Americans should change their toothbrushes every three months for optimal oral health, say leaders of the Chicago Dental Society.
According to a survey by Colgate-Palmolive, only 8.6 percent of consumers comply. In fact, the survey shows that most Americans replace their brushes every nine months, while Japanese consumers replace their brushes every 3.1 months.
"The typical toothbrush is reused for months, never cleaned thoroughly, and usually is stored under warm, moist conditions conducive for bacterial growth," says Astrid Schroetter, D.D.S., a general dentist. "This little piece of plastic, which is the very basis of home daily dental care, repeatedly is plunged into one of the dirtiest parts of the body. More than 300 kinds of microorganisms thrive in the human mouth."
Researchers have established that thousands of microbes can grow on toothbrush bristles and handles. Most are harmless members of the mouth's microbial zoo; others can cause cold and flu viruses, the herpes virus that causes cold sores, staphylococcus bacteria responsible for many ear, nose and throat infections, the candida microbe that causes thrush, and bacteria that can cause periodontal infections.
"A toothbrush is less expensive than a Big Mac®, but some of us are so cheap that we just can't find the money to buy a new brush," says Tom Glass, D.D.S.
"After a while, toothbrush bristles wear down and become breeding grounds for bacteria," he says. "We've conducted numerous studies that show people can become re-infected with all kinds of bacteria from their own toothbrushes. By replacing their toothbrushes more often, we can prevent a lot of illnesses."
But few manufacturers, concedes Dr. Glass, seem to care about creating a brush that can withstand the bacterial onslaught a brush undergoes when placed in the oral cavity.
"It would be like reinventing the wheel, and it would take a lot of money that manufacturers don't want to invest," he says. "There are several products on the market designed to disinfect toothbrushes, but their effectiveness is questionable at best. The best thing consumers can do is simply throw their brushes away more often if they want to remain optimally healthy."
The American Dental Association does not consider the infectibility of toothbrushes to be an issue when it grants manufacturers its coveted Seal of Acceptance. "The toothbrush is not a sterile instrument and becomes even less sterile when a person places it in their mouths," says Wayne Wozniak, PhD, director of Evaluation Criteria for the ADA's Division of Scientific Affairs.
Instead, the ADA sets two criteria for manufacturers who submit products for the organization's seal: The brush must have soft, end-rounded bristles and be able to remove plaque.
"The general feeling is that the main function of a brush is to remove plaque from teeth and provide a means of oral hygiene between dental visits," says Dr. Wozniak. "But we also stress that toothbrushing is not the only oral hygiene procedure; it should be done along with flossing because cleaning between teeth is just as important as brushing teeth. And the key to everything is motivation on the part of the patient."
Dr. Glass stresses that consumers should become a little more motivated when it comes to protecting toothbrushes from germs and bacteria. He offers the following tips.
Don't keep your brush in the bathroom. "Bathrooms are wet and moist--the perfect breeding grounds for bacteria.
Store the brush somewhere dry--perhaps the bedroom--or an open area--not a tightly closed medicine cabinet.
Don't store brushes together. "We've all seen pictures of a cup full of brushes. This is a great way to cross-contaminate the entire family."
Use a brush made from clear or light-colored translucent plastic because light passing through helps to prevent the growth of microbes.
Use two brushes. "This gives the nylon bristles of one brush time to dry before being used again."
Do not use hot water to rinse the toothbrush. "It will shorten the life of the brush."
Dr. Glass believes brushes should be thrown out after roughly 40 to 50 uses. "Healthy people should buy a new toothbrush every two weeks," he says. "People with gum problems, other oral diseases, or weakened immune systems should change brushes more often.
"People with a respiratory illness or other infectious disease should change brushes at the beginning of the illness, again when they first feel better, and once again when they are well. Toothbrushes should be changed every day for patients who are recovering from major surgery because susceptibility to infections is higher at that time."
Dr. Glass suggests that consumers consider a toothbrush sanitizing agent. Some are sprays; other devices use ultraviolet light to kill bacteria. None have received the ADA's seal.
In the future, says Dr. Glass, the microwave may be used to keep toothbrushes germ-free. Researchers at the University of Oklahoma placed toothbrushes in a microwave and found they could wipe out common bugs. However, they also discovered that metal staples that hold the bristles in the manual toothbrush head can interfere with the energy waves and kill the microwave. The Chicago Dental Society cautions that microwave sterilization shows promise but is still in the early phases of research.
In the meantime, consumers should emulate their Japanese counterparts and purchase new brushes on a more regular basis.
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