Evaluation of microbial contamination and efficacy of antimicrobial agents in disinfection of handicapped patients' toothbrushes

This study aimed to evaluate the contamination of toothbrushes usedby patients with disabilities, by microbial culture and cariogenic biofilm formation,and to explore two methods of disinfection. Methods: Experimental procedures were divided into three stages, with the same interval between each stage. In the first stage, the patients brushed their teeth, rinsed them with water, and their toothbrushes were sprayed with sterilized tap water. In the second and third stages, the steps were similar to those of Stage I, except the toothbrushes were sprayed with 0.12% chlorhexidine and 0.05% cetylpyridinium chloride solutions, respectively. At the end of each stage, the toothbrush bristles were cultured in bacitracin sucrose broth (CaSaB) medium. Data were analyzed through Friedman's nonparametric test (5% significance level). Results: In Stage I, mutans group streptococci (MS) were present in 30 toothbrushes (76.9%), and the number of colonies/biofilms ranged from 0 to +100. In Stage II, no MS colonization was observed. In Stage III, only 10.2% of the toothbrushes were contaminated with MS, and the number of colonies/biofilms ranged from 1 to 31. Conclusion: Bristles of toothbrushes used by patients with disabilities became contaminated with MS after a single brushing. The 0.12% chlorhexidine solution eliminated all microorganisms from the bristles of the toothbrushes used by the patients. Both 0.12% gluconate chlorhexidine and 0.05% cetylpyridinium chloride spray solutions can effectively be used for toothbrush disinfection to reduce contamination.

Objetivo: O presente estudo teve como objetivo avaliar a contaminação de escovas de dente utilizadas por pacientes especiais, por meio de cultura microbiana e formação de biofilme cariogênico, explorando dois métodos de desinfecção. Métodos: O estudo foi dividido em três estágios, com o mesmo intervalo de tempo entre cada estágio. No primeiro estágio, os pacientes escovaram os dentes e enxaguaram com água, em seguida, suas escovas foram borrifadas com água destilada. No segundo e terceiro estágios, as etapas foram semelhantes às do estágio I, exceto que as escovas de dente foram borrifadas com soluções de clorexidina 0,12% e cloreto de cetilpiridínio 0,05%, respectivamente. Ao final de cada etapa, as cerdas das escovas de dente foram cultivadas em meio de Caldo Sacarose Bacitracina (CaSaB). Os dados foram analisados por meio do teste não paramétrico de Friedman (nível de significância de 5%). Resultados: No estágio I, os estreptococos do grupo mutans (EM) estavam presentes em 30 escovas de dente (76,9%), e o número de colônias / biofilmes variou de 0 a +100. No estágio II, nenhuma colonização por MS foi observada. No estágio III, apenas 10,2% das escovas de dente estavam contaminadas com MS, e o número de colônias / biofilmes variou de 1 a 31. Conclusão: As cerdas das escovas de dente utilizadas por pacientes especiais contaminaram-se com EM após uma única escovação. A solução de clorexidina 0,12% eliminou todos os microrganismos das cerdas das escovas de dente utilizadas pelos pacientes. Ambas as soluções em spray (gluconatode clorexidina 0,12% e cloreto de cetilpiridínio 0,05%) podem ser utilizadas com eficácia para desinfecção das escovas de dente para reduzir a contaminação.

Identificación de bacterias periodontopáticas en cepillos dentales con y sin agente antibacterial / Identification of periodontopathic bacteria on toothbrushes with and without antibacterial agent

Resumen Introducción y objetivo: Los cepillos dentales pueden servir como reservorio para la translocación de bacterias periodontopáticas. El objetivo fue determinar la contaminación por bacterias periodontopatógenas en dos tipos de cepillos dentales, con y sin antibacterial. Materiales y métodos: Participaron 20 pacientes con periodontitis, que cepillaron 2 cuadrantes al azar con un cepillo antibacterial y los 2 cuadrantes contralaterales con cepillo normal, con la técnica de Bass modificado. Los cepillos se lavaron con agua por 10 segundos y se almacenaron individualmente en bolsas estériles a temperatura ambiente. A las 0, 4 y 24 h se cortaron 4 cerdas de cada cepillo y se suspendieron en el medio de dilución VMGA I, se sembraron en 3 medios de cultivo en anaerobiosis y CO2, se identificaron de acuerdo a la morfología de las colonias y pruebas adicionales con el sistema de identificación RAPID ANA II. Se evaluó la normalidad de las variables cuantitativas, se comparó el número de UFC/ml en los medios de cultivo a los diferentes tiempos de siembra, mediante la prueba U de Mann Whitney, con un alfa de 0,05. Resultados: Hubo diferencias significativas en el número de UFC/ml en agar sangre a las 24 horas de cultivo (p=0,011). Se identificaron a partir de los cultivos en los 3 tiempos bacterias como Porphyromonas gingivalis,Prevotella intermedia/nigrescens, Fusobacterium spp y Eikenella corrodens, mientras que Tannerella forsythia, Eubacterium spp y bacilos entéricos se recuperaron solo en la siembra inmediata. Conclusión:Ambos tipos de cepillos tuvieron contaminación bacteriana en los distintos medios de cultivo.

Abstract Introduction and objective: Dental toothbrushes can serve as reservoir to translocation of periodontopathic bacteria. The aim was to determine periodontal bacterial contamination in both types of toothbrushes, with and without antibacterial bristles. Materials and methods:We included 20 patients with periodontitis, which brushed two randomly selected quadrants with antibacterial brush and the 2 contralateral quadrants with normal toothbrush with modified Bass technique, and thereafter, the brushes were washed with water for 10 seconds and stored in sterile bags at room temperature. At 0, 4 and 24 h bristles were cut from each brush 4 and suspended in the dilution medium VMGA I. These were plated on 3 culture media in anaerobiosis and CO2 and identified according to the colony morphology and further tests such as UV fluorescence, catalase and identification system RAPID ANA II. Normality of the quantitative variables was assessed and compared the number of CFU/ ml in the culture media to different culturing times, by the nonparametric Mann Whitney U test with a significance level of p <0.05. Results: There were significant differences in the number of CFU / ml in blood agar at 24 hours of culture (p = 0.011). Were identified from cultures at 3 times bacteria like Porphyromonas gingivalis, Prevotella intermedia/ nigrescens, Fusobacterium spp and Eikenella corrodens, while Tannerella forsythia, Eubacterium spp and enteric bacilli were recovered only in the immediate culturing. Conclusion: Both types of brushes had bacterial contamination in the different culture media tested.

Using visible electric toothbrushes during the course of oral nursing for patients with peroral endo-tracheal intubation / 中国实用护理杂志

Objective To know the efficacy of oral nursing by visible electric toothbrushes among patients with peroral endotracheal intuabtion. Methods Divided 108 trauma patients with peroral endo-tracheal intubation and clear consciousness into the research group and the control group randomly, there were 54 cases in each group. Routine oral nursing cares were used in the control group, while the visible electric toothbrushes was used in the research group. Compared the efficacy of oral nursing between the two groups. Results The incidence rate of mouth odor, plaque index and oral infection in the research group were better than those of in the control group. Conclusions Using visible electric toothbrushes for trau-ma patients with oral endotracheal tube is a kind of effective and feasibility method, which should be devel-oped in the clinical field.

Eficacia de cuatro cepillos dentales en la remoción de placa bacteriana mediante la técnica modificada de Bass en estudiantes de Salud Oral de la ciudad de Cali / Efficacy of four toothbrushes on removal of plaque with modified Bass technique in Dental Hygiene students at Cali

Objetivo: Evaluar la eficacia de cuatro cepillos dentales de diferente diseño (Colgate Microsonic®, Colgate Twister Fresh®, Colgate 360 Sensitive® y Colgate 360®) para determinar si existe superioridad clínica en la remoción de placa bacteriana de alguno de ellos mediante la técnica de Bass modificado en estudiantes de salud oral de la ciudad de Cali. Materiales y métodos: Se trata de un ensayo clínico aleatorizado que compara la eficacia de cuatro diseños de cepillos dentales a través de diferentes técnicas de cepillado en 200 estudiantes de dos programas de entrenamiento de auxiliares de salud oral, de sexo femenino, con edades comprendidas entres los 15 y 43 años, escogidos por conveniencia y los cuales conformaron los grupos control (cualquier técnica de cepillado) e intervención (técnica de cepillado de Bass modificado). El seguimiento fue realizado durante 21 días a través de la aplicación del Índice de placa bacteriana de O´leary realizada por un odontólogo. Resultados: El cepillo Colgate Twister Fresh® (33%) tuvo mayor probabilidad de reducir el índice de placa bacteriana en cualquier momento del seguimiento cuando se comparó su eficiencia con la de los otros cepillos. La técnica modificada de Bass tuvo mayor probabilidad de reducir placa bacteriana que otras técnicas pero de igual forma esta diferencia no fue significativa. Conclusiones: No se encontró diferencia significativa entre las técnicas de cepillado tenidas en cuenta en este estudio. Ninguno de los cuatro diseños de cepillos empleados en este estudio presentó significancia estadística respecto a la eliminación de la placa bacteriana.

Aim: To evaluate the efficacy of four different designed toothbrushes (Colgate Microsonic®, Colgate Twister Fresh®, Colgate 360 Sensitive® y Colgate 360®) to determine the clinical advantage on removal of plaque using modified Bass technique in dental hygiene students in Cali. Methods: This is a controlled clinical trial to compare the efficacy of four toothbrushes designs with different tooth brushing methods in 200 female dental hygiene students with ages from 15 to 43. Control group used any tooth brushing technique whereas test group used modified Bass technique. Follow up was made daily for 21 days with O´Leary Plaque Index. Results: Colgate Twister Fresh® toothbrush had more probability to reduce plaque index at any time of follow up period than other toothbrushes. Modified Bass technique had more chance to reduce plaque than other techniques but with no significant differences. Conclusions: there were no statistically significant differences between tooth brush techniques. None of the four designs of studied toothbrushes showed differences in regard to plaque elimination.

The study on toothbrush filaments / 대한치주과학회지

The aim of this study is to investigate the end of filaments of the different toothbrushes in the market through the stereomicroscope and to evaluate the % of rounded-end filaments considered to be acceptable. 9 brands, total 11 type toothbrushes were tested. 2 toothbrushes of each type which is marked as roundedend filaments were tested. The toothbrushes which are not marked as rounded-end filaments were excluded. The domestic as well as foreign toothbrushes which are familiar to consumers were tested. 2 tufts of each toothbrushes were cut and examined by stereomicroscope using 40x magnification. The procedure was carried out with blind-technique, and the digital photographs were taken. Besides the % of rounded-end filaments, total tufts number, material of the tuft, stiffness, and other special characteristics were recorded. By the classification of Silverstone and Featherstone, rounded-end filaments were examined and counted. The results shows that there are different range of rounded-end filaments according to the toothbrush types(17.7%-91.2%). Atman toothbrush has the most rounded-end filaments(91.2%) among the observed toothbrushes, and the Advantage Plus(Oral-B) has the next(86.75%). E-Clean #411 has the least(17.70%) and E-Clean #410 of the same brand has also low % rounded-end filaments(20.60%). While G.U.M #409(Butler) has 67.90% rounded-end filaments, G.U.M #471 of the same brand has comparative low 41.83% rounded-end filaments. 4 types of total 11 have the rounded-end filaments over 80%, however other 4 types have under even 50%. Considering that the correct brushing habit with a toothbrush which has rounded-end filaments can protect the gingival injury and tooth abrasion, it is thought that we dentists need to give the correct information about toothbrush to the patients