Influence of tongue brushing and scraping on the oral microflora of periodontitis patients

J Periodontal Res. 2018 Feb;53(1):73-79. doi: 10.1111/jre.12489. Epub 2017 Oct 17.


Objective: To examine the effect of tongue cleaning with a tongue scraper (TS) or toothbrush (TB) in patients with periodontitis.

Background: The tongue is a possible reservoir for bacterial (re)colonization of the periodontal tissues in patients with periodontitis. To date, it is not known what the influence of tongue cleaning is on the tongue coating of patients with periodontitis.

Material and methods: Eighteen systemically healthy, untreated moderate to severe adult patients with periodontitis with some degree of tongue coating were randomly assigned to the use of a TS or TB for cleaning the tongue. Microbial load of the saliva and tongue dorsum, amount of tongue coating and patient perception about tongue cleaning were studied at baseline and 2 weeks later.

Results: Two weeks of tongue cleaning with either a TB or a TS, did not influence the microbiological counts, neither in the saliva, nor in the tongue coating, even though tongue coating was significantly less. The patients themselves experienced no differences in breath odour or taste sensation after 2 weeks of tongue cleaning; however, they felt that their tongue was cleaner at the end of the study compared to baseline. No differences could be detected between the uses of a TS vs a TB.

Conclusion: In patients with periodontitis, tongue cleaning does not influence the bacterial load in the saliva or on the tongue dorsum.

Keywords: microbiology; periodontitis; tongue cleaning; tongue coating.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Bacterial Load
  • Dental Devices, Home Care*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oral Hygiene / instrumentation
  • Oral Hygiene / methods*
  • Periodontitis / microbiology*
  • Saliva / microbiology*
  • Tongue / microbiology*