The Effect of Tongue Cleaning in Periodontitis Patients

Study Overview
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Brief Summary
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The aim of this study was to examine in periodontitis patients with visible tongue coating the changes in microbial load (aerobic and anaerobic) of the 14 day use of a tongue scraper versus the use of a regular toothbrush to clean the tongue.

Detailed Description
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Volatile sulphur compounds (VSC's) are the most important causes of bad breath. Since the micro-organisms that produce VSC's are also periodopathogens, intuitively, one would think that there is a positive correlation between VSC levels in exhaled breath and periodontitis. However, not all periodontitis patients have bad breath. A possible explanation can be a positive relationship between tongue coating an bad breath. In the past, tongue cleaning was already researched in an oral healthy population. This research aimed to examine in periodontitis patients with visible tongue coating the changes in microbial load (aerobic and anaerobic) of the 14 day use of a tongue scraper versus the use of a regular toothbrush to clean the tongue. Additionally changes in tongue coating; and patient perception about tongue cleaning was researched.

Official Title
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The Effect of Tongue Scraping Compared to Tongue Cleaning on the Tongue Coating of Periodontitis Patients

Conditions
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Periodontitis, Tongue Coating

Intervention / Treatment
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* Device: Tongue scraper
* Device: Toothbrush


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: systemically healthy patients periodontitis patients Exclusion Criteria: already using a tongue cleaning device use of antibiotics the previous 6 months rinsing with a chlorhexidine mouth rinse the past month smokers patients who underwent periodontal therapy the past three years were not included.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Tongue scraper<br>In this group the subjects are explained how to use a plastic loop-formed tongue cleaner (Halita® tongue cleaner (Dentaid, Spain)) to clean their tongues. | Device: Tongue scraper<br>* The patients were instructed to start cleaning the tongue by two pulling strokes along the median sulcus of the tongue, followed by two pulling strokes along the lateral edges of the tongue.<br>* Other names: Tongue scraper (Halita® tongue cleaner (Dentaid, Spain));|
| Experimental: Toothbrush<br>In this group the subjects are explained how to use a toothbrush (Oral-B® Indicator® medium tooth brush) to clean their tongues. | Device: Toothbrush<br>* The patients who were assigned to the tooth brush group were taught to perform three forward and backward strokes along the median sulcus and at each lateral part of the tongue.<br>* Other names: Toothbrush (Oral-B® Indicator® medium tooth brush);|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Extension of the tongue coating | Extension of the tongue coating measured according to Miyazaki (1995) and Winkel (2003). | 14 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Bacterial load measured by culturing methods | Microbiological composition of the tongue coating. | 14 days | 
| Bacterial load measured by means of qPCR | Microbiological composition of the tongue coating. | 14 days | 
| Bacterial composition of unstimulated saliva (measured with the aid of culturing methods) | Microbiological composition of the saliva. | 14 days | 
| Bacterial composition of unstimulated saliva (measured with qPCR) | Microbiological composition of the saliva. | 14 days | 
| Experience of the subject of tongue coating related factors measured using a questionnaire | Experience of the subject of the breath odour, taste perception; and cleanliness of the tongue. | 14 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Periodontitis, Tongue coating, Tongue cleaning, Bacterial load