Although it is thought that protease-containing tablets with rough surfaces may be effective for cleaning the tongue surface, no studies have been reported. We investigated how the surface roughness and enzyme content of the tablets decreased the number of bacteria on the tongue. Four types of tablets were used : tablets comprised of several sugars with different solubilities with and without protease (actinidine), and tablets of one type of sugar, also with and without protease. The subjects were 20 healthy young adults and 20 elderly persons requiring support/nursing care. All gave informed consent. They used two tablets of each of the four types, and their efficacy at removing the tongue coating was evaluated employing a crossover study design.
The number of bacteria on the tongue was significantly decreased in the enzymecontaining tablets compared to the non-enzyme-containing group. When the surface property was considered, no significant difference was noted between the tablets prepared with several types of sugar and those prepared with a single type in either of the groups. It was suggested that the presence of protease is more effective at removing the tongue coating than was the rough surface formed by several sugars.

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