What causes black spots on the tongue?

    Under normal circumstances, black spots on the tongue may be caused by dietary factors, medications, tongue ecchymosis, glossitis, or oral melanotic macules. Patients should rinse their mouths with warm water, quit smoking, and follow medical advice regarding medication. It is recommended to seek timely medical attention, identify the cause, and then follow medical instructions for treatment. Specific causes are as follows:

    1. Diet: Consuming excessive amounts of foods containing dark pigments, such as mulberries or dark chocolate, can lead to pigment deposition on the tongue's surface, forming black spots without causing discomfort. No special treatment is required; maintaining oral hygiene and rinsing promptly after eating are sufficient.

    2. Medication factors: Taking certain dark-colored medications or traditional Chinese medicines may result in pigment deposition on the tongue, causing black spots. There are usually no other significant discomfort symptoms. No special treatment is required; observe changes in the spots after discontinuation of the medication.

    3. Tongue ecchymosis: Accidentally ingesting sharp or excessively hot food may cause tongue injuries or burns, leading to ecchymosis and black spots on the tongue. Symptoms may include redness, swelling, pain, or blistering. Treatment may follow medical advice to use medications such as Die Da Huo Xue Capsules, Yunnan Baiyao Capsules, or Sanqi Tablets, which can help promote blood circulation and relieve muscle stiffness.

    4. Glossitis: Glossitis may be triggered by deficiencies in nutrients such as iron and vitamin B12, anemia, or poor oral hygiene. Inflammation leads to congestion and edema of the tongue, which may present with black spots. The tongue surface may appear smooth with black spots, possibly accompanied by burning sensations, pain, or swelling. Treatment may follow medical guidance using medications such as vitamin B12 tablets, ferrous citrate tablets, or folic acid tablets to replenish deficient nutrients.

    5. Oral melanotic macules: Oral melanotic macules are a type of pigmentation disorder potentially associated with long-term smoking or poor oral hygiene. These factors cause pigment deposition on the tongue's surface, resulting in black spots. These spots typically do not cause significant discomfort but may affect aesthetics and self-confidence. Medical treatments such as laser therapy or cryotherapy may be used under a physician's guidance.

    In daily life, maintaining good oral hygiene habits, including regular tooth brushing, flossing, and use of mouthwash, is recommended.