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The Color Atlas of Family Medicine Chapter 36. Black Hairy Tongue Sections: Patient Story, Epidemiology, Etiology and Pathophysiology, Diagnosis, Differential Diagnosis, Management, Patient Education, References. Topics Discussed: black hairy tongue. Excerpt:"A 60-year-old man who smokes presents to the physician's office smelling of alcohol. He complains of a black discoloration of his tongue and a gagging sensation without eating. The history determines that he brushes his teeth infrequently and goes to a dentist only if he has a toothache. He reports that he drinks >5 cups of coffee a day. Figures 36-1 shows the man with poor dentition and a black hairy tongue (HT). The remaining teeth are horribly stained and his tongue shows elongated papillae with brown discoloration. The physician discuss his tobacco and alcohol addictions and offer him help to stop drinking and smoking. The physician also discuss how he needs to take care of his mouth and see a dentist...."
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