To the Editor: Tongue scraping is advocated as a therapy for manag-ing halitosis and as a technique for preventing dental caries by reduc-ing bacterial counts in the mouth (1). The practice has been in existence for centuries (2). A Cochrane review has concluded that tongue cleaning is mar-ginally and temporarily more effective than use of a toothbrush in reducing a measurable marker for halitosis, ex-haled volatile sulfur compounds (3). The use of tongue scrapers may not be limited to those with clinical halitosis, as 10%–30% of Americans report bad breath (4), and websites offer to solve the problem of "your bad breath" for a price. We report the case of a woman in whom infective endocarditis fol-lowed the use of a tongue scraper.A 59-year-old woman with a known history of mitral valve prolapse with associated valvular regurgitation had onset of progressive malaise, fe-ver, sweats, myalgia, and headache; the symptoms lasted 10 days. Two months previously she had begun cleaning her tongue with a plastic tongue scraper purchased at her local pharmacy. She had not undergone recent dental work. Her medical background included mi-graines, hypertension, mild quiescent psoriasis, and previous depression. Her medications were venlafaxine and candesartan
展开▼
