I’ve heard various opinions on the necessity for tongue cleaning. Often, I see extremely coated tongues with green, brown, yellow, and even black debris on the surface. On the other hand, many people have a completely clean and pink tongue. What is the significance of this debris on the tongue? What is the best way to remove it? How often should it be removed? Does it influence caries and periodontal disease? Are young patients immune from debris on their tongues?
Many people have a tendency to collect debris on the surface of their tongue. The tongue is a reservoir for an unbelievable number of living and rotting organisms. It has been postulated that differences in the anatomy and length of taste buds may be a reason for the differences in tongue cleanliness. Whatever the reasons, there is no question that patients have very different tendencies to collect undesirable debris on their tongues.
The concept of tongue cleaning is not new. Tongue cleaning was practiced among wealthy and elite people in various parts of the world for centuries. There are examples of elaborate and ornate tongue cleaners (scrapers) that have been found dating back centuries.
Unfortunately, modern dentistry has somewhat overlooked the importance of tongue cleanliness.
How should you clean your tongue?
When asked if they clean their tongue, some patients say that they brush their tongue with a standard toothbrush. Is that method of tongue cleaning adequate? No, it is not! Studies have shown that merely brushing the tongue removes only a small amount of debris.
The most advisable method to clean the debris is with a tongue scraper. It has been shown that bacterial counts on the tongue can be reduced as much as 50% after only one day of effective tongue hygiene. The taste buds in some people provide a surface much like a shag carpet. When they’re coated with debris, the organisms reside there in great quantities.
Some have irregularities on their scraping surfaces, and some are smooth. Most tongue scrapers are relatively inexpensive and serve for a long time before breaking.Many simple tongue cleaners (scrapers) are readily available on the market. They are available in various materials, including metal and plastic. They vary in width, ranging from about one-half the width of an average adult tongue to wide enough to scrape the entire width of the tongue.
Of course, personal preferences determine what type of tongue scraper a patient prefers. I prefer plastic tongue scrapers that provide some flexibility, are not quite as wide as an average tongue, and with slight irregularities on the scraping edge. These rippled edges provide a raking effect as they gently scrape across the tongue.
Children are not immune from having organisms on their tongues. I’m sure you’ve seen children with significant debris on their tongues. Initiating tongue cleaning at an early age makes children aware of the desirability of cleaning the tongue. Leaving debris on the tongues of children potentially contributes to dental caries, gingivitis, and foul breath, just as in adults.
It’s been shown that dental carious lesions are present in nearly half of children by age five. Brushing teeth reduces some mouth odor, while tongue cleaning has the potential to reduce mouth odor much more effectively.
There is a tendency to gag if a scraper is placed too far down the throat when first using a tongue scraper. I suggest opening the mouth wide and fully extending the tongue.
Then place the scraper as far down the throat as is comfortable the first time and progressively go farther during subsequent cleanings. Use gentle strokes. You will eventually be able to place the scraper far down the throat without eliciting the gag reflex. Thorough tongue cleaning requires only a few seconds.