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Several simple visual methods have been developed for assessing tongue coating, but it is difficult to eliminate biases associated with these. The digital tongue imaging system (DTIS) was designed to acquire tongue surface images using a digital camera under controlled conditions, and to calculate tongue coating area. The aim of this study was to evaluate the potential of DTIS for clinical use by comparing it with the Winkel tongue coating index (WTCI).Forty participants with oral malodour were rated on WTCI by two independent examiners, and photographs of their tongues were assessed using the DTIS. The photographs were also rated by the examiners (blinded toin vivoWTCI and DTIS statuses).Agreements betweenin vivoWTCI ratings and DTIS assessments were relatively high atr= 0.561 for one examiner andr= 0.736 for the other (P< 0.01), while agreements between thein vivoWTCI ratings and tongue photograph-based ratings were also high atr= 0.645 for one examiner andr= 0.742 (P< 0.01) for the other.Digital tongue imaging system was found to be highly reliable and as having potential clinical applications. However, the algorithm for determiningin vivotongue coating status requires improvement.