# Prevalence, distribution and severity of tongue coatings according to the proposed classification of tongue coatings severity index: a gender-based evaluation

## TL;DR

A new index for assessing tongue coatings was evaluated, showing potential for use in monitoring oral health and halitosis.

## Contribution

The Tongue Coatings Severity Index (TCSI) offers a simple, reproducible method for assessing tongue coatings.

## Key findings

- TCSI scores increased with worsening periodontal status and oral malodour.
- TCSI enables quick and reliable assessment of tongue coating extent and severity.
- Validation in larger populations is needed before widespread adoption.

## Abstract

Existing methods to calibrate tongue coatings on the dorsum of the tongue have limitations of subjectivity, complexity, or time inefficiency. The proposed Tongue Coatings Severity Index (TCSI) was designed to fill this gap by offering a simple, reproducible, and time-efficient method for assessment. This study investigated the prevalence, distribution, and severity of tongue coatings and their clinical associations.

A cohort of 200 systemically healthy patients (20–60 years) with equal gender distribution were screened for Tongue Coating Area (TCA), Tongue Coating Severity (TCS), Final Tongue Coating Severity (FTCS), and oral malodour, and compared according to periodontal status.

The mean TCA was higher in males, whereas TCS and FTCS showed higher values in females, although these differences did not achieve statistical significance. TCA, TCS, and FTCS scores increased with worsening periodontal status and were significantly higher in patients with oral malodour.

The TCSI enables clinicians to record both the extent and severity of tongue coatings quickly and reliably, facilitating its use in screening halitosis, monitoring periodontal disease progression, and potentially in public health surveillance. Validation in larger and more diverse populations is required prior to widespread adoption.

Clinical Trials Registry (CTRI/2022/02/040688) last modified on 26/02/2022 and registered on 28/02/2022.