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December 24, 2007

BehindTheMedspeak: Halitosis, tongue scrapers and 'breath valley'


Laura Johannes's "Aches and Claims" column in the December 18, 2007 Wall Street Journal (WSJ) was an excellent summary of current opinion on tongue scraping as a bad breath remedy.

Long story short: There are a wide variety of tongue scrapers available, none of them head and shoulders above the others.

However — this topic has been one of special interest to me and my crack research team for years, and following the WSJ piece I will reveal our nominee for "world's best tongue scraper."

Here's the newspaper item.

    Freshening Your Breath With Tongue Scrapers

    Brushing and flossing help prevent tooth decay, but they often aren't enough to prevent bad breath. A variety of hand-held tongue scrapers remove odor-causing bacteria from the tongue, according to companies that sell them. Some dentists say tongue scraping is a good idea, but warn that people should use them gently to avoid injuring the tongue.

    Bad breath is a common problem, affecting most people at least occasionally and some people chronically. It can be caused by a medical problem, such as cancer, but most of the time the culprit is odor-causing bacteria in the mouth. The bacteria are harbored on teeth and between them, but research has found that most of it is on the back of the tongue. "I call it breath valley," says Israel Kleinberg, a dentist at State University of New York at Stony Brook.

    Some people brush their tongues with a regular toothbrush, but this can cause an unpleasant gag reflex. Tongue scrapers — which come in a variety of shapes and materials and generally cost under $5 — are intended to remove the offending bacteria without making you gag. A nonscientific test of several different models found they caused a slight gagging sensation, but less than a regular toothbrush.

    Clinical research on tongue scraping is sparse. A review of scientific literature published last year by the Cochrane Collaboration found only two studies it considered scientifically worthy of inclusion. The Cochrane reviewers concluded from the two studies that using tongue scrapers is "slightly more effective" in combating bad breath than using a toothbrush to clean the tongue, but warned that the effects may be short-lived.

    Not everyone thinks you need a special tool to clean your tongue. Dr. Kleinberg says his tests have found that brushing your tongue with a toothbrush actually removes more bacteria. Most people can learn to do it without gagging if they persist, he adds.

    Using a tongue scraper is simple: Start at the back of the mouth and bring the implement outward. A 2004 Brazilian study that was one of the two featured in the Cochrane review had patients scrape for three minutes. But study author Vinícius Pedrazzi now believes that's overkill and recommends just nine strokes — three on each side and three in the middle, done prior to brushing so toothpaste doesn't get in the way. When you're done, your tongue should turn from pink to red. If you press too hard, you could cause bleeding.

    There are many materials, including metal, plastic and rubber; some have bristles, while others have a smooth edge. You can even get a regular toothbrush with a tongue cleaner attached, such as a $3.99 model from Colgate-Palmolive Co. that has a soft rubber surface for tongue cleaning attached to the back of the brush head. There is no major published study comparing the efficacy of different designs. But you can easily see for yourself which ones are working best by observing which removes the most film from the tongue, says St. Louis dentist Marvin Cohen. It's important to find one which you can get to the back of your tongue without gagging.


The Oolitt tongue scraper (below),


not mentioned in Ms. Johannes's column, is the Official Tongue Scraper of bookofjoe.


1. It works the best (just take a sniff of the gunk you bring out first thing in the morning and you'll see why — if you don't pass out first)

2. It's the easiest to really get way back towards the base of your tongue without completely gagging (though you will if you use it correctly — at least for the first few weeks)

3. It's got the most elegant, simple design of any of them

4. It's by far the cheapest


December 24, 2007 at 10:01 AM | Permalink


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Same design can be found in any Indian grocery store for half the price. Just so you know...

Posted by: jim` | Dec 24, 2007 10:52:00 AM

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