Tongue Scraping (Jihwa Prakshalana)

Tongue cleaners in classical Ayurvedic literature

A review of the use of metals in the Charaka Samhita, a classical Ayurvedic text, states that metals ranging from gold to iron were used to make instruments including the Jihva Nirlekhana Yantra, which the authors translate as tongue scraper. The same passage lists other metal instruments, such as an applicator for the eyes and an enema nozzle. The review does not date the passage, and it does not describe how the instrument was used.

A later paper on device safety in Ayurveda lists jivha nirlekhana (tongue cleaner) among home-use Ayurvedic devices. It names gold, silver, copper, tin, bronze and iron as materials and assigns the device to its lowest-lettered risk category, Class A. That paper is a modern regulatory-science proposal, not evidence about historical use.

Place within the Ayurvedic daily routine

A review of toothbrushing in Ayurveda describes dinacharya, the daily routine, as a set of activities beginning before sunrise that are considered necessary for maintaining the body's balance. It identifies toothbrushing with soft twigs of medicinal plants, with or without herbal tooth powder, as an essential element. The abstract reviewed mentions tongue scrapers only among the products now on the market, so it does not by itself show that classical sources place tongue cleaning within dinacharya.

Ayurvedic scholars also describe tongue examination as part of diagnosis. A 2026 pilot study from Indian Ayurveda colleges states that tongue examination is documented in Ayurveda and that the severity of tongue coating is regarded as an indicator of ama, a term for undigested or metabolic residue in the tradition.

Spread beyond Ayurveda

Tongue cleaning with scrapers and brushes is now part of general dental advice in several countries. The English National Health Service lists gentle daily tongue cleaning among measures for bad breath, while the American Dental Association describes it as a matter of personal preference. The sources reviewed do not trace when or how the practice entered Western dental care, and no historical account of that transfer was found.

Names and spellings

The scholarly sources reviewed transliterate the Sanskrit term for the tongue cleaner as Jihva Nirlekhana or jivha nirlekhana, and they give the English glosses tongue scraper and tongue cleaner. The title form Jihwa Prakshalana did not appear in the sources opened for this page, so its meaning and its relation to jihva nirlekhana are not established here. Spelling varies between jihwa, jihva and jivha because of different transliteration conventions.

Scraper, cleaner and brush

In dental literature, a tongue scraper is an instrument with an edge, while a tongue brush uses bristles and a tongue cleaner is a general term. A systematic review of mechanical tongue cleaning defines the intervention as the use of a tongue scraper or a tongue brush, compared with toothbrushing alone. Tongue coating is described in a 2025 narrative review as a biofilm of desquamated epithelial cells, food debris and microorganisms.

Related Machipedia pages include Ayurveda, the traditional medical system within which the practice is described, Dinacharya, the daily routine, Oil Pulling, another mouth-based practice, and Hypnodontics, which concerns dental care and anxiety.

What the practice involves in general terms

Tongue scraping and tongue brushing both aim to remove the coating that builds up on the upper surface of the tongue. The sources reviewed describe the tools in general terms: metal scrapers in the Ayurvedic device literature, and scrapers, cleaners and nylon brushes in dental studies. A comparative study of a manual nylon tongue brush and a sonic brush measured the extent of tongue coating, bacterial counts and pain before and after brushing.

The National Health Service describes tongue cleaning as one element of mouth care that also includes tooth and gum brushing and cleaning between the teeth. This page does not give technique, frequency or product advice.

Tongue cleaning in institutional oral care

Tongue cleaning also appears in professional oral care for people who cannot clean their own mouths, such as nursing home residents. In a Taiwanese quasi-experimental pilot, a weekly professional oral care program delivered to residents of two nursing homes was compared with a control group. The program was multicomponent, so the tongue-specific contribution cannot be separated from the rest.

Uses described in the Ayurvedic tradition

The Ayurvedic sources reviewed link the tongue to diagnosis and to the concept of ama rather than to a stated purpose for scraping. Ayurvedic clinicians quoted in the 2026 pilot treat tongue coating as an indicator of ama. The Charaka Samhita review lists the tongue cleaner only as one of several metal instruments, and the sources opened do not state what classical authors held the instrument was for.

Uses described in dentistry

Dental and public health sources describe tongue cleaning chiefly as an aid to controlling bad breath and tongue coating. The National Health Service lists it with other self-care measures for bad breath, whereas the American Dental Association states that tongue cleaning is not a required step. A narrative review proposes that routine tongue hygiene could reduce microbial load and may matter for systemic risks, which it presents as associations through microbial translocation and low-grade inflammation.

Systematic reviews on bad breath

A Cochrane review by Outhouse and colleagues, published in 2006, included two randomized trials with 40 participants comparing tongue cleaning with other methods in adults with halitosis. Neither trial reported the primary outcomes. One trial found volatile sulfur compound reductions of 42 percent with a tongue cleaner, 40 percent with a scraper and 33 percent with a toothbrush, undetectable after 30 minutes in every group; the other reported 75 percent with a scraper and 45 percent with a toothbrush. The authors called the evidence weak and unreliable.

The editorial group later withdrew that review, stating it was being replaced by a broader review of halitosis interventions. The replacement, published in 2019, included 44 trials with 1,809 participants. For mechanical tongue cleaning versus no tongue cleaning, it found very low-certainty evidence from two trials with 46 participants, with a small difference in dentist-rated odor scores (mean difference -0.20, 95 percent confidence interval -0.34 to -0.07), and no data on patient-reported scores or adverse events. The authors drew no conclusions on which intervention was best.

An earlier systematic review of five publications (three randomized and two controlled trials, seven experiments) compared tongue scraping or brushing added to toothbrushing with toothbrushing alone. All experiments showed a positive effect on measures of breath odor, but the authors concluded that data on chronic halitosis were insufficient.

Tongue coating and pneumonia in older adults

A cohort study of 71 edentulous Japanese nursing home residents aged 65 or older found that those with tongue coating had higher salivary bacterial counts and that aspiration pneumonia was more common in those with poorer tongue hygiene scores. The relative risk of pneumonia in the good tongue hygiene group was 0.12 (95 percent confidence interval 0.02 to 0.9). The authors described tongue coating as a risk indicator, which is an association, and the study did not test a tongue-cleaning intervention.

In a 2024 longitudinal study of 63 adults with Alzheimer disease, tongue coating, refusal of oral care and unclear articulation each predicted a decline in swallowing function over one year, and the authors noted the small sample. In the Taiwanese pilot, residents who received weekly professional oral care had lower tongue coating scores and fewer pneumonia hospitalizations than controls, but the intervention covered the whole mouth and the trial was registered retrospectively. These studies do not isolate tongue scraping.

Dental body statements and gaps

The American Dental Association states that there is no evidence that brushing or scraping the tongue prevents bad breath, that tongue cleaning does not improve chronic bad breath, and that odor-causing bacteria can return as fast as they are removed. The National Health Service takes a different position and includes gentle daily tongue cleaning in its self-care list. No controlled study of the Ayurvedic framework, such as whether scraping changes ama, was found.

Reported harms and tolerability

Harm data on tongue scraping are sparse. The 2006 Cochrane review reported adverse effects in one trial as nausea in 60 percent and trauma in 10 percent of participants using the toothbrush, and noted that all participants were receptive to using the scraper. The 2019 review found no adverse-event data for mechanical tongue cleaning. In a small comparison of tongue brushes, impressions of the tongue surface showed significantly more scratching with a manual nylon brush than with a sonic brush, with no significant pain difference.

The National Health Service advises against cleaning so hard that the gums or tongue bleed. The sources reviewed do not quantify how often gagging, bleeding or injury occurs with scrapers.

Limits and care boundaries

Tongue cleaning does not address the underlying causes of bad breath. The American Dental Association lists gum disease, dry mouth, certain foods, tobacco and medical conditions such as sinus problems, reflux, diabetes and liver or kidney disease among causes, and advises an appointment when bad breath does not go away. The National Health Service advises seeing a dentist when bad breath persists after a few weeks of self-care or when gums are painful, bleeding or swollen.

A narrative review states that thick tongue coatings that persist, do not respond to ordinary hygiene and come with other symptoms should be referred to a physician. People who depend on others for mouth care, including those with swallowing difficulty, should have oral care directed by their care team. Tongue scraping should not delay or replace dental or medical assessment. No formal training or credential specific to tongue scraping was found in the sources reviewed.