Certain lifestyle habits and conditions can make people more likely to develop black hairy tongue. They include:
- Poor oral hygiene
- Smoking tobacco
- Drinking a lot of coffee or tea
- Using antibiotics (which may disrupt the normal balance of bacteria in the mouth)
- Being dehydrated
- Taking medications that contain the chemical bismuth (such as Pepto-Bismol for upset stomach)
- Not producing enough saliva
- Regularly using mouthwash that contains peroxide, witch hazel, or menthol
- Getting radiation therapy to the head and neck