Comparison of Three Tongue Cleaners for Removing Tongue Coating

Investigation Into the Effectiveness of Tongue Cleaning With Different Materials Using Visual and Fluorescence Methods

This randomised three-period crossover study compared the effectiveness of three tongue-cleaning devices - a bristled tongue brush, a plastic tongue scraper and a metal tongue scraper - in removing tongue biofilm. Thirty healthy volunteers aged 18 to 30 used each device once daily for 14 consecutive days, with 7-day washout periods between devices during which no tongue cleaning was performed. Tongue biofilm was measured objectively by Quantitative Light-induced Fluorescence-Digital (QLF-D) imaging, alongside the visual Tongue Coating Index, salivary pH, and participant-reported acceptability including gag reflex.

Inclusion Criteria:

• Healthy volunteers aged 18 to 25 years
• No professional dental cleaning within the previous two weeks
• Willing to maintain usual toothbrushing and interdental hygiene practices throughout the study period

Exclusion Criteria:

• -History of significant systemic disease (e.g. diabetes mellitus, immune disorders)
• Clinical salivary gland dysfunction or self-reported xerostomia
• Active oral or mucosal infection (e.g. severe periodontitis, extensive caries)
• Active mucosal lesions
• Fixed orthodontic appliances
• Conditions predisposing to severe gagging beyond normal clinical sensitivity
• Use of topical or systemic antimicrobials or antibiotics within the previous month