The two cornerstones of good oral hygiene are brushing and flossing. Most of us know that, but what we’re less certain about is whether there’s any use scraping our tongues too. Dentist Matt Messina, a spokesperson for the American Dental Association, says that brushing your teeth with fluoride toothpaste twice a day and flossing between the teeth are musts for oral health. Anything else, like using a tongue scraper, is a bonus.
If you brush your teeth and follow with floss, you’re doing a good job of managing your dental hygiene. But you could be doing even more by tongue scraping. But as helpful as tongue scraping can be, it’s not talked about nearly enough, says dentist Mark Burhenne, the founder of AsktheDentist.com.
Here’s what dentists want you to know about why the practice is good for dental hygiene and how to do it.
Tongue scraping is a traditional Ayurvedic morning ritual. (It goes by the tongue-twisting name jihwa prakshalana.) This alternative medicine treatment involves using a long, thin, flat U-shape piece of metal or plastic to scrape or remove bacteria, food, and dead cells from the top of the tongue.
Sure, tongue scraping may be satisfying in the way feeling your smooth, just-brushed teeth is. But this is more than a soothing self-care ritual. The act of scraping your tongue may have health benefits.
When you scrape your tongue, you might be scraping away bacteria. And that has the potential to reduce bad breath. Dr. Burhenne cites a 2005 study that found using a tongue scraper twice a day for seven days reduced bacteria known to cause bad breath and dental decay. Another older study, published in the Journal of Periodontology, found that tongue scraping better removed volatile sulfur compounds responsible for bad breath than brushing alone. It’s worth noting the study was small-only 10 participants. This perk is one of the main reasons people want to try tongue scraping, according to Dr. Burhenne. “It doesn’t really fix the root cause of bad breath, but it’s better than mouth wash,” he says.
The science isn’t all positive, though. A 2019 study published in the Cochrane Database of Systematic Reviews looked at various treatments for halitosis (persistent bad breath). Researchers found no benefit of tongue scraping. Although there is no solid evidence of the value of tongue scraping, the same report indicates tongue cleaning may reduce the release of odor molecules from the tongue, according to Dr. Messina.
One reason Dr. Burhenne is pro tongue scraping is that it may improve overall oral health. “If you’re brushing and flossing, you should also be brushing your tongue because that is one of the aspects of the oral microbiome,” he says. The oral microbiome is where microorganisms like bacteria and various viruses exist. (And not all of them are bad.)
Things that throw off the pH balance in this area, however, could cause dysbiosis, an imbalance of microorganisms. According to Dr. Burhenne, dysbiosis can lead to gum disease, tooth decay, and bad breath. If tongue scraping removes bacteria, as the 2005 study that Dr. Burhenne referenced found, it may prevent oral health issues like cavities and gum disease.
Although it’s not the first thing people notice, the tongue is visible to others when you talk and laugh. If you’ve ever noticed a buildup or yellowish coating, you may have been tempted to scrape your tongue to improve its appearance. Or maybe you’ve spotted creamy white patches on your tongue. This is a result of the fungus candida, which Dr. Burhenne says also causes bad breath. Candida is also responsible for thrush infections. Tongue scraping may eliminate the coating or excess on the tongue and keep it from coming back.
Meals tasting a little bland these days? You may need a good tongue scraping. In an older study, published in the Journal of Clinical Periodontology in 2004, researchers asked 16 people to use a tongue scraper twice daily. After two weeks, participants’ taste sensation improved. Note that the practice reduced bacteria on the tongue a negligible amount.
In general, everyone can scrape their tongue, according to Dr. Burhenne. The procedure has no known risks or side effects, as long as you don’t scrub excessively, Dr. Messina says. Go too hard, however, and you could irritate your tongue or even cut it.“You could scrape your tongue to the point where you damage it,” says Dr. Burhenne. “It’ll heal, but tongue pain is very painful because there are a lot of nerve endings in the tongue, so you just want to be careful.”
If you have a health condition that irritates or inflames the tongue, such as burning mouth syndrome (an ongoing burning in the mouth with no clear cause), geographic tongue (which causes red patches), or some autoimmune diseases, Dr. Messina says you should not scrape your tongue. If you have any questions, ask your dentist or dental hygienist for recommendations.
Dr. Messina says both the back of your toothbrush (some have rough patches specifically for cleaning the tongue) and a dedicated tongue scraper can clean the tongue’s surface. “The tongue scraper is thinner and sometimes produces less response of the gag reflex in people,” he says.
Dr. Burhenne recommends a separate scraper because the back of the toothbrush is a small surface area, meaning it would take longer to scrape the tongue than using a scraper. “It‘s like vacuuming a room with a dustbuster,” he says. “Why not use the big vacuum cleaner?” Note that brushing your tongue with the brush or bristle end is not the same or equivalent to tongue scraping.
Remember that small study in the Journal of Periodontology? It found that tongue scrapers are more effective than toothbrushes in reducing sulfur compounds that cause bad breath. A 2006 review in General Dentistry came to a similar conclusion. Mouthwash also falls short of tongue scraping when it comes to removing coatings or bacteria from the tongue, says Dr. Burhenne. The mechanical removal of bacteria with a tongue scraper is superior. If you invest in a good tongue scraper, it’ll be the last one you’ll ever buy and something you use for the rest of your life.
To get the potential benefits of tongue scraping, it needs to be a habit. If you do an occasional scrape here or there, you may not notice the benefit. “A lot of people try it one time, but they don’t stick with it,” Dr. Burhenne says. He says using the device once a day is fine, and it’s OK to go slow in the beginning. “Tongue scraping can be a little daunting, but you’re going to see a lot of stuff come off the tongue,” he says. “A lot of people are shocked.”
Ready to get started? Follow these steps to scrape your tongue:
Stick out your tongue.
Press the scraper down towards the back of the tongue.
Apply pressure as you move the scraper toward the front of your tongue.
Rinse and repeat.
People who really want to supercharge tongue scraping may want to set aside some time for their first tongue-scraping session. “I would sit there for 10 to 15 minutes and do 10 to 50 passes until you can no longer see that yellowish-beige fluid,” Dr. Burhenne says. “Do that the first time because that will help motivate you. You’re going to feel a difference right away.”
Keep a warm salt water rinse (high-quality salt stirred into an eight-ounce glass of water) nearby. You’ll use it to rinse your mouth (don’t drink it!) after you tongue scrape to help heal and calm the tongue.
Another thing to keep in mind is that you may see some blood the first few times you tongue scrape. Don’t freak out. It’s unlikely that you cut your tongue. According to Dr. Burhenne, this symptom is similar to why gums sometimes bleed when people floss: there is inflammation in the tissue. In this case, that’s the tongue. Once you get into the routine, tongue scraping takes less time than flossing and brushing.
OK, so you’re not ready to buy a tongue scraper. Start with using the back of your toothbrush. They often have ridges meant for this purpose. Don’t try just to hold out your tongue and rub a toothbrush over it—that will often cause you to gag, according to Dr. Messina. “To make this easier, stick out your tongue and hold the tip of your tongue between your thumb and forefinger on your nondominant hand,” Dr. Messina says. “Then use the toothbrush in your dominant hand to gently scrape or clean the surface of the tongue.” And don’t use toothpaste on your brush for tongue scraping.