The relationship between tongue brushing and halitosis in children: a randomized controlled trial.

The study aimed to investigate the clinical and microbiological effects of tongue brushing on malodour in children. One hundred and fifty-one caries-free children were included. After clinical evaluation, halitosis was determined by organoleptic assessment and sulphide monitoring. Then, 69 children with high levels of volatile sulphur compounds (VSC) were randomly assigned into two groups (group 1: scaling-polishing + tooth brushing + tongue brushing and group 2: scaling-polishing + tooth brushing), and tongue coating samples were collected for microbiological analysis. After 2 weeks, VSC measurements, organoleptic assessment, clinical evaluations and sample collection were repeated. In both groups, organoleptic scores, VSC levels, gingival index, plaque index (PI), bleeding on probing and Winkel tongue coating index (WTCI) scores decreased after 15 days. However, only the change in WTCI and PI scores showed a statistically significant intergroup difference. The most prevalent anaerobic bacteria were Veillonella spp., Prevotella spp., Fusobacterium spp., and no intergroup difference was observed in terms of colony counts of bacteria. Tongue brushing did not provide an additional benefit to the treatment for malodour. According to the microbiological culture results, a specific bacterium responsible for halitosis in children could not be identified and more sensitive methods might be used for this purpose.