Treating bad breath via tongue cleaning.

- The single most important step you can take toward curing halitosis is almost always just cleaning your tongue more thoroughly. This page explains why and how.

What tongue

Link to why you need to clean your tongue.


Link to how to clean your tongue.

This should be the first cure you try.

Any person trying to improve the quality of their breath should always start off by establishing a regimen of thorough tongue cleaning (either brushing or scraping). In most cases, it's likely that this will be the only cure that's needed. If not, it at least makes a giant first step. Here's why.

Why tongue cleaning is so important.

  • A study by Delanghe (1998) evaluated subjects with oral malodor and determined that for 87% of them the underlying cause of their problem stemmed from conditions in their mouth.
  • Of these, 51% of cases were due to tongue coating, 32% due to gum disease and 17% from a combination of both.

(Danser 2003) [page references]

That means in roughly 68% of cases, thorough tongue cleaning should either cure or at least have a significant effect toward resolving a person's bad breath.

And in fact, that's precisely what a historic study by Tonzetich (1976) found. The average reduction in oral malodor after tongue cleaning (brushing in this case) was 59 to 88%. (Danser 2003)

[If you're looking for more research evidence that backs up the importance of cleansing your tongue as a cure for halitosis, read the contents of the box located at the other end of this link.]

Illustration showing the Winkel Tongue Coating Index grid superimposed on a picture of a tongue.

Dentists use the Winkel Tongue Coating Index to document the amount of debris that's present.

What you accomplish when cleaning your tongue.

By scrapping or scrubbing the dorsal surface of your tongue (meaning its top side, the side you can see), you're ridding it of what's probably the largest refuge of odor producing bacteria in your mouth, along with the nutrients they feed on. (Some researchers think that it's the latter of these two functions that's the more important one. [Slot 2015])

This is especially true when cleaning its rear-most portion. Remember the breath tests we outlined at the beginning of this topic?

If you did them, you probably found out that the tip portion (anterior part) of your tongue smelled a whole lot better than the back (posterior region). There's a simple explanation for this.

a) The anterior portion of your tongue is fairly self-cleansing.

The tip part of your tongue is relatively self-cleansing and therefore unlikely to harbor large numbers of odor producing bacteria.

Many tongue functions (swallowing, speaking) place it in firm contact with your hard palate. This friction creates a cleansing action that prevents any significant build up of bacteria and debris on it.

Picture showing bacterial accumulation on the back part of the tongue.

Debris accumulation on the back part of the dorsum of the tongue is usually what causes bad breath.

b) The posterior portion is not.

In comparison, the back part of your tongue only touches (at most) your soft palate. And any contact that does take place is relatively gentle.

As a result, your tongue movements don't create enough friction to result in any significant cleansing. Debris, including the bacteria that cause bad breath, will tend to build up in this region.

This is why cleaning your tongue in general, and the back part specifically, can be so effective in curing bad breath.

Look for yourself.

This accumulation is easy enough to see. Just stick your tongue out and look for the white, or even brownish, film on its surface. Like we show in our illustrations, it's usually triangular in shape with its broadest aspect covering across the back part of your tongue.

Takeaways from this section.

It can't be said enough. For most of us, bad breath is caused by the debris that builds up on the back part of our tongue. And if you're not cleaning it off, you won't cure your problems.

How to clean your tongue - General instructions.

When cleaning your tongue, you have two options. You can either brush it or scrape it.

Whichever method you choose, the goals and results of your efforts are exactly the same. Here's what you need to know.

a) You need to clean where the coating is.

For the most part, you should direct the bulk of your efforts toward cleaning the back portion of your tongue. That's because that's where the majority of the film that causes bad breath lies.

But don't reach too far back. You just need to clean the smooth top surface of your tongue (back to about where its main groove in the middle ends). Don't scrape or brush the mounds of tonsillar tissue positioned even further back and off to the sides.

Graphic stating that halitosis is usually caused by plaque accumulation on the back part of the tongue.

The most common cause of bad breath is debris accumulation on the tongue.

Tips and pointers.
  • Don't be surprised if you find that you have an active gag reflex. If you do, you'll probably find that over with time and with practice it will diminish.
  • If gagging is a problem, just do the best you can. If having a mishap seems likely, consider cleaning your tongue at times when your stomach is relatively empty.
  • Scraping, as opposed to brushing, may be less likely to trigger a gag reflex. (Danser 2003)

b) Be gentle.

It's possible to be too rough when cleaning, to the point where you may cause irritation or even bleeding. Doing so should always be avoided.

As a plan, be gentle and use low force. Focus on cleaning in the center region of your tongue, as opposed to its lateral borders (side areas) where the risk of creating traumatic injury is greater.

c) How often do you need to do it?

  • If you're not really having very much of a problem with breath odors, once a day will proably suffice.
  • In cases where a cure is needed, several studies have suggested that twice-daily cleaning is indicated. (Bartold 2016)
  • Considering how little time it takes, it's not a bad idea to just go ahead and do it every time you brush your teeth. The hope is a habit will set in where you're mouth won't feel clean unless you've cleaned your tongue too.

Tongue brushing vs. scraping - Which is better?

For all practical purposes, it probably doesn't make a whole lot of difference which technique you use. However, the type of tool that you use may. Here's what we found out.

  • In an overview of the topic of halitosis, Zurcher (2015) makes mention that scrapers tend to just clean the surface of the tongue, and therefore brushing has a more lasting effect. (We assume because the bristles of a brush have a greater ability to clean in grooves and furrows.)
  • Another literature review (Outhouse 2008) concluded that tongue scrapers and "cleaners" showed a marginal (but statistically significant) advantage in effectiveness over the use of a regular toothbrush.

    Tongue "cleaners" are tools whose design combines aspects of a brush (having either bristles or nubs) and a scraper (as seen in this picture below).

What method should you use?

From reading these papers, it would be our conjecture that:

  • Scraping your tongue using a "cleaner" probably makes the best choice.
  • Next in line would be using a specially designed tongue brush, scraper or even just a spoon (see below).
  • Using an everyday toothbrush probably makes the least effective option.

We think it's important to say that we wouldn't be unduly swayed by the above information.

If there's a technique that you find preferable (more convenient to do, makes you gag less, etc...), and thus using that method will make it more likely that you will take the extra step of cleaning your tongue, then it probably makes the best choice.

Being thorough yet gentle is the key.

We should state that a paper by Yaegaki (2000) which described the treatment of halitosis did not recommend the use of tongue scrapers or even "adult" toothbrushes. This opinion was based on two papers (Kameyama 1969 and Odajima 1979) that reported that mechanical stimulation enhanced the chances of tongue cancer in laboratory animals.

We are unaware of more recent findings on this subject. We'd expect that the level of risk would be greatest for those who are overzealous in their cleaning activities. When you brush or scrape, just keep in mind that it doesn't take a lot of pressure to break up your tongue's coating.

Option #1: Tongue brushing.

To experiment with brushing your tongue, you don't have to buy anything special to get started. You can just use your regular toothbrush.

Then, if you decide that this does make the right choice for you, shop around and take a look at the specialty brushes sold. Generally speaking, you can expect them to do a more effective job.

Instructions- How to brush your tongue.

  • Moisten your brush with tap water to soften up its bristles.
  • Stick your tongue out as far as you can and look for evidence of the coating that's formed. This will give you an idea of what you are trying to remove and where it's located.
  • Starting in the back and as you move forward, make brush strokes across your tongue that break up and scrub off the debris that's there.
  • You'll need to use some pressure but, of course, not enough to irritate your tongue.
  • Stick your tongue out again and evaluate your results. Brush more if you need to. You probably will.
  • Rinse your mouth out when you're finished. Rinse your brush off by holding it under a stream of running water and then set it somewhere where it can air dry.
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You can use something on your brush if you want.

You may be able to improve the effectiveness of your technique by using toothpaste or dipping your brush in mouthwash. (Just brushing is the really important step, the use of a product much less so.)

In general, products containing the following types of compounds should make a comparatively more effective choice. (This page provides more detailed information about their use.)

  • a) Those that neutralize volatile sulfur compounds.

    It's the stinky volatile sulfur compounds (VSC's) produced by anaerobic bacteria that actually cause bad breath. Products that contain VSC-neutralizing agents, such as chlorine dioxide or zinc, therefore can be useful.

  • b) Those that have antibacterial properties. Look for products that contain the antibacterials chlorine dioxide or cetylpyridinium chloride.

Related pages:

Option #2: Tongue scraping.

There are two types of tools you can use with this technique, either a scraper or a cleaner.

a) Scrapers

In its simplest form, a scraper could just be an inverted spoon (see picture below). Or you might choose to use one of the specially designed products sold.

As pluses of using this type of tool, you get the satisfaction of clearly seeing the gunk that's come off your tongue. And you may find that you have less of a tendency to gag when using one.

As disadvantages, scrapers tend to just clean the surface of your tongue, as opposed to down in grooves and furrows like possibly bristles can. And you may be more likely to create tissue trauma when using one, at least until you get the hang of using it.

A picture of a tongue 'Cleaner.'

A tongue "cleaner."

b) Cleaners

Tongue "cleaners" are the middle ground between scrapers and brushes. Their design typically includes:

  • An arrangement of rubber bristles or nubs that help to break up the tongue's coating and clean in grooves and furrows.
  • A blade part that scrapes your tongue's surface.
Which type of device should you use?

By at least a small margin, tongue cleaners are probably the most effective type of tool. But as we mentioned above, a decision about which to use (a cleaner, specially designed scraper or even just a spoon) should simply depend on which you prefer. All are valid implements.

If you shop around for any of these, you'll find that you have no shortage of designs to choose from. And there's no hard or fast rule about how to pick one out. Just go with the type that looks right to you. The one that looks like it would be most effective or easiest to use.

Instructions- How to scrape your tongue.

To experiment with tongue scraping, you don't have to buy anything special. You can just use a spoon out of your silverware drawer. Here's what to do.

A picture of using a spoon as a tongue scraper.

Tongue scraping using a spoon.

  • Pick out a spoon. Smaller is usually better than larger. An ice tea spoon or regular teaspoon can make a good choice.
  • Moisten it (so the gunk you dislodge washes off it easier).
  • Stick your tongue out as far as you can and look for evidence of the coating that's formed. This will give you an idea of what you are trying to remove and where it's located.
  • Turn the spoon upside down. Place it at the back of your tongue, and using just enough pressure so it makes good contact, and draw it forward.
  • Be thorough but gentle. Don't scrape so hard that you irritate your tongue.

    [Most people will find that they've scraped off a lot of whitish goo. You might try smelling it. This is what your breath smells like to others.]

  • Rinse the gunk off your spoon by running it under a stream of tap water.
  • Stick your tongue out and evaluate your work. Repeat the process a few times until that point when little more debris is removed. (Different than with brushing, it's easy enough to tell when you're finished scraping.)

Store-bought cleaners and scrapers are used the same way.

If you find the method described above preferable to brushing, you might just continue on using your spoon. But if you decide to buy a specialty item, you'll find that they're generally used in the same fashion. The tool is pulled from back to front, repeatedly, until the bulk of the tongue's coating has been removed.

Our next page explains which mouthwashes do what, when it comes to curing bad breath.