ED approach to electrical toothbrush associated hand injury, a unique case of non-oropharyngeal injury.

Puncture wounds are common injuries treated in the emergency department (ED). Prior studies have shown that toothbrushes are common reservoirs for oral flora, especially in regions near the head of the toothbrush near the bristles. ED providers must be aware of the danger associated with bacterial contamination of the associated wound and should be familiar with different pathogens and options for treatment. We present a unique case of a 30-year-old male with non-intraoral injury who presented to the ED after puncturing his left palm with the metal post of an electric toothbrush.

Effectiveness of alternative methods for toothbrush disinfection: an in vitro study.

OBJECTIVE: This study aimed to evaluate the effectiveness of alternative methods for toothbrush disinfection. METHODS: Two-hundred eighty toothbrushes were included in the study. The toothbrushes were divided into 7 groups and were contaminated by standardized suspensions of Lactobacillus rhamnosus (L. rhamnosus), Streptococcus mutans (S. mutans), Staphylococcus aureus (S. aureus), and Escherichia coli (E. coli). The following disinfectants were tested: 1% sodium hypochlorite (NaOCl), 100% and 50% white vinegar, microwave (MW) oven, ultraviolet (UV) sanitizer, and mouth rinse-containing propolis (MCP). Data were analyzed with Kruskal Wallis and Dunn's tests. RESULTS: Statistically significant differences were found between different methods and control group for all tested bacteria. There were statistically significant differences between all test groups for all microorganisms. MW was the most effective for L. rhamnosus and 100% white vinegar was the most effective method for S. mutans and S. aureus. NaOCl was the most effective for E. coli. CONCLUSION: This study showed that 100% white vinegar was considered to be effective for tested microorganisms. Similarly, 1% NaOCl is cost-effective, easily accessible, and comparatively effective for toothbrush disinfection. Because these agents are nontoxic, cost-effective and easily accessible, they may be appropriate for household use.

Salivary Candida, caries and Candida in toothbrushes.

BACKGROUND: Candida species are common inhabitants of the normal oral microbiota. A few studies founded a relationship between high levels of Candida albicans in the oral cavity and high DMF scores. Toothbrushes can also be reservoirs of microorganisms, the proliferation of these microorganism on a toothbrush could be a major factor for its distribution in the oral cavity. AIM: To examine the associations between salivary Candida and DMF, and between salivary Candida and Candida in the toothbrush. METHOD: 46 healthy school children, who attended a University pediatric dental clinic, were tested for Candida in their saliva and in their toothbrush. Their DMF was recorded. RESULTS: 38 children were Candida-positive (79.2%), out of whom 5 demonstrated a positive growth of Candida in the toothbrushes. No correlation was found between Candida in the saliva and in the toothbrush. The number of Candida-positive girls was significantly higher than the number in boys. No significant relationship between caries experience and the presence of Candida was found CONCLUSIONS: No correlation was found between Candida in the saliva and in the toothbrush. The origin of the Candida in the toothbrush is not totally clear.

[Microbiological study of the efficiency of various hygienic products for toothbrushes].

Options vary about the microbial contamination of toothbrushes as well as selection of adequate remedies for their disinfection. A microbiological study of contamination of toothbrushes was conducted considering the efficiency of purifying tablets, ultraviolet radiation and 0.05% solution of chlorhexidine as means of toothbrushes disinfection.

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

Efficacy of microwaves and chlorhexidine on the disinfection of pacifiers and toothbrushes: an in vitro study.

PURPOSE: The purpose of this study was to evaluate, in vitro, the contamination of toothbrushes and pacifiers by Streptococcus mutans, and the efficacy of microwave and chlorhexidine for their disinfection. METHODS: Sixty pacifiers and 60 toothbrushes were contaminated with S mutans and then divided into groups according to the disinfection protocol: Group 1-chlorhexidine solution; Group 2-microwave sterilization; and Group 3-sterile tap water. The devices were evaluated microbiologically as to the formation of S mutans colonies/biofilms and were examined by scanning electron microscopy. The results were submitted for statistical analysis by Friedman's test at a 5% significance level. RESULTS: The results of both types of evaluation showed a large number of S mutans colonies/biofilms after spraying with sterile tap water, and chlorhexidine spraying and microwaving were effective in eliminate colonies/biofilms. Groups 1 and 2 were statistically similar to each other (P>.05) and differed significantly from Group 3 (P<.05). CONCLUSIONS: The 0.12% chlorhexidine solution spray and 7 minutes of microwave irradiation were effective for disinfection of pacifiers and toothbrushes.

Candida, mutans streptococci, oral hygiene and caries in children.

OBJECTIVE: to test the association between Candida and mutans streptococci (ms), oral hygiene and caries levels and in children. METHODS: 22 boys and 12 girls (age 6 to 14.5 years) participated in the study. Each participant received a toothbrush, and was asked to brush his/her teeth after proper instructions. Dental caries and oral hygiene were recorded. Candida and ms levels were determined in saliva samples. RESULTS: Candida colonies were observed in 70.5% of the children. No association was found between Candida and caries or plaque and gingival indices. C. albicans-positive children demonstrated significantly higher brushing scores. CONCLUSIONS: Our findings may suggest that there is no clear association between Candida in saliva, and levels of cariogenic bacteria and caries risk in children.

Evaluation of two alternative methods for disinfection of toothbrushes and tongue scrapers.

OBJECTIVE: The aim of this study was to investigate the effectiveness of two alternatives methods for the disinfection of oral cleaning devices. METHODS: One type of toothbrush and two types of tongue scrapers (steel and plastic) were tested in this study. Sixteen specimens of each group were cut with standardized dimensions, contaminated separately with Candida albicans, Streptococcus mutans and Staphylococcus aureus and incubated for 24 h. After this, oral cleaning devices were washed in saline solution to remove non-adhered cells and divided into two groups (n = 8), one irradiated in microwave and other immersed in 3.78% sodium perborate solution, and evaluated for microbial recovery. The values of cfu of each group of microorganism after disinfection were compared by Kruskal-Wallis and Dunn non-parametric test, considering 95% of confidence. RESULTS: The toothbrush harboured a significant larger number of viable organisms than the tongue scrapers. The steel tongue scraper was less susceptible to adhesion of the three oral microorganisms. The time required to inactivate all contaminating microorganisms using microwave oven was 1 min and, for the immersion in 3.78% sodium perborate solution, was 2 and 3 h, respectively, for C. albicans and S. mutans/S. aureus. CONCLUSION: Microwave irradiation proved to be an effective alternative method to the disinfection of tongue cleaners and toothbrushes.

Analysis of fungal contamination and disinfection of toothbrushes.

The aim of this study is to determine the fungal species in the toothbrushes of residents of a neighborhood on the east side of Teresina - PI, and to assess the efficiency of a disinfection method based on 2% sodium hypochlorite. Fifty toothbrushes were divided into two groups: group A comprised 30 toothbrushes used by the residents and group B (control group) 20 new toothbrushes. Fungal evaluation was conducted in Sabouraud culture medium containing chloramphenicol and CHROMagar Candida. Later group A was divided into two subgroups (A1 and A2), which were submitted to disinfection by immersion in 2% sodium hypochlorite and once again screened for the presence of fungi. Seventeen fungal species were identified in group A before the disinfection. Fungal growth was not observed in subgroups A1 and A2, or group B after disinfection. All fungal species isolated from the toothbrushes were considered opportunistic and may cause health problems mainly in immunocompromised patients. The species most frequently found were: Candida albicans, Aspergillus niger, Penicillium citrinum, Geotrichum candidum, Aspergillus fumigatus and Cladosporium oxysporum. Fungal growth did not occur after toothbrush disinfection with 2% sodium hypochlorite, suggesting this is an efficient, low-cost method that can therefore be used by low income populations.

How clean is the toothbrush that cleans your tooth?

Until recently, little attention has been directed towards the role the toothbrush may play in human health, even though a report of toothbrush as a significant factor in the infection appeared in 1920. It is common knowledge that the human mouth harbours a wide variety of microorganisms, some of which, at any given time, can be assumed to be potential pathogens. This was not known when toothbrushes were originally designed, yet the common toothbrush has been used in basically the same form for about 200 years. In today's world of organ transplantation and alteration of the immune system, it is important to consider the toothbrush as a source of potential pathogens. Given the fact that very often people will traumatize themselves with their toothbrush, this trauma may become a potential portal of entry for organisms. In this article, we have attempted to demonstrate the importance of toothbrush disinfection, given tips on home toothbrush care and hope to motivate the dentists to educate the patients on the importance of toothbrush disinfection.

A novel approach to controlling bacterial contamination on toothbrushes: chlorhexidine coating.

PURPOSE: This project was conducted to determine the effectiveness of chlorhexidine-coated toothbrush filaments in reducing quantities of bacteria. MATERIALS AND METHODS: An Institutional Review Board (IRB)-approved, two-group, double-blind, randomized, post-test only study was conducted. Sixty-four individuals utilized control and experimental toothbrushes, for 30 days. At the end of the study toothbrushes were returned and transported to the laboratory for analysis. Microorganisms were detached from the filaments by sonification and vortexing then plated on Mitis Salivarius (MS) (selective) and trypticase soy agar (TSA) 5% Sheep Blood (non-selective) media. Inoculated plates were incubated aerobically for 24 h at 37 degrees C. After incubation, bacterial colony-forming units (CFU) were determined. Data were analysed using Wilcoxon and Kruskal-Wallis tests. RESULTS: Fifty-nine toothbrushes were returned for analysis; experimental (n = 31) and control (n = 28). Data from TSA media revealed a mean CFU for the control group of 5.41 x 10(5) compared with 6.28 x 10(5) for the experimental group. Data from MS agar resulted in a mean CFU for the control group of 4.32 x 10(5) compared with 4.20 x 10(5) for the experimental group. CONCLUSION: Results revealed no statistically significant difference in the quantity of bacteria surviving on toothbrush filaments between control and experimental groups, on both selective and non-selective media, after 30 days.

Reduction in bacterial contamination of toothbrushes using the Violight ultraviolet light activated toothbrush sanitizer.

PURPOSE: This two armed, self-controlled, investigator blinded, clinical study tested the efficacy of an ultraviolet (UV) light toothbrush holder (Violight) to decrease toothbrush bacterial contamination. METHODS: 25 subjects were randomly assigned to control or experimental groups and received two toothbrushes for home use on either even or odd days. The control group rinsed both toothbrushes after use in cold tap water with no mechanical manipulation. The experimental group rinsed one toothbrush in cold running water while storing the other toothbrush in the Violight toothbrush holder after use. The toothbrushes were returned after 2 weeks use in sealed plastic bags and were analyzed for the number of colony forming units (CFU) of S. mutans, S. salivarius, lactobacilli, E. coli, and other coliforms, and total bacterial counts by culture. An additional analysis of the total bacterial profile was performed using denaturing gradient gel electrophoresis (DGGE). RESULTS: The Violight toothbrush holder reduced total CFU by an average of 86% (ANCOVA, P = 0.037). In addition, a tendency was noted for a reduction in total bacterial population as detected by DGGE.

The efficacy of two UV toothbrush sanitization devices. A pilot study.

The authors conducted a study to evaluate the efficacy of two different toothbrush sanitization machines for household use and to determine if one machine's sanitizing power was superior to the other. Bacteria from the same individual were tested for six days using the same brand toothbrush and toothpaste at the same time of day. The toothbrushes were sanitized using the VIOlight and HIGH DENT. In 83% of cases with the VIOlight machine, the amount of bacteria decreased after being sanitized, whereas the HIGH DENT had a 100% decrease in bacteria. Eighty-three percent of brushes sanitized with HIGH DENT resulted in rare or no growth compared to only 33% of those sanitized with VIOlight. While both machines reduced the amount of bacteria present on the toothbrush, the HIGH DENT was 50% more effective than VIOlight in reducing the majority of bacteria on the toothbrush.

Contamination of a toothbrush with antibacterial properties by oral microorganisms.

OBJECTIVES: The aim of this study was to examine the contamination and the survival rate of periodontopathic and cariogenic species on new toothbrushes with antibacterial properties (coated bristles with triclosan), after a single use in periodontitis patients. The decontamination effect of the use of toothpaste was also evaluated. METHODS: Ten patients, who consulted the Department of Periodontology, for treatment of chronic periodontitis, were selected. In each patient four different toothbrushes were used. Two quadrants, randomly selected, were each brushed using a different antibacterial toothbrush. In one of these two quadrants toothpaste was used. The same happened with the remaining quadrants, only with regular toothbrushes. After brushing, the toothbrushes were rinsed and stored in room temperature and a dry environment. After 0, 4 and 24h, four tufts, from each toothbrush, were cut and processed for selective and non-selective culturing techniques, followed by identification and quantification of all species found. RESULTS: Immediately after brushing the toothbrushes harbored a significant number of microorganisms, with no statistically significant difference between the two types of brushes (regular and antibacterial). The reduction of microorganisms from 0 to 4h after brushing was statistically significant (p<0.05). The difference was less obvious from 4 to 24h. When toothpaste was used, brushes harbored significantly (p<0.05) lower numbers of colony-forming units (CFU) compared to those without the use of toothpaste. CONCLUSIONS: The antibacterial toothbrush with triclosan coated tufts failed to limit the bacterial contamination. The toothpaste, on the other hand, significantly reduced the contamination of toothbrushes.

Bacterial contamination and decontamination of toothbrushes after use.

The purpose of this study was to determine the extent of bacterial contamination of toothbrushes after use and the efficacy of chlorhexidine and Listerine in decontaminating toothbrushes. The effectiveness of covering a toothbrush head with a plastic cap in preventing contamination was also evaluated. It was found that 70% of the used toothbrushes were heavily contaminated with different pathogenic microorganisms. Use of a cap leads to growth of opportunistic microorganisms like Pseudomonas aeruginosa, which may cause infection in the oral cavity. Overnight immersion of a toothbrush in chlorhexidine gluconate (0.2%) was found to be highly effective in preventing such microbial contamination.

Perceptions about toothbrush contamination and disinfection among dental students in Bengaluru City: A cross-sectional study.

INTRODUCTION: Toothbrushes are vital to remove dental biofilm and to prevent dental caries and periodontal disease. Repeated use of toothbrushes leads to contamination; hence, disinfection is essential in the maintenance of a brush. Current understanding and perception among dental students about toothbrush contamination and disinfection are essential. AIM: The aim of this study was to assess the perceptions about toothbrush contamination and disinfection among postgraduates and interns in Bengaluru city. MATERIALS AND METHODS: A cross-sectional study was conducted using self-administered questionnaire among 400 postgraduates and interns from five dental colleges in Bengaluru. The statistics were computed with the Statistical Package of Social Sciences (SPSS) version 22 software and Chi-square test was used. A P < 0.05 was considered statistically significant. RESULTS: There was a statistically significant difference regarding the source of information on tooth brush contamination (P = 0.008) and common mode of transmission of contamination (P = 0.01) between the two groups. The difference was found to be statistically significant (P = 0.01) regarding sharing of toothpaste. Only less than half of the participants, in both the groups practiced disinfection. CONCLUSION: There was a statistically significant difference in the perceptions about tooth brush contamination and disinfection among postgraduates and interns that might be attributed to their higher academic knowledge and clinical experience.

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.

Microbial contamination of toothbrushes with different principles of filament anchoring.

BACKGROUND: The retention and growth of cariogenic microorganisms on toothbrushes pose a threat of recontamination. The authors to studied three species of oral microorganisms found at different places on toothbrush filaments. METHODS: The authors tested on patients 30 toothbrushes each of three different toothbrush types made by a single manufacturer. The toothbrushes were divided into three groups by type of construction: staple-set tufting (toothbrush A); in-mold tufting (toothbrush B); individual in-mold placement of filaments (toothbrush C). Subjects used the toothbrushes once under standardized conditions; the authors subsequently examined the brushes for the presence of Streptococcus mutans, lactobacilli and Candida species. The inspection was carried out at three time intervals after use. RESULTS: S. mutans was retained to the highest degree, followed by lactobacilli and finally by C. albicans. The authors found that the number of microorganisms on toothbrush types A and B did not reveal a significant difference either on examination immediately after use or after the toothbrushes had been dried for two hours or eight hours. The technique of individual in-mold placement of filaments made retention of microorganisms more difficult. The difference between the number of germs retained on toothbrush types A and C, as well as that between the number of germs retained on types B and C, was significant or even highly significant. CONCLUSIONS: The results show that toothbrushes made with the technique of individual in-mold placement of filaments appear to retain the least amount of microbial material. CLINICAL IMPLICATIONS: Owing to the fact that toothbrushes always are a possible source of microbial reinfection, the arrangement of the filaments within the head of the toothbrush is of great importance with regard to hygiene.

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.