Diagnostics of tongue coating using autofluorescence

Area of Science:

• Oral Medicine
• Diagnostic Imaging
• Microbiology

Background:

• Tongue coating is a significant factor in halitosis.
• Autofluorescence imaging offers a novel approach to visualize bacterial colonization on the tongue dorsum.
• Standardized indices are crucial for objective tongue coating assessment.

Purpose of the Study:

• To compare the diagnostic efficacy of the VELscope® autofluorescence device with the Winkel Tongue Coating Index (WTCI) for assessing tongue coating.
• To develop a corresponding index for VELscope® imaging.
• To evaluate the reliability of both methods across different examiner experience levels.

Main Methods:

• 100 volunteers underwent tongue dorsum photography with and without VELscope® autofluorescence.
• Tongue photographs were divided into sextants and evaluated by six investigators.
• A new VELscope® Index was developed and compared against the established WTCI.
• Inter-examiner reliability was assessed using kappa coefficients.

Main Results:

• Both WTCI and VELscope® imaging localized maximal coating density to the mid-posterior tongue.
• Significant differences were observed between the two methods (p < 0.001).
• WTCI was more sensitive to sparse coating, while VELscope® better detected dense coating.
• Inter-examiner reliability was comparable for both methods, regardless of experience.

Conclusions:

• The VELscope® device can serve as a valuable adjunct to the WTCI in diagnosing tongue coating.
• VELscope® imaging shows promise for visualizing bacterial load, particularly dense coating.
• The WTCI remains the primary index for comprehensive tongue coating assessment, especially for sparse coating detection.