Get a handle on deplaquing

Oct. 1, 2006
During normal daily use, parking lots accumulate much debris from motorists and pedestrians.

During normal daily use, parking lots accumulate much debris from motorists and pedestrians. Gravel, grime, and garbage cover the pavement through littering and normal wear-and-tear. When the filth piles up and needs to be removed, a mechanical street sweeper slowly and powerfully lowers its swirling “brush” on the surface to efficiently remove the debris for a cleaner concrete surface.

The tongue’s papillae harbors debris from bacterial bioburden much the same way pavement becomes cluttered with refuse. When this bacteria accumulates on the tongue’s surface it may smell foul, and become thick and unsightly. Instructing patients on tongue maintenance to reduce unwanted bacterial conditions should include the introduction of a tongue-cleaning tool.

The tongue harbors bacteria by the millions! These Gram-negative bacteria breed, multiply, decompose, and excrete sulfur-based compounds, which smell dreadful. Anaerobic bacteria target the tongue’s dorsum. Gassy halitosis from the rotting anaerobic bacteria coating accumulates and breaks down membranes in the mouth, which encourages oral disease.

Often patients are diligent with homecare, but their tongue maintenance may be lacking.

By associating bad breath and the tongue’s microbial culprits with whole body health, patients might reduce these harmful microorganisms and improve their oral hygiene and health through mechanical bacterial reduction. When patients need soft plaque pick-up on the tongue, hygienists should recommend a tongue-cleaning device that removes the fixed debris appearing as a gray-white layer on the tongue.

How to use a tongue tool

When a tongue deplaquing device is used correctly, tongue care will not be a gagging event. For home care, the patient should extend his or her tongue over the sink. Generally, the plaque collects on the back base of the tongue and the patient will see the debris. Patients tend to gag easily when the tongue is completely extended, so have them stick their tongue out or slightly relax it to minimize the gag response.

They should place the tool as far back on the tongue as tolerable. Flatten the tongue with light force (so the tool conforms to the tongue anatomy), and drag the tool forward like a squeegee. The tongue cleaner should pull across the tongue surface and sweep it, going from the back to the front of the tongue. Repeat this several times until the fluid debris can no longer be removed. Remove the bacteria each time from the implement by running water over it and drying it when finished.

This deplaquing action may need to be performed several times each day, especially when bothersome build-up and reeking halitosis occur.

How to choose a tongue tool

Make tongue cleaning a component of each recare appointment. Tongue devices may be used many times. Instruct patients chairside and then dispense the necessary tool for home care. Also, a tongue tool can become part of the hygiene tray setup and used during recare visits, then sterilized for multiple uses.

One tool, the Tongue Sweeper by Biocurv Medical, is constructed from rigid surgical grade stainless steel. Measuring six inches, it resembles a bubble wand, with an almost oval cleaning end. The Tongue Sweeper is sturdy, and, with its open-end design, debris can be easily rinsed off of it.

Bulky food particles can be easily removed from the tongue’s grooves during regular cleanings. Sunstar Butler, makers of the GUM Tongue Cleaner, offers a tool with a slender scraper and soft bristle action. The handle has a cushioned thumb rest that makes handling the tongue cleaner easier. Plaque and bacteria can be removed with the two rows of wavy scrapers and bristle tuffs to complete the deplaquing process.

Odor-producing bacteria collect on, and coat, the tongue. The tongue’s texture makes it a propagating place for the harmful bacteria that contribute to bad breath and oral disease. Many patients say their food tastes better when the decaying debris is removed. This makes sense considering the tongue’s taste receptors are now exposed.

Pureline Oralcare’s Professional Tongue Cleaner promotes cleaning to restore taste sensation. Made out of a medical grade bio-compatible safe material, the Professional Tongue Cleaner is autoclavable. It has a large working area, with a sort of stability bar to efficiently eliminate plaque film. To further promote a fresh mouth for your patients, Pureline offers an all-natural breath gel that contains botanicals such as aloe vera and mint oils, which can be applied to improve breath and overall oral care.

The dorsum area of the tongue is especially hard to reach. A toothbrush would likely disturb debris, but would need to be placed nearly sideways to sweep out the debris and remove it as effectively as a device designed only for tongue maintenance. Another tool, the OraSweet Tongue Scraper by OraMedix, has a concave spoon-like scraping edge that prevents lifted debris from dispersing throughout the mouth. Because of its cupped design, it can reach the concave back surface of the tongue where bacteria thrive. This spooned scraper also has a travel type tool, the GoFresh, which folds to 4.5 inches for travel.

When the papillae “pavement” on the tongue becomes filled with filth, safely remove the bulk of the debris with a tongue care device. A variety of tongue cleaners can dramatically improve oral health. Getting a handle on total mouth maintenance is not something to stick your tongue out at - unless you use a deplaquing tongue tool.

The author did not receive compensation for products mentioned. Visit;;;

Karen Kaiser, RDH, graduated from St. Louis’ Forest Park dental hygiene program in 1994 and currently practices at the Center for Contemporary Dentistry in Columbia, Ill. She has written several articles for RDH and other publications, sits on dental hygiene panels, and is an evaluator for Clinical Research Associates. She can be contacted at [email protected].