A digital tongue imaging system for tongue coating evaluation in patients with oral malodour.

OBJECTIVE Several simple visual methods have been developed for assessing tongue coating, but it is difficult to eliminate biases associated with these. The digital tongue imaging system (DTIS) was designed to acquire tongue surface images using a digital camera under controlled conditions, and to calculate tongue coating area. The aim of this study was to evaluate the potential of DTIS for clinical use by comparing it with the Winkel tongue coating index (WTCI). MATERIALS AND METHODS Forty participants with oral malodour were rated on WTCI by two independent examiners, and photographs of their tongues were assessed using the DTIS. The photographs were also rated by the examiners (blinded to in vivo WTCI and DTIS statuses). RESULTS Agreements between in vivo WTCI ratings and DTIS assessments were relatively high at r = 0.561 for one examiner and r = 0.736 for the other (P < 0.01), while agreements between the in vivo WTCI ratings and tongue photograph-based ratings were also high at r = 0.645 for one examiner and r = 0.742 (P < 0.01) for the other. CONCLUSIONS Digital tongue imaging system was found to be highly reliable and as having potential clinical applications. However, the algorithm for determining in vivo tongue coating status requires improvement.

[1]  B. McBride,et al.  Characterization of volatile sulphur production by pathogenic and non-pathogenic strains of oral Bacteroides. , 1981, Archives of oral biology.

[2]  K. Yaegaki,et al.  Volatile sulfur compounds in mouth air from clinically healthy subjects and patients with periodontal disease. , 1992, Journal of periodontal research.

[3]  J Tonzetich,et al.  Production and origin of oral malodor: a review of mechanisms and methods of analysis. , 1977, Journal of periodontology.

[4]  E. D. De Boever,et al.  Assessing the contribution of anaerobic microflora of the tongue to oral malodor. , 1995, Journal of the American Dental Association.

[5]  D. Hinode,et al.  Relationship between tongue coating and secretory-immunoglobulin A level in saliva obtained from patients complaining of oral malodor. , 2003, Journal of clinical periodontology.

[6]  T. Ueda,et al.  New method for evaluation of tongue-coating status. , 2007, Journal of oral rehabilitation.

[7]  A. Gross,et al.  Effects of Tongue Brushing on Tongue Coating and Dental Plaque Scores , 1975, Journal of dental research.

[8]  A. V. van Winkelhoff,et al.  Clinical effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc-lactate on oral halitosis. A dual-center, double-blind placebo-controlled study. , 2003, Journal of clinical periodontology.

[9]  H L Wang,et al.  Relationship between sulcular sulfide level and oral malodor in subjects with periodontal disease. , 2001, Journal of periodontology.

[10]  Y. Shimazaki,et al.  Characteristics of patients complaining of halitosis and the usefulness of gas chromatography for diagnosing halitosis. , 2001, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[11]  David Zhang,et al.  The bi-elliptical deformable contour and its application to automated tongue segmentation in Chinese medicine , 2005, IEEE Transactions on Medical Imaging.

[12]  G. V. D. Van der Weijden,et al.  Tongue coating and salivary bacterial counts in healthy/gingivitis subjects and periodontitis patients. , 2001, Journal of clinical periodontology.

[13]  Chuang-Chien Chiu,et al.  A novel approach based on computerized image analysis for traditional Chinese medical diagnosis of the tongue , 2000, Comput. Methods Programs Biomed..

[14]  M Rosenberg,et al.  Relationship of oral malodor to periodontitis: evidence of independence in discrete subpopulations. , 1994, Journal of periodontology.

[15]  T Takehara,et al.  Correlation between volatile sulphur compounds and certain oral health measurements in the general population. , 1995, Journal of periodontology.

[16]  George Tsebelis.  Assessing the Contributions of the DOSEI Project , 2005 .

[17]  M Ojima,et al.  Reliability of Clinical Parameters for Predicting the Outcome of Oral Malodor Treatment , 2003, Journal of dental research.

[18]  J Egelberg,et al.  Evaluation of tongue coating indices. , 2007, Oral diseases.

[19]  M. Sanz,et al.  Comparative effects of different chlorhexidine mouth-rinse formulations on volatile sulphur compounds and salivary bacterial counts. , 2004, Journal of clinical periodontology.