Intervention Review

Tongue scraping for treating halitosis

  1. Trent L Outhouse1,*,
  2. Rashad Al-Alawi2,
  3. Zbys Fedorowicz3,
  4. James V Keenan4

Editorial Group: Cochrane Oral Health Group

Published Online: 19 APR 2006

Assessed as up-to-date: 19 FEB 2006

DOI: 10.1002/14651858.CD005519.pub2

How to Cite

Outhouse TL, Al-Alawi R, Fedorowicz Z, Keenan JV. Tongue scraping for treating halitosis. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD005519. DOI: 10.1002/14651858.CD005519.pub2.

Author Information

  1. 1

    Awali, Bahrain

  2. 2

    Ministry of Health Bahrain, Periodontology, Manama, Bahrain

  3. 3

    Ministry of Health, Bahrain, UKCC (Bahrain Branch), Awali, Bahrain

  4. 4

    US Navy, Branch Dental Clinic London, Beaconsfield, Bucks, UK

*Trent L Outhouse, Box 25438, Awali, Bahrain.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 19 APR 2006




  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak


Halitosis is used to describe any disagreeable odour of expired air regardless of its origin. Mouthwashes which disguise oral malodor are more socially acceptable and generally more popular than tongue scrapers.


To provide reliable evidence regarding the effectiveness of tongue scraping versus other interventions (including mouthwashes) to control halitosis.

Search methods

We searched the following databases: Cochrane Oral Health Group Trials Register (to 15th September 2005); the Cochrane Central Register of Controlled Trials (The Cochrane Library 2005, Issue 3); MEDLINE (1966 to 15th September 2005); and EMBASE (1974 to 19th September 2005).

Selection criteria

Randomized controlled trials comparing different methods of tongue cleaning to reduce mouth odour in adults with halitosis.

Data collection and analysis

Clinical heterogeneity between the two included trials precluded pooling of data, therefore a descriptive summary is presented.

Main results

This review included two trials involving 40 participants. Both trials were methodologically sound but included no data for the primary outcomes specified in this review. Secondary outcomes expressed as volatile sulfur compound (VSC) levels were assessed by a portable sulfide monitor in both trials. One trial showed reductions of VSC levels of 42% with the tongue cleaner, 40% with the tongue scraper and 33% with the toothbrush. Reduced VSC levels persisted longer with the tongue cleaner than the toothbrush and could not be detected for more than 30 minutes after the intervention in any of the groups. Differences were assessed by the Friedman and Wilcoxon signed rank tests with the level of significance set at P < 0.05. The second trial, in which differences in totaled rank values between groups were compared by the Dunn method α = 0.01, showed a reduction of VSC levels compared with baseline measurements of 75% with the tongue scraper and 45% with the toothbrush. Adverse effects in one trial were nausea (60%) and trauma (10%) with the toothbrush and all participants receptive to using the tongue scraper. Based on the independent data from these two trials there was a statistically significant difference between the effectiveness of either the tongue cleaner or the tongue scraper in reducing VSC levels when compared with the toothbrush.

Authors' conclusions

There is weak and unreliable evidence to show that there is a small but statistically significant difference in reduction of VSC levels when tongue scrapers or cleaners rather than toothbrushes are used to reduce halitosis in adults. We found no high level evidence comparing mechanical with other forms of tongue cleaning.


Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak

Tongue scraping for treating halitosis

Tongue scrapers or cleaners are slightly more effective than toothbrushes as a means of controlling halitosis in adults. This review, which included 2 trials (40 participants) found that, although the use of tongue scrapers was generally well accepted, the effects of tongue cleaning using scrapers or brushes appeared to be very short lived and there was some limited evidence of tongue trauma which occurred with prolonged use of one tongue scraper.



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak

口臭治療のための舌こき (レビュー)






我々は以下のデータベースを検索した。Cochrane Oral Health Group Trials Register(2005年9月15日まで), the Cochrane Central Register of Controlled Trials(2005年Issue 3まで), MEDLINE(1966年~2005年9月第1週), EMBASE(1974年~2005年9月、2005年9月19日に検索)。










監  訳: 鈴木 奈央,佐々木 好幸,JCOHR,2008.4.1

実施組織: 厚生労働省委託事業によりMindsが実施した。

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  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak







我們搜尋了以下的資料庫:Cochrane Oral Health Group Trials Register (一直到2005年九月15號); the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3 2005); MEDLINE 1966年到2005年九月的第一個星期; EMBASE 1974年到2005年九月(2005年九月19號搜尋).






這篇文獻回顧包括二個試驗共有40位受試者.二個實驗在方法上都是完善地,但沒有列出本篇文獻回顧所要觀察的主要評估結果所需的資料.在二個實驗中,次要評估結果都是以可攜式的硫化物偵測儀來評估揮發性的硫磺複合物 (volatile sulfur compound)的濃度.其中一個實驗顯示使用舌頭清潔器可以達到降低42%揮發性的硫磺複合物,使用舌苔刮除器可以降低40%,而使用牙刷則可以降低33%.使用舌頭清潔器來降低揮發性的硫磺複合物濃度比使用牙刷還維持的久,而不管使用哪一種方式處理過後超30分鐘以上都無法偵測到.差異性的評估是利用Friedman and Wilcoxon signed rank tests,顯著差異的設定是在p<0.05.第二個實驗中,各個實驗組的合併等級數值(totaled rank values)的差異是用Dunn method &#945; = 0.01來比較,顯示使用舌苔刮除器可以降低基準值75%的揮發性的硫磺複合物,使用牙刷則降低45%.其中一個實驗中發生的不良反應包括:噁心(佔了60%)和使用牙刷造成的擦傷(佔了10%),而所有的受測者都能接受舌苔刮除器.由這二個實驗中個別獨立的資料來看,不管使用舌苔刮除器或舌頭清潔器,和只使用牙刷做相較,在降低揮發性的硫磺複合物濃度方面,都能達到統計上顯著的差異.





此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。




Laički sažetak

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak

Čišćenje jezika za liječenje neugodnog zadaha iz usta

Naprave za čišćenje jezika nešto su učinkovitije nego zubne četkice kao sredstvo kontroliranja neugodnog zadaha iz usta u odraslih osoba (halitoze). Ovaj Cochrane sustavni pregled, koji je uključio 2 ispitivanja (40 ispitanika), pokazuje da iako su naprave za čišćenje jezika općenito prihvaćene, učinak čišćenja jezika strugalicama ili četkicom ima vrlo kratkotrajan učinak. Osim toga, postoje ograničeni dokazi da produljena uporaba naprava za čišćenje jezika može uzrokovati ozljede jezika.

Bilješke prijevoda

Prevoditelj:: Croatian Branch of the Italian Cochrane Centre