ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Low Level Evidence Shows Tongue Scraper Plus Tooth Brushing Use is More Effective in Reduction of Oral Malodor and Reduction of Bacteria for 4 Days Than The Use of Mouth Rinse or Tooth Brushing
Clinical Question For a patient with oral malodor will tongue scraper plus tooth brushing be more effective than mouth rise or tooth brushing alone in reducing the malodor?
Clinical Bottom Line For patients with oral malodor, the use of a tongue scraper plus tooth brushing is more effective in the long term (4 days) reduction of oral malodor than mouthwash use or toothbrushing only.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 18460399Bordas/200819 subjects exhibiting oral malodor Prospective case series
Key resultsThis trial states there was a statistically significant reduction in bacterial loads observed in both the tongue scraper plus tooth brushing and mouthwash groups compared with the toothbrushing only group as the the control. The bacterial load of log10 1.11−1.96 cfu/sample for subjects who performed thorough tongue cleaning with a mouth wash, and the reduction of log10 0.11−0.40 cfu/sample for subjects who performed tongue scraping and tooth brushing . Data was gathered at days 1 and 4 post treatment. Only subjects who performed tongue scraping and tooth brushing resulted in significant reductions at day 4. Immediately after the use of mouth wash the bacterial load is greatly reduced, but for long term results; the use of a tongue scraper better eliminates the causing bacteria of oral malodor. Significant reductions seen in gram negative anaerobes and streptococcus salivarius in a long term (4 days) effect verses the use of mouth rise.
Evidence Search Impact of different tongue cleaning methods
Comments on
The Evidence
This study was a double blinded crossover study with 19 participants similar at start. All groups were treated the same with an adequate follow up. The compliance and percentage of completion was not documented. There is likely a bias to this study, due to the fact that GlaxoSmithKline funded the trial. A larger larger sample size than 19 would better support this study.
Applicability There is no patient harm in using a tongue scraper. Potential benefits include reduction of bacteria on the dorsal surface of the tongue therefor eliminating or reducing oral malodor. Patients can use this oral hygiene product easily at home and start to see reduction in plaque on the tongue surface. With this plaque removal patients can also expect for breath to freshen. Tongue scrapers are widely available for patients to access with ease of use and are reasonable for most dental practices implement in patient education.
Specialty/Discipline (General Dentistry)
Keywords Impact of different tongue cleaning methods
ID# 2567
Date of submission: 10/21/2013spacer
E-mail saenzcn@livemail.uthscsa.edu
Author Courtney Saenz
Co-author(s) Ali Griffith
Co-author(s) e-mail GriffithAL@livemail.uthscsa.edu
Faculty mentor/Co-author Carol A. Nguyen, MPH, MS
Faculty mentor/Co-author e-mail NGUYENC@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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