Tongue cleaning: all in the best possible taste

As dental care professionals (DCPs), we deal with the health of the oral cavity. Patient compliance is key in the maintenance of good oral health and it is our duty to encourage a strict cleaning regime. As oral health educators, we expect our patients to clean their teeth with fluoride toothpaste, using efficient and evidence-based brushing mechanisms and, if possible, using an electric toothbrush. There is also an expectation upon us to educate our patients in the essential practice of interdental cleaning, demonstrating—if necessary—best practices and discussing with them the best interdental brushes, tailoring the choices to suit their dentition.

The surface of the tongue is covered with millions of nodules called papillae, which give it its rough texture. There are around 10 000 tastebuds situated on or around the papillae. A single taste bud contains 50 to 100 taste cells containing all of the five taste sensations: sweet, sour, bitter, salt and umami (Riley, 2014) (Figure 1). Bacteria and debris collects within the surface of the tongue and release gases that cause bad breath. Poor oral hygiene is the number one cause of bad breath. Although brushing and flossing loosens and moves around debris, they do not actually remove the bacteria, which can affect teeth and gums, leading to caries and periodontal disease. Almost half of our oral bacteria live on—and in—the deep crevices of our tongue (Danser et al, 2005). How many of us, as DCPs, have considered discussing the importance of tongue cleaning? Indeed, how many of us do it ourselves? This consideration is a reminder to us all that we all have a regulatory responsibility to meet the overall health needs of patients. Furthermore, the General Dental Council's (2013) Standards for the Dental Team maintains that all aspects of patients' health and wellbeing should be a consideration, and, as such, the tongue shout be part of this responsibility.