Contamination of a toothbrush with antibacterial properties by oral microorganisms

Bacterial Adhesion of TESPSA and Citric Acid on Different Titanium Surfaces Substrate Roughness: An In Vitro Study with a Multispecies Oral Biofilm Model

This in vitro study analyzed the influence of substrate roughness on biofilm adhesion and cellular viability over triethoxysilylpropyl succinic anhydride silane (TESPSA)- and citric acid (CA)-coated surfaces at 12 and 24 h, respectively. A multispecies biofilm composed of S. oralis, A. naslundii, V. parvula, F. nucleatum, P. intermedia, P. gingivalis, P. endodontalis and F. alocis was developed over titanium discs grouped depending on their roughness (low, medium, high) and antibacterial coating (low-TESPSA, medium-TESPSA, high-TESPSA, and CA). The biofilm was quantified by means of quantitative polymerase chain reaction (PCR) and viability PCR and assessed through confocal laser scanning microscope (CLSM). Quantitative PCR revealed no significant differences in bacterial adhesion and biofilm mortality. CA was the surface with the lowest bacterial counts and highest mortality at 12 and 24 h, respectively, while high harbored the highest amount of biofilm at 24 h. By CLSM, CA presented significant amounts of dead cells compared to medium-TESPSA and high-TESPSA. A significantly greater volume of dead cells was found at 12 h in low-TESPSA compared to medium-TESPSA, while CA also presented significant amounts of dead cells compared to medium-TESPSA and high-TESPSA. With regard to the live/dead ratio, low-TESPSA presented a significantly higher ratio at 12 h compared to medium-TESPSA and high-TESPSA. Similarly, CA exhibited a significantly higher live/dead ratio compared to medium-TESPSA and high-TESPSA at 12 h. This multispecies in vitro biofilm did not evidence clear antiadhesive and bactericidal differences between surfaces, although a tendency to reduce adhesion and increase antibacterial effect was observed in the low-TESPSA and CA.

Chemical vs. natural toothpaste: which formulas for which properties? A scoping review

Introduction

The proliferation of the oral care industry has made it more challenging for shoppers to zero in on the best possible toothpaste for their preventative requirements. It also makes the toothpaste’s various components safer.

Objective

The researchers set out to evaluate the state of information about the biological properties and cytotoxicity of adult toothpaste so that they might make some informed recommendations.

Methods

A scoping review of research published between 2015 and 2020 according to PRISMA guidelines was performed.

Results

In vitro clinical trials account for 44% of the papers, in vivo clinical trials for 25%, systematic reviews for 19%, and metaanalyses for 12%. They have active chemical components that have been shown to be antimicrobial, anti-inflammatory, or desensitizing. Herbal toothpaste has these characteristics and is very secure to use. Toothpaste with sodium lauryl sulfate has been found to be harmful.

Conclusions

Scientists have investigated the biological effects of a wide range of chemically active compounds and plant extracts. Herbal toothpaste, it has been discovered, is both efficient and secure. Companies making toothpaste should be required to clearly label the product’s qualities, active ingredients, and potentially harmful ingredients on the packaging.

Comparative Study of Different Sampling Methods of Biofilm Formed on Stainless-Steel Surfaces in a CDC Biofilm Reactor

The formation of biofilms in dairy processing plants can reduce equipment efficiency, contribute to surface deterioration, and contaminate dairy products by releasing the microorganisms they contain, which may cause spoilage or disease. However, a more representative identification of microbial communities and physico-chemical characterization requires to detach and recover adequately the entire biofilm from the surface. The aim of this study is to develop an efficient technique for in-plant biofilm sampling by growing a strain of Pseudomonas azotoformans PFl1A on stainless-steel surface in a dynamic CDC biofilm reactor system using tryptic soy broth (TSB) and milk as growth media. Different techniques, namely, swabbing, scraping, sonic brushing, synthetic sponge, and sonicating synthetic sponge were used and the results were compared to a standard ASTM International method using ultrasonication. Their efficiencies were evaluated by cells enumeration and scanning electron microscopy. The maximum total viable counts of 8.65 ± 0.06, 8.75 ± 0.08, and 8.71 ± 0.09 log CFU/cm2 were obtained in TSB medium using scraping, synthetic sponge, and sonicating synthetic sponge, respectively, which showed no statistically significant differences with the standard method, ultrasonication (8.74 ± 0.02 log CFU/cm2). However, a significantly (p < 0.05) lower cell recovery of 8.57 ± 0.10 and 8.60 ± 0.00 log CFU/cm2 compared to ultrasonication were achieved for swabbing and sonic brushing, respectively. Furthermore, scanning electron microscopy showed an effective removal of biofilms by sonic brushing, synthetic sponge, and sonicating synthetic sponge; However, only the latter two methods guaranteed a superior release of bacterial biofilm into suspension. Nevertheless, a combination of sonication and synthetic sponge ensured dislodging of sessile cells from surface crevices. The results suggest that a sonicating synthetic sponge could be a promising method for biofilm recovery in processing plants, which can be practically used in the dairy industries as an alternative to ultrasonication.

Comparison of Knowledge, Attitude, and Practice of Nursing and Medical Students in Kermanshah, Iran, about Toothbrush Maintenance and Use

Background

To promote oral health in society, medical and nursing students are required to have acceptable knowledge, attitude, and practice with respect to correct maintenance and use of a toothbrush. This study explored the knowledge, attitude, and practice of Iranian medical and nursing students about the correct maintenance and use of a toothbrush.

Methods

A total of 260 nursing students and 320 medical students were randomly recruited. Data were collected by a researcher-made questionnaire on the knowledge, attitude, and practice about toothbrush maintenance and use. Data were analyzed using descriptive and inferential statistics.

Results

The mean scores of knowledge, attitude, and practice were 54.53 ± 17.18, 49.67 ± 19.17, and 19 ± 51.50 in the nursing students and 54.17 ± 21.42, 51.18 ± 87.28, and 49.87 ± 17.52 out of 100 in the medical students, respectively. There was no significant difference between the medical and nursing students in the mean score of knowledge. The medical and nursing students had a similar attitude and practice in most items of toothbrush maintenance and use.

Conclusion

The medical and nursing students had average knowledge, attitude, and practice regarding toothbrush maintenance and use, which is not acceptable considering their job nature. Hence, interventional measures should be taken to enhance their knowledge, attitude, and practice.

The Toothbrush Microbiome: Impact of User Age, Period of Use and Bristle Material on the Microbial Communities of Toothbrushes

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.

Evaluation of Toothbrush Contamination

Background/Aim: Toothbrushes are one of the main means of cleaning teeth and maintaining oral hygiene, but toothbrushes are also potential reservoir of microorganisms, including pathogens. The aim of this paper was to evaluate the oral health, oral hygiene awareness and assess the degree of contamination of toothbrushes among students attending Secondary Medical School.

Material and Methods: Sixty students (32 boys, 28 girls; mean age ≅ 15,7±2,1) attending highschool were randomly selected for this study. Each student included in the study filled out a questionnaire regarding his/her life habits and oral hygiene. Clinical examinations were initiated in order to determine the DMFT, as well as the CIP, CIT, CIA and CPITN indexes, based of which the assessment of oral health status was performed. One stack of fiber was collected from each toothbrush used by the participantes in the study, and than prepared for further microbiological sampling.

Results: Only 11% of the students had the awareness of potential sources of toothbrushes contamination. The average value of DMFT was 3,2 (%D = 22,5; %M = 4,96; %F = 72,5). A statistically significant difference in comparison of the CPITN index and subjects’ response to the professional plague removal in the last 12 months was identified (χ2 = 13,55; p= 0,033). Staphylococcus aureus, Streptococcus mutans, Micrococcus species and Streptococcus salivarius were most commonly present microorganisms. In most cases, G-positive bacilli or cocci were isolated, while the presence of Candidae albicans was identified in four samples.

Conclusions: Raising the awareness of dental hygiene through the oral health education may improve better plaque control and subsequently the oral health. Handson training how to maintain the oral hygiene are not expensive and more over they are easy to be organized can be useful in oral heath promotion.

Efficacy of two mouth rinse sprays in inhibiting Streptococcus mutans growth on toothbrush bristles

Objective

To compare the efficacy of two types of mouth rinse sprays (Periogard and Plax) in inhibiting the growth of Streptococcus mutans (S. mutans) on toothbrush bristles used by children.

Methods

An experimental comparative study was performed. The sample included 60 children aged 6-8 years with high caries index. Children were divided randomly into 3 groups (20 each) according to materials applied on toothbrush. Each group was further subdivided into 2 subgroups A and B (10 each) according to the laboratory standards for processing microbiological specimens. Each toothbrush was placed in phosphate buffered saline, vortexed then serially diluted. Mitis salivarius bacitracin (MSB) agar plates were inoculated and incubated for 48 h. S. mutans colonies were identified by morphology, gram stain and biochemical tests.

Results

Statistically, significant difference was observed between the three groups either when toothbrushes were processed immediately or when processed after 24 h. Group I showed highest bacterial count followed by group III whereas group II showed least bacterial count. Bacterial counts were significantly decreased by time in group I and group III while in group II no significant decrease as both subgroups showed very low bacterial count.

Conclusions

Although both mouth rinses were effective against S. mutans toothbrush contamination, chlorhexidine gluconate proved to be better.

Is pomegranate peels infusion effective for disinfection of toothbrushes?

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.

Role of Salvadora persica chewing stick (miswak): A natural toothbrush for holistic oral health

From an ancient tool to a modern way of improving oral health, miswak (chewing stick) has proven to be an effective tool for oral health. The miswak removes the bacterial plaque by mechanical and chemical actions. It provides a cheap and easily accessible way of improving oral health of the individuals and populations. The use of miswak was promoted centuries ago by Prophet Muhammad (Peace be Upon Him). In the modern era, the beneficial role of using miswak such as antiseptic, antimicrobial, anticariogenic and analgesic effects have been proven scientifically. This article reviews the various oral health benefits of miswak in the light of religious, scientific and social evidences.

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.

Utilização do hipoclorito de sódio na descontaminação de escovas dentais: estudo in vitro

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.

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.

Mutans streptococci remained viable on toothbrush bristles, in vivo, for 44 h

BACKGROUND

Toothbrushes harbor a high number of cariogenic microorganisms.

AIM

To investigate the viability of mutans streptococci (MS) on toothbrushes bristles and the production of extracellular polysaccharide (ECP) related to drying time.

DESIGN

Twenty children were submitted to brushing without dentifrice. Toothbrushes were kept at room temperature from 0 to 48 h and then submitted to microbiological processing. The number of MS colonies/biofilms was expressed according to scores: 0=no colonies were detected; 1=1 to 50; 2=51 to 100; 3=over 100. The amount of ECP was evaluated according to scores: 0=absence; 1=ECP recovering until 50% of the surface; 2=ECP recovering more than 50% of the surface. Data were analyzed by Wilcoxon test (α=5%).

RESULTS

At the periods of 0 to 16 h, the toothbrushes had intense bacterial contamination (score 3). From the 18-h, there was a statistically significant decrease in the MS viability (P=0.0078), with predominance of score 1 on periods of 20 to 44 h. The most detected ECP amount was at 0- and 12-h period (P<0.05) with reduction until 32-h period.

CONCLUSIONS

Mutans streptococci remained viable on toothbrushes bristles, in vivo, for 44 h.

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.

Effectiveness of three antimicrobial mouthrinses on the disinfection of toothbrushes stored in closed containers: a randomized clinical investigation by DNA Checkerboard and Culture

OBJECTIVES

The aim of this in vivo study was to evaluate the efficacy of three antimicrobial solutions on the disinfection of toothbrushes after storage in closed containers.

MATERIALS AND METHODS

Sixteen healthy subjects were enrolled in this randomized cross-over clinical investigation. The study was conducted in four phases, in which mouthrinses (chlorhexidine gluconate-based or cetilpiridinium-based) and sterile tap water (control group) were used to individually store used toothbrushes in closed containers during 7 days of toothbrushing. Five toothbrushes were used as negative control for bacterial colonisation before contact with oral cavity. Conventional culture and DNA Checkerboard hybridization were used to detect bacterial contamination on the toothbrushes. Subsequently, the number of bacterial species on the bristles was estimated by the DNA Checkerboard method.

RESULTS

One toothbrush presented bacterial contamination in the negative control test. Both culture and DNA Checkerboard showed positive signals of bacterial contamination in the toothbrushes with no differences in the frequency of detection. The control group showed higher total bacterial counts when compared with the mouthrinse groups. Porphyromonas gingivalis had the highest bacterial count followed by Parvimonas micra.

CONCLUSION

Culture and DNA Checkerboard showed positive signals of bacterial contamination. Mouthrinses that contains 0.12% of chlorhexidine gluconate were more effective in reducing bacterial colonisation on the toothbrushes.

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% 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 37ºC 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 37ºC 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% 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.

Toothbrush contamination: a review of the literature

Toothbrushes are commonly used in hospital settings and may harbor potentially harmful microorganisms. A peer-reviewed literature review was conducted to evaluate the cumulative state of knowledge related to toothbrush contamination and its possible role in disease transmission. A systematic review was conducted on adult human subjects through three distinct searches. The review resulted in seven experimental and three descriptive studies which identified multiple concepts related to toothbrush contamination to include contamination, methods for decontamination, storage, design, and environmental factors. The selected studies found that toothbrushes of healthy and oral diseased adults become contaminated with pathogenic bacteria from the dental plaque, design, environment, or a combination of factors. There are no studies that specifically examine toothbrush contamination and the role of environmental factors, toothbrush contamination, and vulnerable populations in the hospital setting (e.g., critically ill adults) and toothbrush use in nursing clinical practice.

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% chlorhexidine digluconate, 50% 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%). 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% 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.

Occurrence, efficacy, metabolism, and toxicity of triclosan

Triclosan has broad-spectrum anti-microbial activity against most gram-negative and gram-positive bacteria. It is widely used in personal care products, household items, medical devices, and clinical settings. Due to its extensive use, there is potential for humans in all age groups to receive life-time exposures to triclosan, and, indeed, triclosan has been detected in human tissues and the environment. Data gaps exist regarding the chronic dermal toxicity and carcinogenicity of triclosan, which is needed for the risk assessment of triclosan. The US Food and Drug Administration (FDA) nominated triclosan to the National Toxicology Program (NTP) for toxicological evaluations. Currently, the NTP is conducting several dermal toxicological studies to determine the carcinogenic potential of triclosan, evaluate its endocrine and developmental-reproductive effects, and investigate the potential UV-induced dermal formation of chlorinated phenols and dioxins of triclosan. This paper reviews data on the human exposure, environmental fate, efficacy of anti-microbial activity, absorption, distribution, metabolism and elimination, endocrine disrupting effects, and toxicity of triclosan.