The Future of Dental Hygiene

Charles C. Labenz Arizona Daily Wildcat

To be sure, there's a market for his unconventional wares - the American Academy of Family Physicians reports that in 1996, over half the Unites States population was afflicted with halitosis. Annual sales of mouthwashes and related over-the-counter products in the United States exceed $500 million, and in around 90 percent of the cases, the disease is localized to the mouth and thus treatable.

Enter the Tongue Scraper - that's my name for it. More formally, and in the marketplace, it's the OraFreshtm Tongue Cleaner. Everything comes from somewhere, and the Tongue Scraper arose from a strange mix of Eastern homeopathic medicine, practiced for centuries, and Western engineering.

The stateside arrival of the tongue cleaner should be no surprise to anyone who has been tracking the rise of Eastern medicine in America. Acupuncture, aromatherapy, natural healing herbs - all mocked a decade ago - are starting to become commonplace here. "When a friend went to India, I would ask them to bring back tongue scrapers," says Dr. Potti. "But they're made of wood and last only three months or so. So I decided to check with the patent office and ..." the rest is dental hygiene history.

It's hard to fault his logic. One study published in Journal of the American Dental Association notes that "research suggests that the tongue plays an important role in the production of oral malodor... The data indicate that the proteolytic, anaerobic flora residing on the tongue play an essential role in the development of halitosis." Another study notes that "bad breath typically originates in the mouth, often from the back of the tongue ... Deep tongue cleaning and optional use of an efficacious mouthrinse will lead to improvement."

The problem is that mouthwash can mask foul breath, but it cannot eliminate it ... and neither can brushing your tongue. Dr. Potti analogizes the process to cleaning snow off your car: "Brushing the snow with your windshield wipers only moves it around. To really get rid of snow, you need to scrape it off." The same is true, I suppose, of cleaning the back of your tongue.

But as anyone who has ever tried to stick a large object into the back of his or her mouth knows, deep cleaning of the back of your tongue can trigger a gag reflex and the results and be pretty unpleasant. Again, Dr. Potti has an analogy: "We all have a cigarette once in awhile. The first time you smoke, you cough a little. Then you do it again, and it isn't so bad. After awhile, you don't even notice. Five seconds of discomfort make for a full day of fresh breath."

But I have to wonder about the price ...We tend to think that all bacteria is bad all the time, but some bacteria are our friends. That concept is intuitive when one speaks of bacteria that eat toxins in our landfills, but there's a fair amount of research that suggests that the bacteria in the back of our mouth also serve an important function.

The offending bacteria, which live in tiny crevices at the back of the tongue, are a kind of "facultative anaerobes"-they can survive with or without oxygen. Instead of glucose, which is required by the human body to survive, these bacteria survive on nitrate.

"Tiny glands at the base of the tongue's papillae secrete bicarbonate, which makes the saliva alkaline and bacteria-friendly," said Nigel Benjamin, a professor of medicine at the University of Aberdeen Medical School in Scotland, in Discover magazine. "So the bacteria are being bathed with vast amounts of nitrate and converting it to nitrite. The nitrite is swallowed and hits the acid in the stomach and turns into nitric oxide. It kills germs in the stomach. So we have the ironic situation where we're using a symbiotic relationship with organisms on the tongue to kill organisms in the stomach."

Benjamin also thinks this nitric oxide may protect against tooth decay by killing acid-producing bacteria around the gums. People who can't make saliva, he notes, tend to have bad teeth. Also, according to Discover, "Benjamin and his colleagues are now investigating a particularly interesting possibility: tongue bugs may help protect us against Helicobacter pylori, the bacterium that has been identified as a cause of stomach ulcers and stomach cancer."

If the University of Toronto studies cited in the OraFresh press release are to be believed, then tongue cleaning really does reduce sulfur gas and odor by up to 75 percent. But at what cost? If Dr. Potti's Tongue Scraper works, it could be creating a serious health problem as it eliminates all the germs at the back of the tongue - bacteria that are part of a process we don't, as of yet, fully understand. Is good breath really worth that much to you?