Reduction of Total and H₂S-Producing Bacteria by a Specialized Toothbrush

Objective: To clinically evaluate the effectiveness of a specialized manual toothbrush with a cleaning implement on the back of the brush head versus a flat-trimmed manual toothbrush on reducing cultivable total salivary bacteria and H₂S-producing salivary bacteria. Methods: Twenty-nine healthy adult subjects took part in a randomized, single use, examiner blind, cross-over design study. Saliva samples were obtained by rinsing with 10 mL of sterile saline for 10 seconds and collecting the expectorant. The subjects brushed their teeth for 1 minute with the assigned toothbrush. Subjects using the toothbrush with the cleaning implement also cleaned their tongue with the implement on the back of the brush head for 10 seconds. Salivary samples collected at baseline and 30 minutes post-brushing were serially diluted in sterile phosphate buffered saline (Difco), and duplicate plated onto TSA II with 5% Sheep Blood agar (BD-BBL) for total viable bacterial counts and onto lead acetate agar selective for H₂S-producing bacteria. After 72-hour incubation, total colony forming units on TSA II and the dark pigmented colonies on lead acetate agar were counted. Results: At 30 minutes post brushing, the toothbrush with the cleaning implement reduced total salivary bacteria and H₂S-producing salivary bacteria 1.03 and 0.88 logs respectively, versus baseline. Reduction in log cfu/mL was 0.45 for the specialized manual toothbrush and 0.33 logs for the flat-trimmed manual toothbrush. The specialized toothbrush provided significantly (p<0.05) greater reduction relative to the control brush in both total salivary bacteria and H₂S-producing salivary bacteria. Conclusion: The clinical results indicate that a toothbrush with a cleaning implement on the back of the brush head is significantly more effective (p<0.05) than a flat-trimmed manual toothbrush in reducing the levels of total salivary bacteria and H₂S-producing salivary bacteria.