Clinical Oral Investigations

, Volume 23, Issue 4, pp 1829–1836 | Cite as

Effects of oral prophylaxis including tongue cleaning on halitosis and gingival inflammation in gingivitis patients—a randomized controlled clinical trial

  • Buket AcarEmail author
  • Ezel Berker
  • Çağman Tan
  • Yağmur D. İlarslan
  • Meryem Tekçiçek
  • İlhan Tezcan
Original Article



The objective of this study was to assess the effect of oral prophylaxis including tongue scraping on level of halitosis, clinical periodontal parameters and local cytokine response in gingivitis patients.

Materials and methods

In this randomized controlled clinical trial, 36 gingivitis patients were randomly assigned into two subgroups after scaling and polishing. Group 1 received oral hygiene instructions including the use of tongue scraper; group 2 received oral hygiene instructions alone without tongue cleaning. Levels of volatile sulfur compounds (VSC), organoleptic and tongue coating scores, clinical periodontal parameters and gingival crevicular fluid (GCF) samples were collected at baseline and 7 days after oral prophylaxis. GCF samples were analyzed using multiplexing analysis for the simultaneous measurements of cytokines. The Chi-square, Mann-Whitney U, Wilcoxon, and Student’s paired and unpaired t tests were used for statistical analysis.


Statistically significant reductions were found in terms of clinical periodontal parameters in both groups. However, significant improvements in VSC levels, organoleptic and tongue coating scores were observed just in tongue scraping group. Moreover, the GCF levels of IL-1β and IL-8 significantly decreased after the treatment in group 1 according to the baseline values.


The present study indicated that oral prophylaxis including tongue scraping was effective in improving intra-oral halitosis and pro-inflammatory cytokine response in GCF in gingivitis patients.

Clinical relevance

The results suggest that tongue scraping can be taken into consideration in order to manage gingival inflammation as well as VSC levels in gingivitis patients but further clinical studies are required to judge the clinical relevance.


Tongue coating Halitosis Cytokines Gingival crevicular fluid Gingivitis 



We are grateful to Dr. Erdem Karabulut for his contributions to the study in terms of statistical analysis.


This study was funded by the Hacettepe University Scientific Research Project, Turkey (grant number THD-2015-5523).

Compliance with ethical standards

All procedures performed in studies involving human participants were in compliance with the ethical standards of the institutional and/or national research committee and with Helsinki Declaration 1975, as revised in 2000.

This study was approved by the Ethical Committee (14/639-06).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethical Committee (14/639-06). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Periodontology, Faculty of DentistryHacettepe UniversityAnkaraTurkey
  2. 2.Department of Pediatric Immunology, Faculty of MedicineHacettepe UniversityAnkaraTurkey
  3. 3.Department of Pediatric Dentistry, Faculty of DentistryHacettepe UniversityAnkaraTurkey

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