Decontamination and Storage for Tooth Cleaning Tools: Systematic Literature Review

Objectives: Toothbrushes and interdental brushes play an essential role in an individual’s oral hygiene and systemic health. Although these devices assist in the reduction of pathogenic bacteria from the oral cavity, they may also serve as a reservoir for harmful microorganisms. The aim of this study was to assess various decontamination methods and proper storage conditions for toothbrushes and interdental brushes according to the literature.
Methods: A systematic literature review from Indexed databases (period 1998 to 2017), was conducted to evaluate studies that identified microorganisms commonly found on toothbrushes and interdental brushes in both healthy and diseased individuals. The review also included studies that discussed various brush sanitation methods. Descriptive statistics were used to demonstrate the data obtained from the literature review.
Results: Twenty-one articles (5 in vitro- and 14 in vivo-studies) were selected. Approximately 1,242 toothbrushes and 36 interdental brushes were tested, collectively. The studies selected found that toothbrushes and interdental brushes harbored over twenty different species of pathogenic bacteria. The literature also discussed various methods of toothbrush decontamination that lessened the microbial load on these devices. A spray disinfectant (containing 40% ethanol/biocide; one study) exhibited almost 100% microbial mortality rate. 0.12% chlorhexidine significantly decreased the bacteria on toothbrushes (three studies), including complete mortality of Streptococcus mutans (one study). Other methods of toothbrush decontamination that displayed a significant reduction in microbial load included 3% H₂O₂ (one study), 0.05% cetylpyridinium chloride (two studies), vinegar (four studies), 2% NaOCl (two studies), mouthwash (three studies), microwave irradiation (one study), amine/stannous fluoride toothpaste (one study), detergent-containing toothpaste (one study) and ultraviolet light (four studies).
Conclusions: A high incidence of bacterial contamination on toothbrushes and interdental brushes was observed. There are various cost-effective decontamination methods that can be employed to reduce bacteria, although a superior method has not yet been identified.