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Evidence about toothbrush disinfection

In vitro evaluation of the retention of three species of pathogenic microorganisms by three 
different types of toothbrush.
Bunetel L, Tricot-Doleux S, Agnani G, Bonnaure-Mallet M.
Equipe de Biologie Buccale, Universite de Rennes 1, France.

The retention and survival of microorganisms on toothbrushes pose a threat of recontamination
for certain patients at risk. In order to measure the influence of brush design and optimize 
the choice of toothbrush model for complementary studies, the in vitro retention of three 
microbial species (Porphyromonas gingivalis ATCC 33277, Streptococcus mutans ATCC 25175 and 
Candida albicans ATCC 26555) was evaluated for three types of toothbrush. Two series of 
standardized experiments were carried out for each brush and microorganism. The first series 
tested the retention of the microorganisms on the head portion of the brush, while the second 
measured retention on the head of the brush and the part of the handle inserted in the mouth 
during brushing. For each series, the microorganisms were counted at T0 and T24 (after storage 
of the brushes at room temperature for 24 h). Depending on the microorganism studied, from 0.2% 
to 2% of the initial inoculum was retained on the brush. The number  detected increased with the
size of the exposed area. After 24 h, P. gingivalis and S. mutans were found on only one type 
of brush. C. albicans survived on all three. These results confirm that microorganisms can 
quickly colonize toothbrushes.

Residual contamination of toothbrushes by microorganisms. Kozai K, Iwai T, Miura K. Department of Pedodontics, School of Dentistry, Hiroshima University, Japan. Procedures for maintaining the cleanliness of oral cleaning instruments have been discussed infrequently. S. mutans and pathogenic microorganisms can be transferred readily when a toothbrush is used, increasing the risk of dental caries and infectious diseases. It is suggested that sterilization equipment or specific detergents be used. PMID: 2723207 [PubMed - indexed for MEDLINE] Scand J Dent Res 1978 Sep;86(5):412-4 Related Articles, Books
Contamination of toothpaste and toothbrush by Streptococcus mutans. Svanberg M. Toothbrushes and toothpaste tubes used by persons infected with S. mutans were examined for the presence of this microorganism. Fifteen minutes after brushing greater than 10(6) S. mutans were isolated from the toothbrushes and after ordinary storage for 24 h 10(4) were recovered. From two out of 10 toothpaste tubes S. mutans was isolated from the orifice of the tube. The implications of these findings for the spread of the microorganism are discussed. PMID: 281764 [PubMed - indexed for MEDLINE] J Dent Res 1988 Jun;67(6):964-8 Related Articles, Books
Effect of inoculum size and frequency on the establishment of Streptococcus mutans in the oral cavities of experimental animals. Ooshima T, Sumi N, Izumitani A, Sobue S. Department of Pedodontics, Osaka University Faculty of Dentistry, Japan. SPF Sprague-Dawley rats and ICR mice were inoculated with either Streptococcus mutans MT8148R (serotype c) or 6715 (g), and the influence of inoculum size, inoculum frequency, and sucrose on the establishment of S. mutans in the oral cavity was examined. Successful colonization of S. mutans in the experimental animals was absolutely dependent on the number of the cells introduced orally. Furthermore, inoculum frequency and sucrose seemed to act as secondary factors to modify the establishment of S. mutans, and it is suggested that high inoculum frequency may decrease the inoculum size necessary for the colonization of S. mutans in the oral cavity. PMID: 3170911 [PubMed - indexed for MEDLINE] J Can Dent Assoc 1995 Jun;61(6):511-6 Related Articles, Books, LinkOut
Contaminated toothbrushes and their disinfection. Caudry SD, Klitorinos A, Chan EC. Department of Oral Biology, Faculty of Dentistry, McGill University, Montreal, Que. Twenty toothbrushes used by healthy subjects were screened for the presence of microorganisms. Microbes were dislodged from the brushes by vortexing, and an average of 4 x 10(3) CFU/mL were recovered from the suspending fluid. Bristles removed from the vortexed brushes still yielded confluent bacterial growth on brain-heart infusion agar medium. Virkon (one per cent), Listerine, Cepacol, Scope, and Plax were tested for their bactericidal effects on microorganisms sedimented from the suspending fluid, on toothbrush bristles and proxabrushes, and on various test species including Candida albicans, Mycobacterium smegmatis, M. bovis, and Streptococcus mitis. Virkon and Listerine killed all the test species and virtually all the microorganisms on the toothbrush bristles and proxabrushes. Six volunteers tested the efficacy of a Listerine soaking regime to prevent the bacterial contamination of toothbrushes. Soaking the toothbrush head (bristles) in Listerine for 20 minutes after brushing was sufficient to eliminate bacterial contamination. PMID: 7614433 [PubMed - indexed for MEDLINE] Pediatr Dent 2000 Sep-Oct;22(5):381-4 Related Articles, Books
Microbial contamination of toothbrushes and their decontamination. Nelson Filho P, Macari S, Faria G, Assed S, Ito IY. Department of Pediatric Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Brazil. PURPOSE: The objective was to determine the level of contamination of toothbrushes by mutans streptococci using microbiological identification, to access the bacterial contamination using scanning electron microscopy (SEM) and to evaluate the efficacy of two toothbrush disinfectants. METHODS: Nineteen children used their toothbrushes once a day, for five consecutive days. The toothbrushes were then immersed into disinfectant solutions for 20 h: Group I--0.12% chlorhexidine gluconate; Group II--1% sodium hypochlorite; Group III--sterile tap water. They were then placed into test tubes containing CaSa B, for 3 to 4 days at 37 degrees C. The number of MS cfu was counted and the toothbrushes were submitted to SEM analysis. RESULTS: There was no bacterial growth in Groups I and II; Group III showed MS growth (range, 21 to 120 cfu). Scanning electron microscopy showed biofilm formation on toothbrush bristles. CONCLUSION: Immersion in 0.12% chlorhexidine gluconate and 1% sodium hypochlorite are efficient methods for toothbrush disinfection. PMID: 11048305 [PubMed - indexed for MEDLINE] J Okla Dent Assoc 1994 Spring;84(4):24-8 Related Articles, Books
The effectiveness of a u-v toothbrush sanitizing device in reducing the number of bacteria, yeasts and viruses on toothbrushes. Glass RT, Jensen HG. Department of Oral Pathology, University of Oklahoma College of Dentistry. Sixty-six sterile toothbrushes were exposed to one of the following microorganisms: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Bacillis subtilis, Serratia marcescens and Baker's yeast. The Pollenex DS60 Daily Dental Sanitizer was found to be effective in substantially reducing the number of retained bacteria and yeasts as compared to contaminated toothbrushes not treated with such a device. Different toothbrush types had different response rates. Seventy-two sterile toothbrushes were exposed to Herpes Simplex Virus, Type I and seventy-two sterile toothbrushes were exposed to Parainfluenza Virus, Type III. The Pollenex DS60 Daily Dental Sanitizer consistently killed both viruses on all of the toothbrushes treated. Both viruses were consistently retained on non-treated toothbrushes for at least 24 hours. PMID: 7931767 [PubMed - indexed for MEDLINE] Acta Odontol Scand 1994 Apr;52(2):93-8 Related Articles, Books
Microorganisms on toothbrushes at day-care centers. Malmberg E, Birkhed D, Norvenius G, Noren JG, Dahlen G. Department of Pedodontics, Faculty of Odontology, University of Goteborg, Sweden. The microflora on 44 toothbrushes at 4 day-care centers in the city of Goteborg have been investigated as a presumptive risk factor for transmission of microorganisms by children. Non-supervised toothbrushing without the use of toothpaste was performed at the day-care centers twice a day. Streptococci, predominantly S. salivarius, S. sanguis, and S. mitis, were the most frequently recorded group of microorganisms and generally constituted the greatest part of the flora (on average, 50%). Beta-hemolytic streptococci were not found in any sample. Haemophilus species were noted in 82% of the samples. H. parainfluenzae being the most frequent, and H. influenzae being identified in only one sample. Anaerobes constituted on average a third of the microflora. Staphylococci were identified in 86% of the samples, S. epidermidis dominating. Fungi including molds were found in 50% of the samples, and from one day-care center large numbers of enteric organisms were identified. Thus this studyshows that unsupervised toothbrushing at day-care centers can be questioned, more from a general hygienic point of view than from the risk of transmitting serious pathogens. PMID: 8048328 [PubMed - indexed for MEDLINE] -- (u. a. _die_ Mailingliste für die Dentalbranche) PGP-key (RSA/IDEA) kommt mit angeforderter Empfangsbestätigung (return receipt)