Abstract
BackgroundThe effects of tongue cleaning on reconstruction of bacterial flora in dental plaque and tongue coating itself are obscure. We assessed changes in the amounts of total bacteria as well as Fusobacterium nucleatum in tongue coating and dental plaque specimens obtained with and without tongue cleaning.MethodsWe conducted a randomized examiner-blind crossover study using 30 volunteers (average 23.7 ± 3.2 years old) without periodontitis. After dividing randomly into 2 groups, 1 group was instructed to clean the tongue, while the other did not. On days 1 (baseline), 3, and 10, tongue coating and dental plaque samples were collected after recording tongue coating score (Winkel tongue coating index: WTCI). After a washout period of 3 weeks, the same examinations were performed with the subjects allocated to the alternate group. Genomic DNA was purified from the samples and applied to SYBR® Green-based real-time PCR to quantify the amounts of total bacteria and F. nucleatum.ResultsAfter 3 days, the WTCI score recovered to baseline, though the amount of total bacteria in tongue coating was significantly lower as compared to the baseline. In plaque samples, the bacterial amounts on day 3 and 10 were significantly lower than the baseline with and without tongue cleaning. Principal component analysis showed that variations of bacterial amounts in the tongue coating and dental plaque samples were independent from each other. Furthermore, we found a strong association between amounts of total bacteria and F. nucleatum in specimens both.ConclusionsTongue cleaning reduced the amount of bacteria in tongue coating. However, the cleaning had no obvious contribution to inhibit dental plaque formation. Furthermore, recovery of the total bacterial amount induced an increase in F. nucleatum in both tongue coating and dental plaque. Thus, it is recommended that tongue cleaning and tooth brushing should both be performed for promoting oral health.
Highlights
The effects of tongue cleaning on reconstruction of bacterial flora in dental plaque and tongue coating itself are obscure
Baseline measurements At baseline, there were no significant differences for Winkel tongue coating index (WTCI), amounts of collected tongue coating and dental plaque samples, and amounts of total bacteria and F. nucleatum in whole collected samples as well as those in 1-mg samples between subjects with and without tongue cleaning (Table 1)
The volume of tongue coating was greater than dental plaque, while the amounts of both total bacteria and F. nucleatum in the 1-mg samples were greater in those from dental plaque
Summary
The effects of tongue cleaning on reconstruction of bacterial flora in dental plaque and tongue coating itself are obscure. Tongue mucosa is a major habitat of Candida species, which can cause severe infections in immunocompromised hosts such as patients in the perioperative period or bedridden elderly [5]. Such microorganisms aggregate with mucosal epithelium detachment, as well as food and saliva components, and others, and cover the tongue surface to form the so-called tongue coating. We utilized a crossover design and compared changes in total bacteria amounts in dental plaque and tongue coating samples obtained from subjects with and without tongue cleaning using polymerase chain reaction (PCR) assays
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