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Green Tongue Coating in a Smoker Treated with Antibiotics

13/07/2023

The New England Journal of Medicine recently published a case study of a 64-year-old smoker who developed a “green tongue coating” after taking antibiotics. Alarmed, he sought medical attention, and on the doctor’s instruction, he gently wiped his tongue four times a day with a toothbrush. The illness ultimately went away after six months.

The man from Ohio, United States, discovered his “hairy tongue” and sought medical assistance, according to reports from the New York Post and the Daily Mail. The diagnosis was “hairy tongue” or “black hairy tongue,” which is a deposit of bacteria, yeast, nicotine, and food residue on the filiform papillae of the tongue that appears to be green hair.

According to the American Academy of Oral Medicine (AAOM), this is a “temporary” condition caused by “poor oral hygiene” and is more common in persons over the age of 40, with males being more prone to it than women. Depending on circumstances such as mouthwash, candy, and other variables, the color of the “hair” can range from brown to white to green to pink. This illness affects approximately 13% of all Americans. The most severe symptom is a burning feeling on the tongue, which is generally asymptomatic.

The hospital did not reveal how long the man had been smoking, but he had recently taken the antibiotic clindamycin to treat a gum infection. Antibiotics, according to the medical website WebMD, can alter the quantity and types of bacteria, altering the balance of oral microbiota and resulting in bacterial buildup. Smokers’ lips have a larger collection of bacteria and plaque, making them more prone to hairy tongues.

The report does not specify whether the disease was brought on by smoking, antibiotic use, or a combination of the two. Despite not quitting smoking, the patient used a toothbrush and tongue scraper four times a day to clean his tongue. After six months of diligent washing, the “hair” on his tongue had vanished.

The human tongue has four types of papillae: “fungiform papillae,” which are thread-like and cover most of the tongue’s surface; “filiform papillae,” which are thread-like and cover most of the tongue’s surface; “circumvallate papillae,” which are located at the back of the tongue’s base; and “foliate papillae,” which are found on the lateral posterior parts of the tongue.

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