Tongue-cleaning methods: a comparative clinical trial employing a toothbrush and a tongue scraper

J Periodontol. 2004 Jul;75(7):1009-12. doi: 10.1902/jop.2004.75.7.1009.


Background: It is estimated that approximately 85% of all halitosis cases have their origin within the mouth; of these, 50% are caused by tongue residues. Previous studies have established that hydrogen sulfide and mercaptans are the primary components of halitosis. Thus, tongue cleaning gains importance as a means of halitosis management.

Methods: This investigation compared the efficacy of two mechanical methods for tongue cleaning through a handheld sulfide monitor. This crossover trial was carried out with 10 healthy subjects, 20 to 50 years old. Before the baseline measurement of the volatile sulfur compounds (VSCs), the subjects were instructed to refrain from any tongue cleaning method for 48 hours. The 10 participants were then placed in one of two groups (five each): 1) first week: tongue scraper, second week: soft-bristle toothbrush; 2) first week: toothbrush, second week: tongue scraper, with a 48-hour wash-out period between each week.

Results: The baseline measurements were compared with those of the end of each week using the Dunn method (alpha = 0.01). The tongue scraper showed a 75% reduction in VSCs, while the toothbrush only achieved a 45% reduction in VSCs.

Conclusion: Although the tongue coating was removed by both methods, the tongue scraper performed better in reducing the production of volatile sulfur compounds.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Breath Tests / instrumentation
  • Cross-Over Studies
  • Dental Devices, Home Care*
  • Female
  • Halitosis / etiology
  • Halitosis / therapy*
  • Humans
  • Male
  • Middle Aged
  • Oral Hygiene / instrumentation*
  • Statistics, Nonparametric
  • Sulfur Compounds / analysis*
  • Tongue*


  • Sulfur Compounds