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31-07-2011 | Internal medicine | Article

Reduction in oral malodor with periodontal treatment or tongue cleaning


Free abstract

MedWire News: Oral malodor can be differentially reduced in patients with periodontal or gingival disease by using periodontal treatment or tongue cleaning.

Oral malodor, or halitosis, is caused by the putrefaction of proteins in the oral cavity by micro-organisms, and can lead to significant social problems. It is caused by poor oral hygiene including the build up of plaque on teeth, and the coating of the tongue with bacteria, epithelial cells and other debris.

Although many studies have examined the effects of different treatment methods on oral malodor, including mouth rinsing and gum chewing, few studies have assessed the efficacy of a combined regimen of periodontal treatment with tongue cleaning for the treatment of this problem.

In the current study, Masayuki Ueno (Tokyo Medical and Dental University, Japan) and colleagues evaluated the effect of a combined treatment protocol of periodontal treatment (including oral hygiene instruction, scaling and polishing) and tongue cleaning on 218 Japanese patients who presented with oral malodor. Of these patients, 102 had periodontitis and 116 had gingivitis.

Patients in each disease group were randomly assigned to receive either tongue cleaning followed by periodontal treatment, or periodontal treatment followed by tongue cleaning. Measurements of plaque index, tongue coating score, organoleptic score (malodor level) and BANA test score (micro-organism level) were made 1 week after each treatment. The length of periodontal treatment was determined by the severity of periodontal disease of the patient.

For patients in the periodontitis group, significant reductions in plaque level, tongue coating, BANA test score and oral malodour were observed following periodontitis treatment or tongue cleaning. However, larger reductions were observed following periodontitis treatment.

For patients in the gingivitis group, significant reductions in plaque level, tongue coating, BANA test score and oral malodour were again observed following both periodontal treatment and tongue cleaning. In contrast to the periodontitis group, larger reductions in oral malodour were observed following tongue cleaning.

Writing in the Journal of Periodontal Research, the authors conclude that "These finding suggest that periodontal treatments played an important role and that tongue cleaning contributed to a lesser extent to oral malodour reductions in periodontitis patients."

They went on to say "In contrast, tongue cleaning alone can be the most effective approach to reduce oral malodour in gingivitis patients."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Iain Bartlett

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