Development of a novel tongue biofilm index using bacterial biofluorescence

Abstract Conventional methods for assessing tongue bacterial biofilms have low inter-examiner reliability due to visualization challenges. This study aimed to develop and assess a novel Tongue Biofilm Fluorescence Index (TBFI) for the accurate detection and objective evaluation of the quantitative a...

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Main Authors: Sol Park, Eun-Song Lee, Areum Kim, Hyo-Jung Kim, Joo-Young Lee, Sang-Kyeom Kim, Hoi-In Jung, Baek-Il Kim
Format: Article
Language:English
Published: Nature Portfolio 2024-12-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-80696-5
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author Sol Park
Eun-Song Lee
Areum Kim
Hyo-Jung Kim
Joo-Young Lee
Sang-Kyeom Kim
Hoi-In Jung
Baek-Il Kim
author_facet Sol Park
Eun-Song Lee
Areum Kim
Hyo-Jung Kim
Joo-Young Lee
Sang-Kyeom Kim
Hoi-In Jung
Baek-Il Kim
author_sort Sol Park
collection DOAJ
description Abstract Conventional methods for assessing tongue bacterial biofilms have low inter-examiner reliability due to visualization challenges. This study aimed to develop and assess a novel Tongue Biofilm Fluorescence Index (TBFI) for the accurate detection and objective evaluation of the quantitative and qualitative characteristics of tongue biofilms at the chairside. Data were collected from 81 elderly individuals (n = 162 images). Qraycam captured white-light and fluorescence images of the dorsal tongue, and two examiners assessed tongue coating (TC) using the TBFI. The TBFI was calculated based on biofilm intensity and coverage (0–2 scale). Inter-examiner agreement (Kappa) was compared with the Winkel’s Tongue Coating Index (WTCI) and the Oho Index. Validity was evaluated through correlations with hydrogen sulfide (H₂S) and methyl mercaptan (CH₃SH) levels. TBFI demonstrated the highest inter-examiner reliability (TBFI, κ = 0.752; WTCI, κ = 0.317; Oho Index, κ = 0.496), particularly for thickness rating (agreement rate: TBFI, 96.3%; WTCI, 76.5%; Oho Index, 79.6%). H₂S and CH₃SH concentrations showed significant positive correlations with all three indices, with the highest correlation observed between H₂S and TBFI (TBFI, r = 0.369; WTCI, r = 0.304; Oho Index, r = 0.308; p < 0.01). Furthermore, H₂S levels increased significantly with higher TBFI scores (p < 0.0001). TBFI shows enhanced reliability and validity, supporting its clinical potential.
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spelling doaj-art-123ee0d342eb4d1ea11fd2ea69b4e1e12025-08-20T02:31:00ZengNature PortfolioScientific Reports2045-23222024-12-011411810.1038/s41598-024-80696-5Development of a novel tongue biofilm index using bacterial biofluorescenceSol Park0Eun-Song Lee1Areum Kim2Hyo-Jung Kim3Joo-Young Lee4Sang-Kyeom Kim5Hoi-In Jung6Baek-Il Kim7Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of DentistryDepartment of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of DentistryDepartment of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of DentistryDepartment of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of DentistryDepartment of Dental Hygiene, Kyungbok CollegeDepartment of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of DentistryDepartment of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of DentistryDepartment of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of DentistryAbstract Conventional methods for assessing tongue bacterial biofilms have low inter-examiner reliability due to visualization challenges. This study aimed to develop and assess a novel Tongue Biofilm Fluorescence Index (TBFI) for the accurate detection and objective evaluation of the quantitative and qualitative characteristics of tongue biofilms at the chairside. Data were collected from 81 elderly individuals (n = 162 images). Qraycam captured white-light and fluorescence images of the dorsal tongue, and two examiners assessed tongue coating (TC) using the TBFI. The TBFI was calculated based on biofilm intensity and coverage (0–2 scale). Inter-examiner agreement (Kappa) was compared with the Winkel’s Tongue Coating Index (WTCI) and the Oho Index. Validity was evaluated through correlations with hydrogen sulfide (H₂S) and methyl mercaptan (CH₃SH) levels. TBFI demonstrated the highest inter-examiner reliability (TBFI, κ = 0.752; WTCI, κ = 0.317; Oho Index, κ = 0.496), particularly for thickness rating (agreement rate: TBFI, 96.3%; WTCI, 76.5%; Oho Index, 79.6%). H₂S and CH₃SH concentrations showed significant positive correlations with all three indices, with the highest correlation observed between H₂S and TBFI (TBFI, r = 0.369; WTCI, r = 0.304; Oho Index, r = 0.308; p < 0.01). Furthermore, H₂S levels increased significantly with higher TBFI scores (p < 0.0001). TBFI shows enhanced reliability and validity, supporting its clinical potential.https://doi.org/10.1038/s41598-024-80696-5Tongue coatingTongue biofilmOral biofilmBiofluorescenceQuantitative light-induced fluorescenceOptical
spellingShingle Sol Park
Eun-Song Lee
Areum Kim
Hyo-Jung Kim
Joo-Young Lee
Sang-Kyeom Kim
Hoi-In Jung
Baek-Il Kim
Development of a novel tongue biofilm index using bacterial biofluorescence
Scientific Reports
Tongue coating
Tongue biofilm
Oral biofilm
Biofluorescence
Quantitative light-induced fluorescence
Optical
title Development of a novel tongue biofilm index using bacterial biofluorescence
title_full Development of a novel tongue biofilm index using bacterial biofluorescence
title_fullStr Development of a novel tongue biofilm index using bacterial biofluorescence
title_full_unstemmed Development of a novel tongue biofilm index using bacterial biofluorescence
title_short Development of a novel tongue biofilm index using bacterial biofluorescence
title_sort development of a novel tongue biofilm index using bacterial biofluorescence
topic Tongue coating
Tongue biofilm
Oral biofilm
Biofluorescence
Quantitative light-induced fluorescence
Optical
url https://doi.org/10.1038/s41598-024-80696-5
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