Evaluation of toothbrush disinfection via different methods

The aim of this study was to compare the efficacy of using a dishwasher or different chemical agents, including 0.12% chlorhexidine gluconate, 2% sodium hypochlorite (NaOCl), a mouthrinse containing essential oils and alcohol, and 50% white vinegar, for toothbrush disinfection. Sixty volunteers were divided into five experimental groups and one control group (n = 10). Participants brushed their teeth using toothbrushes with standard bristles, and they disinfected the toothbrushes according to instructed methods. Bacterial contamination of the toothbrushes was compared between the experimental groups and the control group. Data were analyzed by Kruskal–Wallis and Duncan's multiple range tests, with 95% confidence intervals for multiple comparisons. Bacterial contamination of toothbrushes from individuals in the experimental groups differed from those in the control group (p < 0.05). The most effective method for elimination of all tested bacterial species was 50% white vinegar, followed in order by 2% NaOCl, mouthrinse containing essential oils and alcohol, 0.12% chlorhexidine gluconate, dishwasher use, and tap water (control). The results of this study show that the most effective method for disinfecting toothbrushes was submersion in 50% white vinegar, which is cost-effective, easy to access, and appropriate for household use.

Bacterial colonization status of cystic fibrosis children's toothbrushes: A pilot study.

BACKGROUND: Pseudomonas aeruginosa and Staphylococcus aureus toothbrush contamination in cystic fibrosis (CF) is unknown. This pilot study aimed to determine their prevalence and the potential involvement of toothbrushes in pulmonary infection. METHODS: Toothbrush bacteriological analysis for children aged 8-18 years was conducted on 27 CF patients, 15 healthy siblings, and 15 healthy children from the general population. RESULTS: S. aureus was detected on 22% of the patients' toothbrushes, and 13% of healthy children's toothbrushes and P. aeruginosa on 15% of patients' toothbrushes and 0-13% of healthy children's toothbrushes. There was no statistical correlation between pulmonary colonization and toothbrush contamination. P. aeruginosa genotyping showed two identical clones on the patients' toothbrushes and in their sputum, and between one patient's sputum and his sibling's toothbrush. CONCLUSION: S. aureus and P. aeruginosa can colonize CF patients' toothbrushes. The impact on pulmonary colonization remains unknown. Toothbrush decontamination methods need to consider these bacteria in CF patients.

Knowledge and behavior of dentists in a dental school regarding toothbrush disinfection

The aim of this study was to evaluate the knowledge and behavior of dentists regarding toothbrush disinfection. This study included 147 dentists (88 women and 59 men) who were actively employed at a dental school in Ankara, Turkey. Participants were asked to fill out a standard questionnaire, which contained questions regarding their demographics, brushing habits, toothbrush storage and disinfection habits, toothpaste use, knowledge about toothbrush disinfection, and whether they advised their patients about toothbrush storage. Descriptive statistics were calculated, and statistical analyses were performed with t-tests, chi-squared tests, and Fisher exact tests, where appropriate. Among the 147 surveyed dentists, 62.6% and 85.7% reported that they did not have any knowledge about toothbrush disinfection and did not disinfect their toothbrushes, respectively. However, approximately two thirds of surveyed dentists thought that toothbrush disinfection should be performed by everyone, including healthy individuals. Significant associations were found between knowledge about toothbrush disinfection and the professional title of dentists, how they stored their toothbrushes, and whether their toothbrushes were in contact with each other during storage (p < 0.05). A minority of dentists reported that they disinfected their toothbrushes.

Influence of time, toothpaste and saliva in the retention of Streptococcus mutans and Streptococcus sanguinis on different toothbrushes

Objectives: The intraoral transmission of cariogenic and periodontopathogenic species seems to be facilitated by contaminated toothbrushes and other oral hygiene devices. The aim of this investigation was to analyze the in vitro retention and survival rate of Streptococcus mutans and Streptococcus sanguinis on different toothbrushes. The impacts of human saliva and antimicrobial toothpaste on these parameters were further evaluated. Material and Methods: Part I: Four toothbrushes (Colgate 360°, Curaprox CS5460 ultra soft, elmex InterX, Trisa Flexible Head3) were contaminated by S. mutans DSM 20523 or S. sanguinis DSM 20068 suspensions for three minutes. Bacteria were removed from the toothbrushes after either three minutes (T0) or 24 hours (T24) of dry storage and grown on Columbia blood agar plates for the quantification of colony-forming units (CFUs). Part II: The effects of saliva from a caries-active or a caries-inactive person and of toothpaste containing 0.12% chlorhexidine digluconate were also tested. Results: Part I: After three minutes of dry storage, approximately one percent of the bacteria were still detectable on the toothbrushes. After 24 hours, S. sanguinis exhibited a more pronounced decrease in viable cell numbers compared with S. mutans but the differences were not significant (Kruskal-Wallis test, p>0.05). Part II: The addition of human saliva from a caries-active or caries-inactive person slightly increased the retention of both streptococcal species at T0. The use of toothpaste had no influence on the amount of viable streptococci at T0, but it reduced the microbial load after 24 hours of storage. There were only slight nonsignificant differences (p>0.05) between the four toothbrushes. Conclusions: In vitro bacterial retention and survival of S. sanguinis and S. mutans on different toothbrushes occurred. Within the limitations of this study, the use of human saliva or an antimicrobial toothpaste ...

Antimicrobial capacity of Aloe vera and propolis dentifrice against Streptococcus mutans strains in toothbrushes: an in vitro study

OBJECTIVES: This study evaluated in vitro the efficiency of Aloe vera and propolis dentifrice on reducing the contamination of toothbrush bristles by a standard strain of Streptococcus mutans (ATCC 25175; SM), after toothbrushing. MATERIAL AND METHODS: Fifteen sterile toothbrushes were randomly divided into 5 toothbrushing groups: I (negative control): without dentifrice; II: with fluoridated dentifrice; III: with triclosan and gantrez dentifrice; IV (positive control): without dentifrice and irrigation with 10 mL of 0.12 percent chlorhexidine gluconate; V: with Aloe vera and propolis dentifrice. In each group, 1 sterile bovine tooth was brushed for 1 min, where the toothbrush bristles were contaminated with 25 µL of SM. After toothbrushing, the bristles were stored in individual test tubes with 3 mL of BHI under anaerobiosis of 37°C for 48 h. Then, they were seeded with sterile swab in triplicate in the Mitis salivarius - Bacitracin culture medium. The samples were kept under anaerobiosis of 37°C for 48 h. Scores were used to count the number of colony forming units (cfu). The results were submitted to the Mann-Whitney statistical test at 5 percent significance level. RESULTS: There was statistically significant difference (p<0.05) for the reduction of bristle contamination comparing groups II, III, IV and V to group I. CONCLUSIONS: It may be stated that after toothbrushing, the Aloe vera and propolis dentifrice reduced the contamination of toothbrush bristles by SM, without differentiation from the other chemical agents used.

Disinfection of toothbrushes contaminated with Streptococcus mutans.

PURPOSE: To determine the most effective method to kill Streptococcus mutans on contaminated toothbrushes. METHODS: Seven toothbrushes (one for each treatment and the control) were contaminated with S. mutans. Toothbrushes were then rinsed in phosphate buffered saline (PBS) and treated as follows: (1) control without treatment; (2) air dry for 4 hours; (3) Crest Pro-Health mouthwash for 20 minutes; (4) Listerine mouthwash for 20 minutes; (5) normal cleaning cycle in a dishwasher; (6) microwave on high power for 5 minutes; and (7) ultraviolet light using the DenTek Toothbrush Sanitizer for 10 minutes. All toothbrushes were rinsed again with PBS. The bristles were cut and vortexed in PBS. Serial dilutions were performed and the number of colonies enumerated after incubation. The experiment was independently repeated seven times. RESULTS: The Crest Pro-Health mouthwash and the dishwasher almost completely eliminated S. mutans. The second most effective treatment was the microwave. The Listerine mouthwash and the air dry groups were not significantly different from each other and ranked third. Although UV light significantly decreased the number of bacteria compared to the control, reduction in the number of S. mutans CFU was significantly lower than that of all the other treatments evaluated. Crest Pro-Health mouthwash for 20 minutes and a normal dishwasher cycle are the most effective methods to eradicate S. mutans from contaminated toothbrushes. Dent

Evaluation of alternative methods for the disinfection of toothbrushes

The aim of this study was to evaluate alternative methods for the disinfection of toothbrushes considering that most of the previously proposed methods are expensive and cannot be easily implemented. Two-hundred toothbrushes with standardized dimensions and bristles were included in the study. The toothbrushes were divided into 20 experimental groups (n = 10), according to microorganism considered and chemical agent used. The toothbrushes were contaminated in vitro by standardized suspensions of Streptococcus mutans, Streptococcus pyogenes, Staphylococcus aureus or Candida albicans. The following disinfectants were tested: 0.12 percent chlorhexidine digluconate, 50 percent white vinegar, a triclosan-containing dentifrice solution, and a perborate-based tablet solution. The disinfection method was immersion in the disinfectant for 10 min. After the disinfection procedure, the number of remaining microbial cells was evaluated. The values of cfu/toothbrush of each group of microorganism after disinfection were compared by Kruskal-Wallis ANOVA and Dunn's test for multiple comparisons (5 percent). The chlorhexidine digluconate solution was the most effective disinfectant. The triclosan-based dentifrice solution promoted a significant reduction of all microorganisms' counts in relation to the control group. As to the disinfection with 50 percent vinegar, a significant reduction was observed for all the microorganisms, except for C. albicans. The sodium perborate solution was the less effective against the tested microorganisms. Solutions based on triclosan-containing dentifrice may be considered effective, nontoxic, cost-effective, and an easily applicable alternative for the disinfection of toothbrushes. The vinegar solution reduced the presence of S. aureus, S. mutans and S. pyogenes on toothbrushes.

Contaminação das escovas dentais: uma revisão crítica da literatura / Contamination of toothbrushes: a critical review of the literature

Apesar das escovas dentais serem consideradas importantes meios para a remoção do biofilme bacteriano, diversos estudos têm demonstrado que, após o uso elas podem ficar contaminadas por várias espécies de microrganismos patogênicos ao ser humano. Dessa forma, o objetivo do presente estudo foi realizar uma revisão crítica sobre a problemática da contaminação das escovas dentais e os possíveis métodos para diminuir ou controlar a proliferação de microrganismos nestes instrumentos, a partir de informações obtidas em bases de dados como Medline, Lilacs e Scielo. Verificou-se que o local de armazenamento das escovas exerce grande influência no tipo e quantidade de microrganismos colonizadores, e que existem diferentes formas de se promover descontaminação, seja por meios físicos ou químicos, cada um apresentando vantagens e desvantagens. Pelo fato de muitos profissionais não terem recebido informações a esse respeito durante sua formação, acabam por não discutir este assunto com seus pacientes, apesar de terem papel fundamental na orientação dos mesmos em relação a esta problemática. A partir do exposto, sugere-se que as empresas do ramo odontológico e os cursos de formação na área enfoquem com mais frequência e abrangência este assunto, desenvolvendo produtos e protocolos para controlar a contaminação das escovas, visando a promoção de saúde bucal na população.

In spite of toothbrushes being considered important means of removing dental biofilm, several studies have demonstrated that after use, they become contaminated with several species of microorganisms potentially pathogenic to human life. Therefore, the objective of the present study was to accomplish a critical review of the problem of toothbrush contamination and the possible methods to diminish or control the proliferation of microorganisms on these instruments, starting with information obtained indatabases such as Medline, Lilacs and Scielo. It was verified that the place where toothbrushes are stored exerts great influence on the type and number of invading microorganisms, and that there are different ways to promote toothbrush decontamination, either by physical or chemical means, each one presenting advantages and disadvantages. As many professionals received no information about this matter during their undergraduate studies, they do not discuss this issue with their patients, although of dentistsplaying a fundamental role in guiding their patients with regard to this problem. Starting from the above discussion, it is suggested that the dental companies and under graduatecourses in dentistry should focus on a more adequate manner of dealing with this issue, by developing products and protocols to control contamination on toothbrushes, with the goal of promoting the oral health of the population.

Avaliação microbiológica das cerdas de escovas dentárias: novas, sem uso, e após a imersão em substâncias antissépticas / Microbiology research of the toothbrushes bristles

Com o objetivo de verificar a contaminação nas cerdas das escovas e após comprovar a contaminação das mesmas, promover a descontaminação com substâncias antissépticas (Cepacol, Plax, Listerine Peroxyl e Periogard) e verificar qual apresentou melhor efetividade. Foi realizada uma pesquisa microbiológica em duas diferentes marcas e modelos de escovas dentárias brasileiras novas e sem uso, Oral B (indicator 30-35) e Kolynos (doctor). As escovas foram escolhidas por meio de questionário distribuídos aos pacientes inscritos para tratamento na Clínica do Curso de Periodontia da EAP-SCDP/ABO-PE. 42 escovas dentárias foram analisadas, sendo 21 da Oral B e 21 da Kolynos, onde após leitura com 24, 48 e 72 horas, 33 (80 por cento) apresentaram-se contaminadas. Destas, 30 foram distribuídas em grupos de seis para cada substância, com tempo de vinte minutos, e em seguida colocadas em caldo nutriente por 72 horas. Todas as substâncias promoveram descontaminação das cerdas, sendo o Cepacol a de menor efetividade, onde só descontaminou uma escova

Gingivitis and toothbrushes: potential roles in viridans streptococcal bacteraemia.

We report a case of Streptococcus oralis bacteraemia in a paediatric neutropenic patient with acute myeloid leukaemia whose predominant form of oral compromise was severe gingivitis, rather than mucositis. By phenotypic and genotypic analyses, the strain of S. oralis from blood culture was indistinguishable from an isolate from his mouth, suggesting that gingivitis may have provided a portal of entry for viridans streptococci into the bloodstream. To improve the patient's oral and dental hygiene and reduce gingivitis, conventional disposable foam toothettes were substituted with a new soft toothbrush for use as part of the oral care protocol. As there are no guidelines regarding the frequency of replacement of toothbrushes used by immunocompromised patients, the brush was swabbed regularly and culture performed to detect microbial colonization. Viridans streptococci were cultured from the toothbrush after 2 weeks of use. Phenotypic, followed by genotypic analyses, demonstrated that a strain of S. oralis from the toothbrush was indistinguishable from the strain previously isolated from blood culture and mouth. Soft toothbrushes may be useful tools for maintaining oral hygiene in immunocompromised individuals. However the results of this study indicate that regular replacement is warranted, as the toothbrush itself may become colonized with the organisms responsible for bacteraemia.

Microorganismos adheridos a la cabeza plástica de cepillos dentales con uso habitual: su relación con el estado de salud dental y el recuento de s. mutans / Microorganisms isolated from plastic head of dental brushes: it relation with dental health and s. mutans isolation

A 25 alumnos de la Facultad de Odontología de la Universidad de Chile, 11 hombres y 14 mujeres de 18 y 23 años, se les encuestó respecto a la marca de cepillo, pasta dentífrica, tiempo de uso y frecuencia diaria de cepillado. Se les realizótambién un recuento de S. mutans mediante un método semicuantitativo, un índice COP-d y radiografías Bite-Wing, de manera de identificar el estado de salud dentario y los niveles de riesgo cariogénico individual. Posteriormente, se les retiró su cepillo de uso habitual, el que fue llevado al Laboratorio de Microbiología de la Escuela Dental. En el laboratorio, se les tomó muestra Microbiológica a la cabeza plástica de entre los penachos, esta muestra se colocó en un medio de transporte (RTF) y se llevó al Vortex Mixer por 45 segundos. Luego se sembraron 100 microlitros en cada uno de los siguientes medios de cultivo: Agar TYCSB para los S. mutans, el Agar LBS para los Lactobacilos, el Agar Sabureaud + cloramfenicol para las Cándidas, el Agar Chapman para los Estafilococos, el Agar Mac Conkey para las Enterobacterias y finalmente el Agar Sangre + Hemina + Menadiona para los anaerobios facultativos totales. Los resultados respecto a tiempos de uso, frecuencia del cepillado, marca y tipo de pasta dentífrica usada, no influenciaron los resultados de la investigación. El desarrollo de S. mutans fue escaso (8 por ciento), al igual que las levaduras (8 por ciento) y los Estafilococos (4 por ciento). No se observó desarrollo de Lactobacilos, pero sí hubo un gran desarrollo de anaerobios (50 por ciento), lo cual coincide con un trabajo anterior (5 por ciento). Posiblemente el escaso crecimiento del S. mutans y la ausencia total de colonias de los Lactobacilos sea debido a la presencia de Flúor y otras sustancias químicas antibacterianas de las pastas dentífricas. Se observó contaminación ambiental de la base plástica de los cepillos representada por la presencia de Enterobacterias, y posiblemente ésta contaminación, sea más importante que la contaminación endógena por la microflora propia de la cavidad bucal

Tipo y grado de contaminación por bacterias bucales y levaduras de cepillos dentales con uso habitual / Type and degree of contamination by oral bacteria and yeasts of toothbrushes with normal use

Durante un programa de salud oral para estudiantes de primer año de la Facultad de Odontología, Universidad de Chile, se analizó el grado de contaminación microbiana de 40 cepillos dentales un número igual de alumnos, para ser sometidos a un estudio microbiológico y detectar bacterias y levaduras bucales. Los cepillos dentales se retiraron sin importar su estado, marca comercial, calidad ni el tiempo de uso, a su vez, cada alumno recibió uno nuevo. Cada cepillo usado fue envasado en una bolsa de papel estéril, una vez en el laboratorio, se colocaron en un tubo con medio de thioglicolato por su parte activa donde fueron incubados por 24 horas. Posteriormente, de cada tubo se tomaron muestras (100 µL en cada uno) y se sembraron en diversos medios de cultivo Agar TYCSB, Agar Sabureaud + CAF, Agar LBS y Agar sangre + hemina + menadiona, medios que son selectivos para: S. mutans, Cándidas Lactobacilos y Anaerobios totales, respectivamente. Los resultados de los cultivos, mostraron un pequeño porcentaje de S. mutans (2,8 por ciento), de Cándidas (2,8 por ciento), de Lactobacilos (1,2 por ciento), pero sorprendentemente, para los anaerobios totales, fue de (100 por ciento), éste último valor, puede deberse a una gran cantidad de factores, entre ellos: calidad de las pastas dentales, las cuales contienen químicos que inhiben a ciertos microorganismos y poseen fuertes propiedades antienzimáticas. También es posible, que las bacterias anaeróbicas, deriven de esa película bacteriana que se deposita en el plástico en que se insertan las cerdas del cepillo de dientes

Determinación del grado de contaminación por microorganismos bucales de los cepillos dentales a diversos tiempos de uso / Determination of contamination level by oral microorganisms of dental brushes at different time of use

Se seleccionaron 120 alumnos de la Facultad de Odontología , U. de Chile, los que se dividieron en dos grupos: el grupo A escobilló sus dientes con cepillo dental humedecido en agua solamente y el B, con pasta dental con monofluorfosfato de Na, carbonato de Ca y carragenato de Ca. A todos los participantes al inicio de la investigación, se les entregó un cepillo nuevo. Cada grupo fue a su vez dividido en tres sub-grupos: A-1, A-2, A-3, B-1, B-2 y B-3; los sub-grupos A-1 y B-1 terminaron la experiencia a los 15 días, devolviendo sus cepillos; los sub-grupos A-2 y B-2, los entregaron a los 30 días y los sub-grupos A-3 y B-3, a los 60 días. De los 120 alumnos, sólo 82 terminaron la investigación de acuerdo a las exigencias, el resto fue retirado de la investigación. Los cepillos que los alumnos entregaban estaban protegidos de la contaminación externa y se llevaron al laboratorio de microbiología de la Facultad, para su procesamiento. Este consistió en cortar en forma aséptica las cerdas del 1/3 anterior de cada cepillo, tomar 20 de éstas y sembrarlas en un tubo con caldo thioglicolato para luego ser agitadas en el vortex mixer por 1 minuto. De cada tubo se tomaron 100 uL para ser sembrados en los siguientes medios de cultivo: agar TYCSB para el S. mutans, agar Sabureaud + Cloramfenicol para las Cándidas, el agar LBS para los l,actobacilos y agar sangre + hemina + menadiona para la flora periodontal total. Resultados: no hubo desarrollo de cándidas en ninguno de los subgrupos, los lactobacilos sólo estuvieron presentes en un solo caso del universo total de 82. El desarrollo del S. mutans fue escaso en el medio TYCSB, un caso en el sub-grupo A-1 tres en el sub-grupo A-3 y uno en el sub-grupo B-3. Con respecto al medio de agar sangre+hemina+menadiona, el desarrollo de los anaerobios totales periodontales fue positivo en 34 casos, lo que hace un 41,5 por ciento del total

Persistence of group A beta-hemolytic streptococci in toothbrushes and removable orthodontic appliances following treatment of pharyngotonsillitis.

OBJECTIVE: To investigate the persistence of group A beta-hemolytic streptococci (GABHS) in toothbrushes and removable orthodontic appliances (ROAs) in children who suffer from acute GABHS pharyngotonsillitis and the association with penicillin treatment failure. SETTING: Private practice setting. PATIENTS AND METHODS: Pharyngotonsillar and toothbrush cultures were obtained from 104 children with acute GABHS pharyngotonsillitis before and after 10 days of penicillin V potassium therapy. Cultures of ROAs were also obtained from 21 children. The persistence of GABHS in 10 daily rinsed and 10 nonrinsed toothbrushes was studied in vitro. RESULTS: Group A beta-hemolytic streptococci were isolated from 11 (11%) of the toothbrushes and 18 (17%) of the patients after the completion of penicillin therapy. Toothbrushes of 5 (28%) of the 18 children who harbored GABHS were colonized with the organism. Group A beta-hemolytic streptococci were also isolated from 4 (19%) of 21 ROAs after therapy. In vitro studies illustrated the persistence of GABHS in nonrinsed toothbrushes for up to 15 days. In contrast, the organism was not isolated from rinsed toothbrushes beyond day 3. CONCLUSION: Toothbrushes and ROAs that harbor GABHS may contribute to the persistence of GABHS in the oropharynx and may account for the failure of penicillin therapy in some cases of pharyngotonsillitis.