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tongue mapping
The large surface area of the
tongue dorsum provides a
unique environment that
promotes accumulation of
microorganisms and oral
debris. It has recently been
shown that there is a direct
relationship between the
distribution of bacteria on
the tongue, bacterial load
and oral malodor.
The effect of tongue cleaning on the
complex interaction between the
distribution of bacteria on the tongue,
bacterial load and oral malodor has
been revealed in research and is
discussed below.
Topographic distribution of
bacteria on the tongue
In their paper in The Archives of Oral
Biology (2008), Allaker et al provided
the first detailed mapping of the tongue
surface in relation to the bacteria
associated with oral malodor. The study
analysed the type and load of bacteria
present in cultures collected from six areas
of the human tongue.
The human tongue
DORSAL POSTERIOR
CIRCUMVALLATE
PAPILLAE
CIRCUMVALLATE
PAPILLAE
LATERAL POSTERIOR
Results showed that:
• on the dorsum of the tongue, there was
a trend towards increasing bacterial load
when moving from the anterior to the
posterior surface of the tongue
• the most heavily colonised tongue
site was the dorsal posterior to the
circumvallate papillae
• the relative proportions of bacterial
group remained similar at each site,
with Streptococcus salivarius being
consistently lowest.
To hear Dr Allaker discuss the findings
from this study go to the IADR/CED
Symposium section of the Aquafresh
Science Academy website.
DORSAL POSTERIOR
VENTRAL POSTERIOR
(UNDER THE TONGUE)
DORSAL MIDDLE
DORSAL ANTERIOR
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Further reading
Allaker RP, Waite RD, Hickling J et al. Topographic
distribution of bacteria associated with oral
malodor on the tongue. Arch Oral Biol 2008; 53
(suppl 1): S8–S12.
Bordas A, McNab R, Staples AM et al. Impact
of different tongue cleaning methods on the
bacterial load of the tongue dorsum. Arch Oral
Biol 2008; 53 (suppl 1): S13–S18.
Bacterial counts by tongue area
(CFU/sample x105)
350
300
Bacterial counts CFU/sample x105
250
200
150
100
50
0 bacterial load
DA
Total anaerobes
Total aerobes
Gram-negative anaerobes
VSC-producing bacteria
Streptococcus salivarius
Data are presented as mean±SE (n=50)
Relationship between
bacterial load and
oral malodor
In several studies, it has been identified
that the dorsal posterior of the tongue
makes the primary contribution to
oral malodor (summarised in Bordas
et al 2008). However, in the past little
attention has been paid to the area
posterior to the circumvallate papillae
(DPCP). In order to investigate this, an
organoleptic assessment using an intensity
scale where 0=no malodor and 5=very
strong malodor was performed. Subjects
were subdivided into those with slight/
moderate malodor (intensity score 1–3) or
strong malodor (intensity score 4–5). Their
study revealed that:
• subjects with strong malodor had higher
levels of total anaerobes, Gram-negative
DM DP DPCP LP VP
Tongue area
DA = Dorsal anterior
DM = Dorsal middle
DP = Dorsal posterior
DPCP = Dorsal posterior to the
circumvallate papillae
LP = Lateral posterior
VP = Ventral posterior
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anaerobes and volatile sulfur compound
(VSC) producing bacteria recovered
from the DPCP than those with slight/
moderate malodor
• total aerobe and Streptococcus salivarius
numbers were higher at the DPCP in
the slight/moderate group than in the
strong malodor group.
Effect of tongue cleaning on
At the IADR/CED symposium on oral
malodor, Dr Allaker highlighted that
most odor-causing bacteria are found
beyond the reach of normal oral hygiene
procedures. To further investigate this,
Bordas et al’s Archives of Oral Biology
paper (2008) studied whether tongue
cleaning provided an improved method of
reducing tongue bacterial load compared
with tooth brushing.
After collecting and analysing samples
of tongue coating before and after tooth
cleaning, they found that:
• tooth brushing alone had no significant
impact on tongue bacterial populations
• tooth brushing and tongue scraping
consistently, but modestly, reduced
bacterial populations
• tooth brushing and thorough tongue
cleaning with a high speed aspiration
device resulted in highly significant
reductions in bacteria.
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