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Bizarre! Ohio man develops greens and hairy tongue from smoking and antibiotics

Discover the rare side effect of a green and hairy tongue in an Ohio man caused by smoking and antibiotics, as doctors diagnose and treat the condition.

Bizarre Ohio man develops greens and hairy tongue from smoking and antibiotics; see picture snt
First Published Jul 12, 2023, 4:18 PM IST

An unusual side effect of smoking tobacco and taking antibiotics caused a 64-year-old Ohio man's tongue to turn green and hairy. He sought medical help at a primary care clinic when he noticed the color change. A few weeks prior, he had completed a course of the antibiotic clindamycin for a gum infection. The man was also a smoker, but it was unclear whether smoking alone, antibiotic use alone, or a combination of both caused his condition. Previous research has shown that smoking can have long-lasting effects on oral health, such as plaque and bacteria buildup, while antibiotics can disrupt the mouth's microbiome, allowing bacteria to accumulate on the tongue.

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The doctors diagnosed the man with hairy tongue, a condition characterized by an abnormal coating on the top surface of the tongue, known as the dorsal area. Hairy tongue occurs when dead skin cells accumulate on the papillae, the parts of the tongue that contain taste buds. As a result, the papillae grow longer than normal, giving the tongue a hairy appearance. These elongated papillae can also trap bacteria and yeast. While hairy tongue typically doesn't cause symptoms, some people may experience a burning sensation due to the accumulation of bacteria and yeast on the tongue's surface. According to the American Academy of Oral Medicine (AAOM), approximately 13 percent of Americans are affected by hairy tongue, with older individuals and men being more commonly affected.

The discoloration of the tongue in cases of hairy tongue is typically black, but it can also appear brown, yellow, or green. Smoking has long been associated with negative effects on oral health, contributing to the buildup of bacteria and plaque. Antibiotics, like the ones the patient was taking, can also disrupt the mouth's bacterial balance, leading to the formation of new bacteria that may accumulate and contribute to hairy tongue.

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Risk factors for hairy tongue include smoking, dehydration, poor oral hygiene, and antibiotic use, as mentioned by the authors of the case study. Individuals who have experienced hairy tongue in the past are more likely to develop it again in the future. Fortunately, hairy tongue is generally a harmless and temporary condition.

In this particular case, doctors advised the man to gently scrub the surface of his tongue with a toothbrush four times a day. Additionally, he received counseling on smoking cessation. The AAOM recommends practicing good oral hygiene, which includes brushing the top of the tongue with a toothbrush or using a tongue scraper, to prevent hairy tongue. Despite continuing to smoke, the patient's tongue returned to its normal state after six months.

The case study documenting this unique occurrence was published in the New England Journal of Medicine.

(Image Credit: New England Journal of Medicine)

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