Toothbrush Contamination: A Review of the Literature

Table 2

Studies Selected.

Study	Purpose	Design	Sample	Results
In vitro studies
Bunetel et al. (2000) [8]	Does retention and survival of microorganisms on toothbrushes pose a threat to patients at risk of infection?	Experimental	𝑁=3 toothbrush types with two series of experiments	Contamination of toothbrushes occurs early in the life of the brush and tends to increase with repeated use.
Dayoub et al. (1977) [18]	To determine the degree of bacterial contamination of toothbrushes after contamination and storage in vented containers or in air.	Experimental	𝑁=103 toothbrushes	The numbers of bacteria on toothbrushes stored in room air after use decrease more quickly than on brushes in containers.
Glass and Jensen (1994) [9]	To evaluate toothbrush design and UV sanitation on microbial growth.	Experimental	𝑁=72 toothbrushes	UV sanitizing kills bacteria; viruses can survive on toothbrushes for 24 hours; toothbrush design, color, opacity, and bristle arrangement are a major factor in retaining microorganisms.
In vivo studies
Efstratiou et al. (2007) [14]	To examine the contamination and the survival rate of periodontopathic and cariogenic species on new toothbrushes with antibacterial properties after a single use in periodontic patients.	Experimental	𝑁=10 patients; 4 toothbrushes per patient.	Immediately after brushing, the toothbrushes harbored a significant number of microorganisms with no difference between the types of toothbrushes. The antibacterial toothbrush did not limit bacterial contamination.
Mehta et al. (2007) [10]	To determine the extent of bacterial contamination of toothbrushes after use, evaluate the efficacy of chlorhexidine and Listerine in decontamination, and effectiveness of covering the toothbrush head with a cap.	Experimental	𝑁=10 patients	Toothbrushes become contaminated during use; retention of moisture and the presence of organic matter may promote bacterial growth. Toothbrush contamination may lead to colonization and infection. Caps increase bacterial growth. Chlorhexidine was more effective than Listerine.
Quirynen et al. (2003) [15]	To evaluate the effects of coated tuffs and toothpaste on toothbrush contamination.	Experimental	𝑁=8 patients	Toothbrushes become contaminated and toothpaste reduced bacterial growth in toothbrushes.
Taji and Rogers (1998) [11]	To investigate the microbial contamination of toothbrushes.	Descriptive	𝑁=10 patients	Most toothbrushes were contaminated.
Verran and Leahy-Gilmartin (1996) [13]	To evaluate toothbrush contamination using a range of selective and nonselective media.	Descriptive	𝑁=28 toothbrushes	Used toothbrushes supported a wide variety of microorganisms. All media showed growth.
Combination of both in vitro and in vivo studies
Caudry et al. (1995) [5]	To demonstrate, quantitatively, the presence of microorganisms adherent to toothbrush bristles.	Experimental	𝑁=20 toothbrushes	Toothbrushes, in normal use, are heavily contaminated by microorganisms and the bacteria are extremely adherent to the bristles.
Glass and Lare (1986) [6]	Do toothbrushes harbor pathogenic microorganisms and if there is a correlation between contaminated brushes and the presence of disease.	Descriptive	𝑁=30 toothbrushes	Toothbrushes can harbor pathogenic microorganisms.