Halitosis is a common complaint with up to one third of the general population being affected, and can sometimes become an obsessive concern to the individuals whom it affects.
Arising from a number of sources including the sinuses, gastrointestinal tract, ingested food and lungs, the mouth remains the most frequent cause of oral malodour. It is most commonly associated with the by-products of dying bacteria in periodontal pockets and particularly the top of the tongue. These by-products result from the microbial fermentation of proteins, peptides and mucins found in lysed neutrophils, desquamated epithelial cells, saliva blood, gingival crevicular fluid and any residual food stuffs retained on the oral surfaces. The most evident of the malodorous compounds are known as volatile sulphur compounds (VSC’s) with hydrogen sulphide, methyl mercaptan and dimethyl sulphate accounting for around 90% of the VSC’s.
The micro-organisms implicated in halitosis are predominantly Gram-negative anaerobes which secrete chemicals that produce the malodour in many instances. More recent research has revealed that the Gram-positive bacteria aids the efforts of the anaerobes by denuding the available glycoproteins of their sugar chains, resulting in the production of odorous gasses from the proteolytic breakdown of the denuded proteins. Species that produce these malodorous compounds include treponema denticola, porphyfomonas gingivalis, tannerella forythensis and eubaterium species.
There is a vast array of ‘tongue cleansers’ that have become available in the UK market (38 at the last count!). The most consistent shape for a tongue cleanser throughout history has been the “U” shape.
Historically, a widely used material utilised for tongue cleaning was the bark of the Neem tree. The neem tree (Azadirachta indica) is a tropical evergreen related to mahogany. The bark to the neem tree was believed to have healing properties in the Ayurvedic system. The bark is now known to possess large numbers of catechins and immuno-modulatory and immuno-stimulating compounds. The aroma from the moistened neem bark leaves a pleasant and clean after taste. Tongue cleansing has a fascinating and wonderfully rich history embedded in cultural and religious symbolism as well as medicinal and herbal regimens.
The Tianos, an ancient Puerto Rican community discovered by Columbus, used beautifully carved ‘vomiting sticks’ to induce regurgitation and then cleanse the tongue as part of a ritual inhalation of the hallucinogen ‘cohoba’. Hallucinations were believed to be communication with the various gods. Thus, the cleansing of the gateway to the body had huge cultural and religious significance.
There are many ancient religions that emphasized cleanliness of the oral cavity including the tongue. Early Buddhist literature cites numerous evils associated with an unclean tongue, stating: “The mouth becomes evil smelling, the taste conducting nerves of the mouth are not cleaned, and bile, phlegm and food cover the tongue over”.
According to the noted dental historian, Menzies Campbell, tongue cleansers were also sold because of the demand fuelled by the ‘high prevalence of thickly coated tongues’.
So, far from being just a gimmick, tongue cleansing has a long and established international history with a growing body of clinical evidence to support the regular use of tongue cleaning aids. So, as with toothbrushes, for those of us that prefer to keep it simple, perhaps it’s best to stick with the tried and tested – why reinvent the wheel when the round one works perfectly well?