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Khan SA, Syed FA, Khalid T, Farheen N, Javed F, Kazmi SMR. An updated systematic review on toothbrush contamination: An overlooked oral health concern among general population. Int J Dent Hyg 2024; 22:95-105. [PMID: 37680184 DOI: 10.1111/idh.12740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 04/20/2023] [Accepted: 07/30/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES The present systematic review was conducted to give an overview of toothbrush contamination among the general population and the factors affecting toothbrush contamination with an evidence-based approach. DATA/SOURCES Medline (Pub Med), CINAHL Plus, Cochrane Library and Dentistry and Oral Health Sciences Source were searched for the results after applying the search strategy from January 2012 to May 2022, following inclusion and exclusion criteria. The data were collected using a self-made data collection form on study characteristics, population attributes and the main features, including the study's outcomes. The methodological quality of the included studies was independently evaluated based on the Joanna Briggs Institute's (JBI) critical appraisal checklist for cross-sectional studies and the Risk of Biasness Tool-1 (Rob-1) for randomized controlled trials (RCTs). A descriptive analysis of the included studies was done using SWiM guidelines. The impact of charcoal and non-charcoal brushes on toothbrush disinfection was quantitatively analysed using a forest plot. STUDY SELECTION Of the 687 studies screened by title and abstract, 27 articles were selected for full-text evaluation using the EndNote reference program (Ver. X9.2). From these, 15 qualified and were included in the systematic review. Among the selected studies, eight were RCTs, six were cross-sectional studies, and the remaining one was an in vitro experimental study. CONCLUSIONS The toothbrush becomes contaminated even after its first usage, and the contamination level rises with continued use. There are a number of factors that lead to the contamination of brushes, such as increased humidity brought on by a plastic cover or a toilet setting. Charcoal brushes show significant efficacy as compared to regular bristles in reducing toothbrush contamination; however, more RCTs are needed to further assess its efficacy. Nevertheless, rinsing with chlorhexidine mouthwash after daily brushing shows favourable results.
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Affiliation(s)
| | | | - Taimur Khalid
- Section of Dentistry, The Aga Khan University, Karachi, Pakistan
| | - Nudrat Farheen
- Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Faizan Javed
- Section of Dentistry, The Aga Khan University, Karachi, Pakistan
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Ribeiro YJS, Peixoto ITA, Segato RAB, Nelson Filho P, Queiroz AMD, Paula-Silva FWG. Visual Inspection and Toothbrush Care: A Mother-Baby Paired Cross-Sectional Study. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Shayankia A, Hajiahmadi M, Faghri J, Saliminabi Z, Moshkelgosha H, Heidari F. In vitro antimicrobial effects of green tea, microwaving, cold boiled water, and chlorhexidine on Streptococcus mutans and Candida albicans on silicone pacifiers. Dent Res J (Isfahan) 2022. [DOI: 10.4103/1735-3327.340108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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The Toothbrush Microbiome: Impact of User Age, Period of Use and Bristle Material on the Microbial Communities of Toothbrushes. Microorganisms 2020; 8:microorganisms8091379. [PMID: 32916797 PMCID: PMC7563892 DOI: 10.3390/microorganisms8091379] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/07/2020] [Accepted: 09/07/2020] [Indexed: 11/24/2022] Open
Abstract
Toothbrushes play a central role in oral hygiene and must be considered one of the most common articles of daily use. We analysed the bacterial colonization of used toothbrushes by next generation sequencing (NGS) and by cultivation on different media. Furthermore, we determined the occurrence of antibiotic resistance genes (ARGs) and the impact of different bristle materials on microbial growth and survival. NGS data revealed that Enterobacteriaceae, Micrococcaceae, Actinomycetaceae, and Streptococcaceae comprise major parts of the toothbrush microbiome. The composition of the microbiome differed depending on the period of use or user age. While higher fractions of Actinomycetales, Lactobacillales, and Enterobacterales were found after shorter periods, Micrococcales dominated on both toothbrushes used for more than four weeks and on toothbrushes of older users, while in-vitro tests revealed increasing counts of Micrococcus on all bristle materials as well. Compared to other environments, we found a rather low frequency of ARGs. We determined bacterial counts between 1.42 × 106 and 1.19 × 107 cfu/toothbrush on used toothbrushes and no significant effect of different bristles materials on bacterial survival or growth. Our study illustrates that toothbrushes harbor various microorganisms and that both period of use and user age might affect the microbial composition.
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Gupta B, Nissar I, Gupta R, Sharma A, Raina K, Kotia P. A study to compare the efficacy of three different chemical agents as toothbrush disinfectant: A triple blind study. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2019. [DOI: 10.4103/jiaphd.jiaphd_95_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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FREIRE PLDL, CAMPOS PH, CARVALHO FG, RODRIGUES JA, DINIZ MB. Is pomegranate peels infusion effective for disinfection of toothbrushes? REVISTA DE ODONTOLOGIA DA UNESP 2016. [DOI: 10.1590/1807-2577.01416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction Methods of decontamination or sanitization of toothbrushes have been questioned. Objective This study assessed the effectiveness of pomegranate peels infusion as a disinfectant of toothbrushes against Streptococcus mutans. Material and method A sample of 16 schoolchildren aged between 7 and 9 years performed brushing 5 days/week, with a careful brushing once a day. After each day of brushing, the toothbrushes were washed and sprayed with one disinfectant solution. This procedure was repeated for 4 weeks using one of the different solutions per week: distilled water (G1; negative control), pomegranate (Punica granatum Linn) peels infusion (G2), 1% sodium hypochlorite (G3) and 0.12% chlorhexidine digluconate (G4). After the fifth day, toothbrushes were collected for laboratory analysis. Toothbrushes heads were subjected to agitation in saline dilution of 10–1, 10–2,10–3, and 25 μL of each dilution were seeded in mitis salivarius agar culture medium for S. mutans colony-forming unit (CFU) counting. One calibrated examiner (Kappa = 0.91) performed the CFU (mL–1 × 104) counts. Kruskal-Wallis and Dunn Multiple Comparison tests were used at a significance level of 5%. Result G1 presented the highest number of CFU (3.9 ± 8.4), followed by G2 (3.2 ± 4.0). No S. mutans growth was observed in G3 and G4. There was no statistically significant difference between G1 and G2 and between G3 and G4 (p>0.05). Conclusion Pomegranate infusion was completely ineffective for the disinfection of toothbrushes against S. mutans when compared with 1% sodium hypochlorite and 0.12% chlorhexidine digluconate solutions.
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Basman A, Peker I, Akca G, Alkurt MT, Sarikir C, Celik I. Evaluation of toothbrush disinfection via different methods. Braz Oral Res 2015; 30:S1806-83242016000100203. [PMID: 26676193 DOI: 10.1590/1807-3107bor-2016.vol30.0006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 07/07/2015] [Indexed: 11/22/2022] Open
Abstract
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.
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Affiliation(s)
- Adil Basman
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Ilkay Peker
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Gulcin Akca
- Department of Microbiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Meryem Toraman Alkurt
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Cigdem Sarikir
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Irem Celik
- Department of Microbiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Busato CDA, Cavazzola AS, Ortega ADOL, Guaré RDO, Saleh Neto A. Utilização do hipoclorito de sódio na descontaminação de escovas dentais: estudo in vitro. REVISTA DE ODONTOLOGIA DA UNESP 2015. [DOI: 10.1590/1807-2577.04214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ResumoIntroduçãoA escovação dentária é um método utilizado para controle do biofilme dental; entretanto, as escovas dentais tornam-se um meio de contaminação de microrganismos após seu uso, com lacunas importantes em relação a estes métodos de desinfecção, principalmente no uso coletivo.ObjetivoO objetivo desta pesquisa foi avaliar a descontaminação de escovas dentais contaminadas in vitro, utilizando-se hipoclorito de sódio 0,08% em diferentes períodos de tempo (5, 10 e 15 minutos).Material e métodoForam utilizadas, nesta pesquisa, 72 escovas dentais distribuídas em seis grupos, levando-se em conta o microrganismo utilizado para contaminação, sendo: grupo 1, contaminadas com Escherichia coli; grupo 2, com Stafilococcus aureus; grupo 3, com Streptococcus pyogenes; grupo 4, com Enterococus faecalis; grupo 5, com suspensões de todas as bactérias, e grupo 6, o grupo-controle. Após a contaminação, os grupos foram imersos na solução de hipoclorito de sódio a 0,08% por períodos de 5, 10 e 15 minutos, sendo considerado positivo para desinfecção a não turvação do meio de imersão.ResultadoNo tempo de imersão de 5 minutos, ocorreu a desinfecção dos grupos 2 e 3; em 10 minutos, houve desinfecção dos grupos 1,2 e 3; após 15 minutos de imersão, ocorreu a desinfecção de todos os cinco grupos.ConclusãoO uso de hipoclorito de sódio 0,08% foi efetivo na descontaminação de escovas dentais contaminadas com bactérias Escherichia coli, Stafilococcus aureus, Streptococcus pyogenes, Enterococcus faecalis, num tempo de imersão de 15 minutos.
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do Nascimento C, Trinca NN, Pita MS, Pedrazzi V. Genomic identification and quantification of microbial species adhering to toothbrush bristles after disinfection: A cross-over study. Arch Oral Biol 2015; 60:1039-47. [PMID: 25912552 DOI: 10.1016/j.archoralbio.2015.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 03/20/2015] [Accepted: 03/22/2015] [Indexed: 12/31/2022]
Abstract
PURPOSE The aim of this clinical investigation was to identify and quantify the microbial species adhering to toothbrush bristles after controlled brushing and storage in different antimicrobial agents. METHODS Sixteen healthy participants were enrolled in this study and randomly submitted to 4 interventions in a cross-over design: brushing and toothbrush storage in (I) Periogard/(II) Periobio (Chlorhexidine gluconate 0.12%), (III) Cepacol (cetylpyridinium chloride 0.05%) and (IV) distilled water (positive control). Thirty-eight bacterial species including putative pathogens and 5 Candida spp. were assessed by Checkerboard DNA-DNA hybridization. RESULTS The results of the study have shown a striking reduction of the total microbial counts, including bacteria and Candida spp., on the toothbrush bristles after storage in cetylpyridinium chloride 0.05% (p < 0.0001). Chlorhexidine gluconate 0.12% showed no differences on the total bacterial count when compared to distilled water (p > 0.05). Cetylpyridinium chloride solution also presented the lowest genome counts and frequency of detection for individual target species; distilled water showed the highest individual genome counts (p < 0.05). Potential pathogenic species were recorded in moderate to high levels for chlorhexidine gluconate and distilled water. CONCLUSION Cetylpyridinium chloride 0.05% was the most effective storage solution in the reduction of total and individual microbial counts, including pathogenic species.
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Affiliation(s)
- Cássio do Nascimento
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n°, Monte Alegre, Ribeirão Preto, SP 14040-904, Brazil
| | - Nayara Nascimento Trinca
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n°, Monte Alegre, Ribeirão Preto, SP 14040-904, Brazil
| | - Murillo Sucena Pita
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n°, Monte Alegre, Ribeirão Preto, SP 14040-904, Brazil
| | - Vinícius Pedrazzi
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n°, Monte Alegre, Ribeirão Preto, SP 14040-904, Brazil.
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