Cochrane · intervention · CD005519

Tongue scraping for treating halitosis

Cochrane Database of Systematic Reviews · 2006 · Cochrane Library

Oral Health Oral medicine and oral cancer2 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

5

current version

GRADE rated

0

No studies

3

Included studies

2

as reported

No studies 3 · 60%Ungraded 2 · 40%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Adults (over 18 years) with a clinical or self-assessed diagnosis of halitosis	Adults with halitosis and raised baseline VSC (n=40); Seemann 2001: 30 adults (15 male, 15 female) from a bad-breath consultation clinic, Germany, baseline VSC > 130 ppb (28 analyzed); Pedrazzi 2004: 10 adults aged 20 to 50 years, Brazil
Intervention	Tongue scraping / mechanical tongue cleaning (any tongue scraper, tongue cleaner or toothbrush used to clean the tongue)	Tongue cleaner (One Drop Only, brush and scraper) (n=28); Tongue scraper (Tongue-Putzer) (n=28); Polystyrene scraper (n=10)
Comparison	Placebo; nothing (no intervention); mouthwash; other interventions (e.g. toothbrush used to clean the tongue)	Toothbrush (n=38)
Outcomes	Primary: self-expressed (perceived) and organoleptic (human nose) assessment of halitosis using a validated malodor intensity scale; Secondary: halitosis measured by halimeter (portable sulfide monitor) or gas chromatography with flame-photometric detection; Adverse effects (hypersensitivity to mouthwashes; physical trauma to tongue tissue from scrapers)	VSC levels by portable sulfide monitor (n=40); Adverse effects and acceptability questionnaire (n=10); primary self-expressed/organoleptic outcomes not reported
Study designs	Randomized controlled trial (RCT)	2 randomized controlled trials, both cross-over design
Timing	Minimum 4 weeks (planned)	Very short follow-up: immediately to 35 minutes post-intervention (Seemann 2001); 1 week (Pedrazzi 2004)

Search date: 2005-09. Databases: Cochrane Oral Health Group Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE

Questions and results

Current version only

Tongue scraping (mechanical tongue cleaning) vs Placebo or no intervention (nothing)

Population: Adults (over 18 years) with a clinical or self-assessed diagnosis of halitosis

CD005519.PUB2 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 4 weeks (planned) same question in other reviews	No eligible randomized controlled trials comparing tongue scraping with placebo or no intervention were identified.	0 studies	No studies

Tongue scraping (mechanical tongue cleaning) vs Mouthwash or other chemical intervention

Population: Adults (over 18 years) with a clinical or self-assessed diagnosis of halitosis

CD005519.PUB2 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 4 weeks (planned) same question in other reviews	No randomized controlled trials comparing mechanical tongue cleaning with mouthwashes were identified; the review notes "the somewhat unexpected lack of randomized controlled trials comparing the effectiveness of…	0 studies	No studies

Tongue scraper or tongue cleaner (One Drop Only tongue cleaner; Tongue-Putzer scraper; polystyrene scraper) vs Toothbrush (used to clean the tongue)

Population: Adults (over 18 years) with a clinical or self-assessed diagnosis of halitosis

CD005519.PUB2 (current) · 3 questions

Outcome	Effect	Evidence	Status / GRADE
Self-expressed (perceived) or organoleptic (human nose) assessment of halitosis Minimum 4 weeks (planned) same question in other reviews	Neither of the two included trials provided any self expressed (perceived) or organoleptic (human nose) assessments of halitosis (the review's primary outcomes); no data.	0 studies	No studies
Volatile sulfur compound (VSC) levels measured by portable sulfide monitor Immediately to 35 min post-intervention (Seemann 2001); 1 week (Pedrazzi 2004) same question in other reviews	No summary of findings table or GRADE assessment (pre-GRADE review); narrative synthesis, data not pooled. Seemann 2001: peak VSC reduction 42% with the tongue cleaner, 40% with the tongue scraper and 33% with the…	2 studies · 40 participants	Ungraded
Adverse effects (tongue trauma, nausea) and acceptability 1 week (Pedrazzi 2004) same question in other reviews	Pedrazzi 2004: six of ten (60%) participants complained of nausea and one participant of tongue trauma, only with the toothbrush; all participants were receptive to the tongue scraper. Seemann 2001: no adverse effects…	2 studies	Ungraded

Tongue scraping (mechanical tongue cleaning) vs Placebo or no intervention (nothing)

Population: Adults (over 18 years) with a clinical or self-assessed diagnosis of halitosis

CD005519 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 4 weeks (planned)	no estimate extracted	0 studies	No studies

Tongue scraping (mechanical tongue cleaning) vs Mouthwash or other chemical intervention

Population: Adults (over 18 years) with a clinical or self-assessed diagnosis of halitosis

CD005519 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 4 weeks (planned)	no estimate extracted	0 studies	No studies

Tongue scraping (mechanical tongue cleaning) vs Toothbrush or other mechanical tongue-cleaning method

Population: Adults (over 18 years) with a clinical or self-assessed diagnosis of halitosis

CD005519 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 4 weeks (planned)	no estimate extracted	0 studies	No studies