Summary
Dentist Dr. Mark Burhenne (Dr. B) provides a comprehensive masterclass on tongue scraping, covering the who, when, how often, and how of the practice. He explains the deep connections between tongue health, blood pressure, nitric oxide production, and the oral microbiome. Dr. B describes the tongue surface as a meadow of mushroom-like papillae where a thick biofilm can accumulate, trapping food debris and creating an anaerobic environment that favors harmful bacteria. Tongue scraping thins this biofilm, allowing oxygen and saliva nutrients to reach the oral microbiome underneath. He connects this to systemic health outcomes including blood pressure regulation, erectile dysfunction, taste sensitivity, and satiety. The episode includes detailed practical advice on building the habit (using a blank Post-it note as a reminder), optimal timing (morning after hydrating), choosing between serrated plastic and smooth stainless steel scrapers, managing the gag reflex, and knowing when to stop based on the color of the fluid scraped off. Dr. B ranks tongue scraping alongside flossing as one of the two most important oral hygiene practices.
Key Points
- Tongue scraping supports nitric oxide production by the oral microbiome, which helps regulate blood pressure
- The tongue surface has mushroom-like papillae where thick biofilm can trap debris and create anaerobic conditions
- Scraping thins the biofilm and allows oxygen and saliva nutrients to reach beneficial bacteria underneath
- Dr. B recommends scraping once daily in the morning after hydrating, on a wet tongue
- Scrape until you no longer see the beige-colored fluid; some initial bleeding indicates tongue inflammation
- Two scraper types recommended: serrated plastic (with soft/regular settings) and smooth stainless steel
- Toothbrush tongue cleaning is ineffective compared to a dedicated tongue scraper
- Dr. B ranks tongue scraping alongside flossing as one of the two most important oral hygiene habits
Key Moments
Tongue scraping supports nitric oxide production and blood pressure
Dr. B explains that bacteria on the back of the tongue produce nitric oxide, which helps regulate blood pressure and erectile function. He connects tongue scraping to improved cardiovascular health.
"Production of nitric oxide based on the oral microbiome, these bugs on the back of your tongue can help with that as well. Blood pressure alone should be a great motivator"
The tongue as a mushroom meadow and biofilm disruption
Dr. B describes the tongue surface as mushroom-shaped papillae creating spaces where thick anaerobic biofilm accumulates. Tongue scraping thins this biofilm and allows oxygen and saliva nutrients to reach beneficial bacteria.
"Think of your tongue as a meadow, a surface, a carpeted surface of big mushrooms with thin little stalks and big whatever those things are called. I should know my mushrooms. I love mushrooms. Flanges or the cap."
Tongue scraping ranked alongside flossing as most important oral hygiene
When asked what single oral hygiene practice matters most, Dr. B places tongue scraping alongside flossing as the two most important habits, ranking both above toothbrushing.
"you know, talked about, okay, if you have the ideal diet, which is not fair, given the question I was presented with, then all you would have to do is probably tongue scrape once a week. You wouldn't even have to floss, but it would be between flossing, just to give you an idea of how important it is, it would be between flossing and tongue scraping. Those are the two important things."
Oral microbiome testing shows halitosis score improvement after scraping
Dr. B describes how oral microbiome testing before and after a tongue scraping regimen shows measurable improvement in halitosis scores, indicating better nitric oxide production by tongue bacteria.
"we'll do another oral microbiome test. And I would say 99% of the time, we see a difference and a change. And we see that halitosis score drop, which means that your oral microbiome is able to produce this life-giving longevity gas, nitric oxide."
