April 8, 2022

Mouth health affects whole body health and poor general health is reflected in the mouth. For centuries, many cultures have assessed health by the condition of a patient’s tongue. A healthy tongue is generally pink and relatively free of heavy coating — even first thing in the morning. Changes in the tongue's appearance, including white or thick coating, scalloping, or other discoloration, may offer clues about what is happening in the mouth and elsewhere in the body.

At a microscopic level, the surface of our tongue is home to important healthy oral bacteria responsible for producing nitric oxide, a compound that plays an important role in cardiovascular health.

The strategies I teach have allowed thousands of people to improve their overall oral health. One of the first changes people notice is how clean their tongue and mouth feel when they wake in the morning. This is a testimony to the improvements in their mouth’s ecology, and it is why I have never needed to recommend flossing or the mechanical mouth-cleaning method known as tongue scraping.

I do not routinely recommend tongue scraping. If your tongue is heavily coated, I believe the more important question is not simply, "How do I scrape this off?" but "Why is this coating developing in the first place?"

Why I Don't Recommend Tongue Scraping

Anyone with an unhealthy or inflamed mouth should, in my opinion, be especially cautions with aggressive mechanical cleaning in areas that may bleed. Oral bacteria can enter the bloodstream when tissues are disrupted — a temporary event known as bacteremia. An event of this kind occurred after tongue scraping, and was recorded in this article. And there have been reports about carcinogenic plastics and other materials found in floss and equipment like plastic tongue scrapers.  

There are no conclusive studies to show flossing or tongue scraping are superior to good tooth brushing. The goal for sustainable oral health (a healthy oral ecology) cannot be achieved by mechanical cleaning and scraping — but instead by the support of our mouth’s healthy bacteria and the development of a protective oral microbiome, everywhere in the mouth.

If you have a coating on your tongue that you feel needs to be removed, consider it a signal. This should motivate you to improve the balance of your mouth and digestive health. Simply scraping it off your tongue will not solve the underlying problem of the coating developing in the first place.

How To Improve Tongue Health

My advice for anyone with a coating on their tongue (or in their mouth) would be to use my Complete Mouth Care System and recommended strategies (xylitol and mouth resting) in conjunction with a probiotic diet and supplements to help improve digestive health. Garden of Life Colon Health Probiotic is a probiotic I recommend for 2-3 months during oral health changes. Constipation and poor digestion are often associated with a coating on the tongue, and a coated tongue is linked with worsening gum health, periodontal pocketing, and gum disease. Harmful mouth bacteria cause cavities and dental destruction and people with multiple cavities, diseased teeth, and gum disease often find they have raised Inflammatory markers in their blood. These markers are an indication of an increased risk for a cardiovascular event, stroke, arthritis, dementia, or Alzheimer’s. 

My strategies progressively improve oral health over a period of about six months, though depending on your oral health history, it may take a bit longer. You can review a realistic healing timeline here. Enjoy Zellie’s xylitol mints or gum at the end of every meal, snack and drink. Xylitol is a prebiotic that nurtures healthy mouth bacteria, and in synergy with my Complete Mouth Care System, helps control damaging plaque and plaque accumulations, everywhere in the mouth — including your tongue! 

Interesting Information On Tongue Scraping:

Dr. Anthony: What Your Tongue Says About Your Health
Cleveland Clinic: What Your Tongue Can Tell You About Your Health

Dr. Ellie


My passion is educating people about oral health. For decades I’ve worked with patients of all ages, in different countries, in high and low-risk communities, and from every walk of life. I’ve seen the same results over and over again –people who transformed their oral health – sometimes in days or weeks, even after they had suffered years of pain and frustration. It’s never too late, and my ways will give you the key to a lifetime of improved oral health.

Dr. Ellie Phillips

More blog posts:

Children’s Oral Care: What Parents Need to Know
Are You Using Xylitol the Wrong Way?
Can Your Teeth Really Heal?
What Is A Tooth Made Of?
5 Minute Guide to Oral Health
The Ebb & Flow of Health
Shopping The Correct Products
A Realistic Healing Timeline
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