Worried about bad breath during the festive feasting and visiting period? Dentists say that the practice of tongue scraping might help.
Dr Koh Chu Guan, senior consultant at the National Dental Centre Singapore’s Periodontics Unit, Department of Restorative Dentistry, says: “The tongue is often the biggest source of halitosis-causing bacteria.”
Cleaning the tongue with either a toothbrush or tongue scraper will thus remove bacteria, give you a fresher mouth feel and help your breath smell sweet.
However, dentists are divided over whether tongue scraping will improve your oral health.
Dr Eunice Foo from Q & M Dental Group (Singapore) says: “While tongue scraping can reduce oral malodour, its impact on improving dental or overall health has yet to be established.”
That has not stopped influencers and celebrities from promoting the practice of using a purpose-made tool to scrape the surface of the tongue.
Tongue scraping took off as a TikTok trend from November 2022, when actress Gwyneth Paltrow shared on Instagram that her morning routine includes scraping her tongue using a curved metal implement. Paltrow is also the owner of lifestyle brand Goop, which sells tongue-scraping tools.
Tongue scrapers are also part of supermodel-turned-beauty entrepreneur Cindy Crawford’s wellness routine. “You have to do it first thing in the morning, don’t even drink water,” she told style publication The Cut in an interview published in March 2023.
Celebrities overseas swear by tongue scraping, but the practice is not as popular in Singapore any more, according to dentists.
Dr Foo says: “While no official research has been done locally, research from different populations show that the percentage of people who tongue scrape hovers around 10 to 20 per cent.”
Dentist James Ho notes that while the younger generation is less keen on tongue scrapers, he recalls that in his childhood, his parents were more likely to scrape their tongues than to floss.
The founder and chief executive of G Dental Center and GPlus Dental Center says tongue scraping is part of his daily oral hygiene routine, along with brushing his teeth and flossing.
“I don’t feel clean until I scrape my tongue,” says Dr Ho, adding that he makes a point of doing this before going to bed to prevent the build-up of bacteria on the tongue.
Why scrape the tongue?
The tongue has a large surface area and its upper surface has many small structures called papillae, which can make the tongue look or feel rough.
Dr Leroy Kiang, dentist at Orchard Scotts Dental, says these factors predispose the tongue to being covered with a coating that acts as a “reservoir” for bacteria, which can produce foul-smelling compounds that lead to bad breath.
Apart from bacteria and other micro-organisms, the coating on the tongue contains food debris, salivary components and dead epithelial cells, he adds. Tongue scraping can remove this coating and reduce the amount of bacteria in the mouth.
If a thick layer builds up on the tongue, that can also “block” your taste buds and affect your sense of taste, he adds. “Some studies suggest that tongue scraping twice a day can improve one’s taste perception, especially bitter and salty tastes.”
Dr Koh says it is likely that many do not realise that tongue scraping is an important step of the oral hygiene regimen, apart from brushing and cleaning in between your teeth.
“The part of the tongue that harbours the most bacteria, and that often gets missed by even the people who clean their tongue regularly, is the back-most portion,” he adds. This is because the papillae in that part of the tongue are longer and bacteria are more likely to persist there.
How to clean your tongue?
Dentists stress that brushing your teeth and flossing are most important to oral hygiene. Dr Kiang suggests tongue scraping first and then using a mouth-rinse if that is part of your oral hygiene regimen. Brush third, and floss last.
Dr Ho says that as soon as children are old enough to brush their teeth or have their teeth brushed, they can start with a tongue-cleaning routine.
The biggest challenge that many face will be the gag reflex, he adds. The urge to gag activates when the tongue is touched, but could reduce over time as you form the habit of cleaning your tongue regularly.
Tools on the market for cleaning the tongue include flexible metal strips; ridged plastic tools; and scrub pads on the back of toothbrushes. Dentists suggest experimenting with such purpose-built tools to find what is comfortable for you.
Dr Foo says that the tongue should be scraped or cleaned from the rear to the front. Either a tongue scraping tool or toothbrush can be used. “Studies show that both yield comparable results with statistically significant reductions in bacterial count,” she adds.
“Try to avoid using makeshift scrapers with household items,” she says, adding that one study showed that a spoon was less effective at removing bacteria compared with a tongue scraper.
Dr Koh says it can be dangerous to clean the tongue with items not designed for this purpose. “You could cause trauma, such as cuts, to your tongue.”
Dr Benjamin Yap, dental surgeon at Raffles Dental, cautions that tongue scraping should be done gently.
“Overzealous tongue scraping can be counterproductive – causing irritation, micro-cuts or infection – especially if the tool used is not clean. It is important to use only gentle pressure and a clean, specifically designed tongue scraper to prevent such issues,” he says.
People with medical conditions that affect the tongue, such as ulcers, should avoid scraping it, he adds. Those with piercings should also exercise care. “Anyone who is unsure should always consult a dental professional.”
Impact on oral health
Can tongue scraping improve your oral health? Dr Yap thinks so.
“The presence of bacteria can cause dental diseases such as tooth decay or gum disease. Effective tongue scraping can help reduce the overall bacteria load in the mouth, hence improving dental health,” he says.
In contrast, Dr Koh says there is no evidence that tongue scraping can improve dental health. It has not been proven to reduce the incidence of caries in the teeth or gum infections.
Dr Kiang says: “Including tongue scraping in one’s oral healthcare routine may slow down the formation of new dental plaque and indirectly reduce the risk of tooth decay and gum disease.”
He adds that reducing the bacteria in dental plaque is more important than reducing the total number of bacteria in the mouth. “A colony of bacteria in a layer of plaque on the teeth can collectively cause tooth decay by breaking down sugars and producing acid, or cause gum disease by producing toxins,” he says.
“Proper brushing and flossing should be the main focus of one’s oral hygiene routine, as this allows one to mechanically disrupt the layer of plaque on the surface of the teeth, which directly reduces the risk of tooth decay and gum disease.”
Dr Foo sums up the consensus as follows: “Tongue scraping is very effective at reducing halitosis, but does not really have a significant impact on oral or overall health.
“Nevertheless, it is undoubtedly an overlooked area of our oral cavity and we would still benefit from incorporating tongue scraping into our daily routine.”
The Bottom Line: Scraping your tongue regularly can help give you a fresher mouth feel and reduce the risk of bad breath. Use a clean tongue scraper, tongue cleaner or toothbrush for this purpose, but remember that brushing your teeth and flossing are still most important when it comes to oral hygiene.
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