Dental Plaque, Oral Biofilm, Oral Hygiene, Tongue Coating
Conditions
Keywords
QLF-D, tongue scraper, tongue brush, Delta F, Tongue Coating Index, crossover
Brief summary
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.
Interventions
DEVICEBristled tongue brush
Over-the-counter tongue brush with a bristled cleaning surface (R.O.C.S. Pro Lingua, Moscow, Russia). Participants used the device once daily for 14 consecutive days, performing a single-directional sweeping motion from the posterior vallate papillae to the anterior tip of the tongue dorsum, using gentle self-regulated pressure sufficient to alter tissue curvature without causing mucosal discomfort.
DEVICEPlastic tongue scraper
Over-the-counter smooth plastic tongue scraper (Pearldent, DentaRAM, Istanbul, Türkiye). Participants used the device once daily for 14 consecutive days, performing a single-directional sweeping motion from the posterior vallate papillae to the anterior tip of the tongue dorsum, using gentle self-regulated pressure sufficient to alter tissue curvature without causing mucosal discomfort.
DEVICEMetal tongue scraper
Over-the-counter rigid metal tongue scraper (Glimo, Haltron, Istanbul, Türkiye). Participants used the device once daily for 14 consecutive days, performing a single-directional sweeping motion from the posterior vallate papillae to the anterior tip of the tongue dorsum, using gentle self-regulated pressure sufficient to alter tissue curvature without causing mucosal discomfort.
Sponsors
Istanbul Kent University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
Yes
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
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change From Baseline in Maximum Fluorescence Loss (Delta F Max) of Tongue Dorsum Biofilm Assessed by Quantitative Light-Induced Fluorescence-Digital (QLF-D) Imaging | Baseline (Day 1), Day 7 and Day 14 of each 14-day intervention period |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Average Fluorescence Loss (Delta F Average) | Baseline (Day 1), Day 7 and Day 14 of each period | — |
| Change From Baseline in Total Fluorescence Loss (Delta Q) | Baseline (Day 1), Day 7 and Day 14 of each period | — |
| Change From Baseline in White Spot Area | Baseline (Day 1), Day 7 and Day 14 of each period | — |
| Change From Baseline in White Spot Delta R | Baseline (Day 1), Day 7 and Day 14 of each period | — |
| Change From Baseline in Tongue Coating Index (TCI) | Baseline (Day 1), Day 7 and Day 14 of each period | The tongue dorsum is divided into nine regions (three posterior, three middle, three anterior). Each region is scored for coating thickness (0 = no coating, 1. = thin, 2 = thick) and for discolouration (0 = none, 1 = white, 2. = yellow/light brown, 3 = brown), following Shimizu et al. Higher scores indicate a greater quantity of tongue coating. |
| Change From Baseline in Unstimulated Salivary pH | Baseline (Day 1), Day 7 and Day 14 of each period | Unstimulated whole saliva collected with participants seated after refraining from eating and drinking for at least 60 minutes. Measured immediately with MQuant pH indicator strips (Merck KGaA, Darmstadt, Germany); the median of two readings was recorded. |
| Participant-Reported Device Acceptability | End of study (Day 14 of the third period) | — |
| Participant-Reported Gag Reflex Severity | End of study (Day 14 of the third period) | — |
Countries
Turkey (Türkiye)
Outcome results
None listed