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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 Black hairy tongue is more common in men, people who use intravenous drugs, and those who are HIV-positive