"Effects of Tongue Scraping on Plaque, Gingivitis, and Cavities"
This is the first of a five-video series on tongue cleaning.
What is tongue scraping, and is it the most effective way
to clean our tongue?
Watch the series to find out.
In my last video series on halitosis, I explored the benefits of eating
a high-fiber diet for causing a reduction of halitosis.
This effect is thought to be due to the “self-cleaning”
of the mouth while chewing food.
However, soft foods, like how most fast food is designed so we can
gulp it down, do not sufficiently scrape at the coating on your tongue,
and so you can be left with a tongue coating, a whitish-gray layer of
debris and microorganism, particularly towards the back of your tongue.
During the putrefaction of debris on the tongue, volatile
sulfur compounds are created like the rotten egg gas hydrogen sulfide.
This putrefaction process may be responsible
for up to 90 percent of bad breath.
I did a video on dietary tweaks to lessen the formation
of these compounds in the first place,
but if you are unwilling or unable to change your diet
Natural self-cleaning mechanisms might not necessarily remove
the tongue coating if it’s really thick, in which case,
mechanical tongue cleaning can remove debris,
but often tongue cleaning is not considered a routine part
of oral hygiene. Should it be? Let’s find out.
Unless you have some pocket of pus from like periodontal disease,
the most likely source of bad breath is the surface of your tongue.
And it’s not like there is one bad actor bacteria.
Dozens of different bacteria can produce the same volatile
sulfur compounds from the sulfur containing
amino acids concentrated in animal protein.
That’s why probiotics may fail to change the emissions.
In fact, if you compared the tongue microbiome in healthy subjects
versus those with bad breath, they have almost the same
bacterial composition, so it may be less which type of bacteria
you have on your tongue, and more the sheer quantity of how many
bacteria you have living there.
Population studies suggest that the use of tongue scrapers
is associated with less severe symptoms of halitosis,
but maybe those who use tongue scrapers are also more scrupulous
about oral hygiene in other ways.
The only way to know for sure, is to...put it to the test.
First, though, some background.
Tongue scraping and brushing have been practiced for centuries
in many continents around the world,
but has been almost unknown elsewhere.
“Why clean your tongue?” asked this editorial in the
Journal of the American Dental Association.
Dentists, hygienists and manufacturers of toothpaste, toothbrushes
and floss have long emphasized the need to remove dental plaque
from your teeth to prevent cavities,
but why do so many Americans produce two immaculate,
shining rows of teeth separated by an organ
covered with millions of microorganisms,
emitting a strong malodor?
First of all, though what might be the effect of tongue brushing
on formation of dental plaque?
Like if you stopped brushing your teeth completely would it matter
if you brushed your tongue? No.
Stop brushing your teeth and the plaque builds up either way.
Yeah, but what if you continue brushing but just add tongue brushing
alongside tooth brushing?
No effect on the buildup of plaque on your teeth,
suggesting that the majority of the important plaque-forming bacteria
might not originate from the tongue,
though another reason for not ﬁnding an effect of tongue brushing
on plaque formation may be that brushing of the back of the tongue
is difﬁcult because it can make you gag.
What about gingivitis, gum inflammation?
Those who clean their tongues tended to have less bleeding on probing,
suggesting healthier gums, but you don’t really know,
if it's cause and effect.
until you put it to the test.
A randomized controlled clinical trial, tongue scraping versus
no tongue scraping, and… it made no significant difference.
What about tongue scrapping as a means of reducing the acid-producing
bacteria that cause cavities called strep mutans?
This study showed a beneficial effect, compared to using
Listerine brand oral care strips or salt water rinses,
but this other study found no significant effect.
Maybe the population of bacteria is just so large that scraping
removed only a small portion, or maybe it’s like sweeping a rug,
where you’re just kind of moving stuff around.
The bottom line is that studies investigating the role of tongue brushing
and plaque accumulation or gum inﬂammation show conﬂicting results,
and so on the basis of the medical literature,
there appears to be no data that justify the necessity
to clean the tongue on a regular basis.
Ah, but the one exception would be oral malodour.
It works for combatting bad breath, which we’ll explore, next.