Authors : J A Madhumitha; Sangeet Chavan; R Palanivel Pandian; Premkumar P; Subhashini M; Ramalakshmi G

Volume/Issue : Volume 9 - 2024, Issue 9 - September

Google Scholar : https://tinyurl.com/bdhjv2m6

Scribd : https://tinyurl.com/3pab8asn

DOI : https://doi.org/10.38124/ijisrt/IJISRT24SEP1009

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Introduction: The tongue microbiota, like other parts of the oral cavity, plays a significant role in the development of dental caries. S. mutans and L. acidophilus species, are associated with the initiation and progression of dental caries.  Aim: To assess the efficacy of benzalkonium Chloride gel along with tongue cleaning aids in the reduction of tongue coating and bacterial count on dorsal surface of the tongue.  Materials and Methods: A double blinded randomized control trial was conducted among 17-25 years old college students. A total of 60 participants were randomly divided into 4 groups according to their use of tongue cleaning aids as follows: Group A, Tongue Brush Alone; Group B, Tongue Brush with Chlorhexidine Mouthwash (Clohex ADS); Group C, Tongue Brush with Chlorhexidine Gel (Hexigel); and Group D, Tongue Brush with Benzalkonium Chloride Gel. The Winkel tongue coating index (WTCI) was used to measure the tongue coating at baseline and at 14th day and the participant’s tongue coatings on dorsal surface were sampled using swab method, and the number of S. mutans and L. acidophilus colonies were counted before and after intervention.  Results: Both the Hexigel group and Benzalkonium chloride gel group reduced both the bacterial load and tongue coating at 14th Day compared to the baseline data.  Conclusion: This study suggests that usage of Tongue brush along with Benzalkonium Chloride gel decreased the tongue coating and the number of bacteria on the dorsal tongue surface.

Keywords : Benzalkonium Chloride Gel, Tongue Coating, Tongue Brush, S. Mutans and L. Acidophilus.

References :

1. Marsh PD. 2006. Dental plaque as a biofilm and a microbial community— implications for health and disease. BMC Oral Health 6 Suppl 1:S14.
2. Takahashi N, Nyvad B. 2011. The role of bacteria in the caries process: ecological perspectives. J Dent Res 90:294–303.
3. Winkel EG, Roldán S, Van Winkelhoff AJ, et al. Clinical effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc-lactate on oral halitosis. A dual-center, double-blind placebo controlled study. J Clin Periodontol 2003;30(4):300-307.
4. Danser MM, Gómez SM, Van der Weijden GA. Tongue coating and tongue brushing: a literature review. Int J Dent Hyg. 2003 Aug;1(3):151-8.
5. Van der Sluijs E, Van der Weijden GA, Hennequin-Hoenderdos NL, Slot DE. The effect of a tooth/tongue gel and mouthwash regimen on morning oral malodour. Int J Dent Hygiene. 2017;00:1–11.
6. Dwivedi V, Torwane NA, Tyagi S, Maran S. Effectiveness of Various Tongue Cleaning Aids in the Reduction of Tongue Coating and Bacterial Load: A Comparative Clinical Study. J Contemp Dent Pract. 2019 Apr 1;20(4):444-448. PMID: 31308274.
7. Choi HN, Cho YS, Koo JW. The Effect of Mechanical Tongue Cleaning on Oral Malodor and Tongue Coating. Int J Environ Res Public Health. 2021 Dec 23;19(1):108.
8. Aas JA, Paster BJ, Stokes LN, Olsen I, Dewhirst FE. Defining the normal bacterial flora of the oral cavity. J Clin Microbiol. 2005 Nov;43(11):5721-32.. PMID: 16272510; PMCID: PMC1287824.
9. Ciancio SG, Mather ML, Bunnell HL. Clinical evaluation of a quaternary ammonium-containing mouthrinse. Journal of Periodontology. 1975 Jul 1;46(7):397-401.
10. Quirynen M, Bollen CM, Vandekerckhove BN, Dekeyser C, Papaioannou W, Eyssen H. Full-vs. partial-mouth disinfection in the treatment of periodontal infections: short-term clinical and microbiological observations. Journal of dental research. 1995 Aug;74(8):1459-67.
11. Gonçalves ACS, Martins MCN, Paula BL, Weckwerth PH, Franzolin SOB, Silveira EMV. A new technique for tongue brushing and halitosis reduction: the X technique. J Appl Oral Sci. 2019 Apr 1;27:e20180331. PMID: 30970113; PMCID: PMC6442830.
12. Shivhare UD, Jain KB, Mathur VB, Bhusari KP, Roy AA. Formulation and development and evaluation of diclofenac sodium gel using water soluble polyacrylamide polymer.
13. Eltay EG, Gismalla BG, Mukhtar MM, Awadelkarim MO. Punica granatum peel extract as adjunct irrigation to nonsurgical treatment of chronic gingivitis. Complementary Therapies in Clinical Practice. 2021 May 1;43:101383.
14. Persson S., Edlund M.B., Claesson R., Carlsson J. The formation of hydrogen sulfide and methyl-mercaptan by oral bacteria. Oral Microbiol. Immunol. 1990;5:195–201.
15. Anil, S., & Gutkowski, R. (2014). Tongue diagnosis in integrative medicine. Integrative Medicine Insights, 9(6), 1-9.
16. Rosenberg M. Clinical assessment of bad breath: Current concepts. JADA. 1996;1217:475–482.
17. Funahara M, Yanamoto S, Soutome S, Hayashida S, Umeda M. Clinical observation of tongue coating of perioperative patients: factors related to the number of bacteria on the tongue before and after surgery. BMC Oral Health. 2018;18:223.
18. Tonzetich J, Ng SK. Reduction of malodor by oral cleansing procedures. Oral Surg Oral Med Oral Pathol 1976;42:172-81.
19. Laleman I, Koop R, Teughels W, Dekeyser C, Quirynen M. Influence of tongue brushing and scraping on the oral microflora of periodontitis patients. Journal of periodontal research. 2018 Feb;53(1):73-9.
20. Dwivedi V, Torwane NA, Tyagi S, Maran S. Effectiveness of Various Tongue Cleaning Aids in the Reduction of Tongue Coating and Bacterial Load: A Comparative Clinical Study. J Contemp Dent Pract. 2019 Apr 1;20(4):444-448. PMID: 31308274.
21. Gondhalekar R, Richard KM, Jayachandra MG, Aslam S, Reddy VN, Barabde AS. Effect of tongue cleaning methods and oral mutans streptococci level. J Contemp Dent Pract. 2013 Jan 1;14(1):119-22. PMID: 23579907.
22. Quirynen M, Bollen CM, Vandekerckhove BN, Dekeyser C, Papaioannou W, Eyssen H. Full-vs. partial-mouth disinfection in the treatment of periodontal infections: short-term clinical and microbiological observations. Journal of dental research. 1995 Aug;74(8):1459-67.
23. Ileri Keceli T, Gulmez D, Dolgun A, Tekcicek M. The relationship between tongue brushing and halitosis in children: a randomized controlled trial. Oral diseases. 2015 Jan;21(1):66-73.
24. Funahara M, Soutome S, Nakamura A, Soh I, Honda H, Hikiji H. Comparison of the efficacy of three types of disinfectants approved for oral use in Japan in reducing the bacterial count of tongue coating: a randomised-controlled study. Oral Health Prev Dent. 2021 Jan 1;19:405-9.
25. Shimizu T, Ueda T, Sakurai K. New method for evaluation of tongue-coating status. J Oral Rehabil 2007; 34: 442–447.