 Effects of tongue scraping on plaque, gingivitis, and cavities. This is the first of a five-video series on tongue cleaning. What is tongue scraping, and is it the most effective way to clean our tongue? Watch this series to find out. In my last video series on halitosis, I explored the benefits of eating a high-fiber diet for causing a reduction of halitosis. This effect is thought to be due to the self-cleaning of the mouth while chewing food. However, soft foods, like how most fast food is designed so you can gulp it down, do not sufficiently scrape at the coating on your tongue, and so you can be left with a tongue coating, a whitish-grade layer of debris and microorganisms, particularly towards the back of your tongue. During the putrefaction of debris on the tongue, volatile sulfur compounds are created, like the rotten egg gas hydrogen sulfide. This putrefaction process may be responsible for up to 90% of bad breath. I did a video on dietary tweaks to lessen the formation of these compounds in the first place, but if you're unwilling or unable to change your diet, natural self-cleaning mechanisms might not necessarily remove the tongue coating, if it's really thick, in which case mechanical tongue cleaning can remove debris. But often tongue cleaning is not considered a routine part of oral hygiene. Should it be? Let's find out. Unless you have some pocket of pus from like periodontal disease, the most likely source of bad breath is the surface of your tongue. And it's not like there's one bad actor bacteria. Dozens of different bacteria can produce the same volatile sulfur compounds from the sulfur-containing amino acids concentrated in animal protein. That's why probiotics may fail to change the emissions. In fact, if you compare the tongue microbiome and healthy subjects versus those with bad breath, they have almost the same bacterial composition. So it may be less which type of bacteria you have on your tongue and more the sheer quantity of how many bacteria you have living there. Population studies suggest that the use of tongue scrapers is associated with less severe symptoms of halitosis. But maybe those who use tongue scrapers are also more scrupulous about oral hygiene. And otherwise, the only way to know for sure is to put it to the test. First though, some background. Tongue scraping and brushing have been practiced for centuries in many continents around the world. But it's been almost unknown elsewhere. Why clean your tongue? asked this editorial in the Journal of the American Dental Association. Dentists, hygienists, and manufacturers of toothpaste, toothbrushes, and floss have long emphasized the need to remove dental plaque from your teeth to prevent cavities. But why do so many Americans produce two immaculate, shining rust of teeth separated by an organ covered with millions of microorganisms emitting a strong mal odor? First of all though, what might be the effect of tongue brushing on formation of dental plaque? Like if you stop brushing your teeth completely, would it matter if you brush your tongue? No, stop brushing your teeth and the plaque builds up either way. Yeah, but what if you continue brushing but just add tongue brushing along with tooth brushing? No effect on the build-up of plaque on your teeth, suggesting that the majority of the important plaque-forming bacteria might not originate from the tongue. Though another reason for not finding an effective tongue brushing on plaque formation may be that brushing the back of the tongue is difficult because it can make you gag. What about gingivitis and gum inflammation? Those who clean their tongues tend to have less bleeding on probing, suggesting healthier gums, but you don't really know if it's caused an effect until you put it to the test. Randomize, control clinical trial tongue scraping versus no tongue scraping, and it made no significant difference. What about tongue scraping as a means to reduce the acid-producing bacteria that caused cavities called strep mutants? This study showed a beneficial effect compared to using Listerine brand oral care strips or saltwater rinses, but this other study found no significant effect. Maybe the population of bacteria is just so large that scraping removed only a small portion or maybe it's like sweeping a rug where you're just kind of moving stuff around. The bottom line is that studies investigating the role of tongue brushing and plaque accumulation or gum inflammation show conflicting results. And so on the basis of the medical research, there appears to be no data that justified the necessity to clean the tongue on a regular basis. But the one exception would be oral malodour. It works for combating bad breath, which we'll explore next.