Paroxetine-induced black hairy tongue and necrotizing sialometaplasia: a case report

This case demonstrates the need to consider black hairy tongue and necrotizing sialometaplasia as differential diagnoses in patients with relevant risk factors presenting with oral lesions. Black hairy tongue and necrotizing sialometaplasia can both be managed conservatively by removal of the causative factor and maintaining good oral hygiene; nevertheless, timely and accurate diagnosis is important owing to the fact that necrotizing sialometaplasia may closely resemble more sinister pathology. Clinicians may also consider including black hairy tongue and necrotizing sialometaplasia as rare side effects of paroxetine when offering medication counseling.