Effectiveness of a new toothbrush design versus a conventional tongue scraper in improving breath odor and reducing tongue microbiota

Abstract

For centuries, specific instruments or regular toothbrushes have routinely been used to remove tongue biofilm and improve breath odor. Toothbrushes with a tongue scraper on the back of their head have recently been introduced to the market. The present study compared the effectiveness of a manual toothbrush with this new design, i.e., possessing a tongue scraper, and a commercial tongue scraper in improving breath odor and reducing the aerobic and anaerobic microbiota of tongue surface. The evaluations occurred at 4 moments, when the participants (n=30) had their halitosis quantified with a halimeter and scored according to a 4-point scoring system corresponding to different levels of intensity. Saliva was collected for counts of aerobic and anaerobic microorganisms. Data were analyzed statistically by Friedman's test (p<0.05). When differences were detected, the Wilcoxon test adjusted for Bonferroni correction was used for multiple comparisons (group to group). The results confirmed the importance of mechanical cleaning of the tongue, since this procedure provided an improvement in halitosis and reduction of aerobe and anaerobe counts. Regarding the evaluated methods, the toothbrush's tongue scraper and conventional tongue scraper had a similar performance in terms of breath improvement and reduction of tongue microbiota, and may be indicated as effective methods for tongue cleaning.

Biology of the Tongue Coating and Its Value in Disease Diagnosis

“…The TC is a visible white-brownish layer adherent to the dorsum of the tongue, consisting of desquamated epithelial cells, blood cells, metabolites, nutrients, and bacteria [9,10]. Therefore, any factors that are involved in the disability of keratinization and apoptosis of epithelial cells of the tongue [11], blood cell infiltration, erythrocyte diapedesis, and complex microbial colonization will have a profound effect on the metabolites and nutrients that are the main causes for TC formation.…”

“…Casemiro et al [9] summarized the microbial species isolated from the tongue, which included Porphyromonas gingivitis , Aggregatibacter actinomycetemcomitans , members of the Spirochaetes , Prevotella intermedia , and Capnocytophaga spp. In recent studies it has been verified that the microbiome of the human body is associated with the human physiology, pathophysiology, and health status [24].…”

The effect of periodontal therapy on intra‐oral halitosis: a case series

“…There are several studies suggesting that tongue cleaning/scraping can reduce the levels of VSCs in exhaled air (Lee et al 2003, Casemiro et al 2008, Tsai et al 2008, Pham et al 2011, Lu et al 2014. One published review of the literature reported that the efficacy of tongue cleaning/scraping is conflicting (Van der Sleen et al 2010) whereas another systematic review demonstrated that there was a minor superiority of tongue scrapers as compared to brushing in reducing halitosis (Outhouse et al 2006).…”

HALITOSIS – A Social Malady

“…The evaluated methods were equally effective in the improving breath odour and reducing the facultative aerobic and anaerobic microbiota on tongue surface of the studied population. 73 Carvalho MD et al demonstrated the beneficial impact of mouthrinses on morning breath even in the absence of mechanical plaque control. In a cross-over trial on college students, the VSC formation was inhibited in descending order, 0.2% chlorhexidine, 0.12% chlorhexidine, triclosan and essential oils and cetylpyridinium chloride.…”