Simple. Quick. And it gets rid of a lot of germs. Scraping the tongue is an ancient practice of mechanically removing the gunk which harbours microbes, including those that damage your teeth, gums and other parts of the mouth. These microbes can cause severe infections, especially in those who have a weak constitution or an impaired immune system.

The upper surface of the tongue, or dorsum, is covered by taste buds housed in numerous protuberances called lingual pappilae.

While most of us brush our teeth at bedtime and in the morning, few are as enthusiastic about cleaning the tongue. “The tongue harbours hundreds of species of microorganisms, some of which are capable of starting periodontopathic diseases [in the supporting structures of the teeth and surrounding tissue],” says Ashok Surana, a senior orthodontist.

One can compare the tongue to a bacteria sponge, spreading bad bacteria, or periodontal pathogens, throughout the mouth. The surface of the tongue can be a reservoir for all the bad bacteria we keep away from the teeth by brushing. These bacteria go back to attacking the teeth after a longish period has passed after brushing. People with periodontal disease (problems in the gum) are more likely to have a thicker coat on their tongue as well as microbial flora that produces more volatile sulphur compounds compared to those who have healthy gums.

The tongue normally looks pink but may acquire a white or coloured coating due to diet, reduced salivary flow, reduced oral hygiene or tongue anatomy. Says Surana, “Tongue cleaning or scraping reduces this coating and the amount of bacteria in it.” He recommends tongue cleaning as part of overall oral hygiene, alongside proper brushing. However, he suggests that the tongue be cleaned with a toothbrush or a tongue cleaner made of plastic or similar material. “A metal cleaner is too harsh as it tends to damage the taste buds and papillae [protuberances] on the tongue,” he says.

While tongue cleaning has existed in Eastern culture for ages, Western civilisations placed less emphasis on it. Between the 15th and 19th century, tongue cleaning was practised only by the affluent. It was only in the 20th century that a wide variety of sophisticated tongue cleaning devices came on the market.

The surface of the tongue can be cleaned with a tongue cleaner, tongue brush or scraper or toothbrush. Says maxillofacial surgeon Dr Shibalik Mukherjee, “Toothbrushes are not effective for this purpose because they have a smaller width and are designed for brushing teeth, which have a solid structure unlike the spongy tissue of the tongue. This can reduce its ability to remove debris and microorganisms. Some toothbrush designs, however, have projections on the back of their heads to act as a tongue cleaner. You can also use an electric tongue cleaner.”

Ergonomic tongue cleaners are shaped according to the anatomy of the tongue, are optimised to lift and trap the plaque coating, and effectively clean the surface of the tongue. There are many different types of tongue cleaners. They can be plastic or metal straps, plastic or small brush bristles that form “rakes” or circular devices with handles. Their effectiveness varies, depending on shape, dimensions, configuration, quality of the contact surfaces and materials used. Tongue cleaners are mostly inexpensive, small, easy to clean and durable. Tongue cleaning gels can also be used in conjunction with tongue cleaners. Its antibacterial agents may enhance the cleaning effects.

Despite the many benefits of tongue cleaning, it is not always beneficial. If you have a persistent burning sensation, pain, discomfort or loss of sensation in your tongue, for instance, you must avoid cleaning it. Says Prof. R.R. Paul, a senior oral oncopathologist, “The tongue may manifest the signs or reflect many local and systemic diseases. For instance, a persistent burning sensation, pain, discomfort or loss of sensation, bald appearance due to loss of papilla from the surface of tongue, white, red, pigmented or ulcerated lesions may be indicative of a wide spectrum of disease processes, ranging from anaemia, syphilitic lesions, pre-cancerous lesions like leukoplakia, to even squamous cell carcinoma. Incidentally, the tongue is one of the commonest sites for oral cancer. Patients who have sharp or broken teeth can also have ulceration to the lateral or dorsum of the tongue. This, however, can stay hidden, and therefore untreated, for long.”

“One must also refrain from cleaning the tongue, especially with a metal tongue cleaner, when the tongue turns smooth as papillae is lost because of anaemia,” warns Dr Paul. “Also in the case of oral submucous fibrosis, a precancerous condition, one must not go for tongue cleaning.”

However, if one doesn’t have any of these conditions, cleaning the tongue with a plastic tongue cleaner or small brush bristles that form rakes is useful. Says Dr Paul, “It’s important to maintain overall oral hygiene. Brush properly two times daily with a standard toothpaste, rinse mouth well after meals and see a dentist once in six months for a check-up.”

Clean teeth and tongue scrupulously to have fresh breath and keep tooth decay at bay.