling-San () and a modification of Da-Yuan-Yin (). After 2 weeks of CHM treatment, the patient's BHT was nearly eliminated, and the thick white coating and the corresponding symptoms were ameliorated. After 4 weeks of CHM treatment, the BHT was completely resolved. LESSON AND CONCLUSION: We present a case of BHT, a benign condition that may be caused by antibiotics. The literature does not contain reports on TCM-based diagnosis and treatment strategies for BHT. Using the 4 diagnostic methods of TCM, we observed that BHT was associated with gastrointestinal symptoms, which is consistent with the TCM theory. Moreover, CHM treatment rapidly relieved BHT and related symptoms without adverse events.

[Tongue coating, mouth odor, gustatory sense disorder - earlier and new treatment options by means of tongue scraper]. / Zungenbelag, Mundgeruch und Schmeckstörung - bisherige Behandlungsmethoden und neue Therapieoption durch mechanische Zungenreiniger.

The tongue is said to be the mirror of physical health. The tongue dorsum is most delicate regarding the sense of touch. Pathologic coating of the tongue accounts for paresthesia during chewing, swallowing, speaking, tasting, and also may result in mouth odor. Tongue coating can result from increased formation or decreased natural abrasion, and from xerostomia or dyschylia. In clinical otorhinolaryngology pathologic tongue coating often is idiopathic or present after surgery of the oral cavity or pharynx. Critical analysis of published studies reveals that effectivity and justification to administer xenobiotics or vitamins in that condition is doubtful. Recently, it has been shown that tongue fur was able to be reduced by an easy-to-handle mechanical tongue cleaner or tongue scraper. Due to its simple use, tongue scrapers could be a welcome supplement for the treatment of tongue fur, mouth odor, and in particular cases, to enhance gustatory sense. Preliminary results of an ongoing prospective trial showed that tongue scrapers can effectively be applied after surgery of the oral cavity or pharynx. After tonsillectomy, tongue fur seemed to be reduced and gustatory sense to be enhanced when tongue scrapers were applied during postoperative care. After confirming these promising results in further investigations, an inexpensive and simple option for the treatment of a large amount of patients in clinical otorhinolaryngology would exist.

Oral hygiene: a history of tongue scraping and brushing.

Tongue scraping and brushing have been practiced for hundreds of years but are still little appreciated or used by the public. Throughout the centuries, tongue scrapers have been constructed of thin, flexible strips of wood, various meals, ivory, mother-of-pearl, whalebone, celluloid, tortoiseshell, and plastic. Recent scientific evidence has validated the need to practice habitual and thorough tongue brushing as part of daily home oral hygiene procedures.