How clear is your toothbrush?


Common toothbrushing is essential to take away plaque from the enamel and mushy tissues. An efficient toothbrushing approach utilizing a handbook or powered toothbrush and a fluoride toothpaste is important to keep up good oral hygiene and for the prevention of caries and periodontal illness. The mouth incorporates a major variety of microorganisms (micro organism, viruses and fungi) which contaminate the toothbrush after preliminary use and improve with repeated use.

The purpose of this overview was to evaluate the extent of toothbrush contamination and the elements affecting contamination within the basic inhabitants.


A protocol was registered with the PROPERO database.  Searches had been performed within the Cochrane library, Cinahl Plus, Medline/PubMed, and Dentistry and Oral Well being Sciences Supply databases. Peer-reviewed research reporting on toothbrush contamination revealed in English between 2012 and 2022 had been thought of. Two reviewers independently chosen research and assessed examine high quality utilizing the Cochrane threat of bias software for randomised managed trials (RCTs) and the Joanna Briggs Institute’s (JBI) Vital Appraisal Guidelines for analytical and descriptive cross-sectional analysis. The knowledge of proof was assessed utilizing the Grading of Suggestions Evaluation, Improvement, and Analysis’ (GRADE) framework.


  • 15 research (8 RCTs, 6 cross-sectional, 1 in-vitro) had been included.
  • The typical length of the research was 3-4 weeks (vary, 1 day – 7 months).
  • 2 cross -sectional research had been thought of to be at low threat of bias and 4 at reasonable threat.
  • 3 RCTs had been assessed as being at low threat of bias, 4 at excessive threat and one at reasonable threat.
  • All 15 research reported contamination of toothbrushes.
  • 4 research had been analysed for impact of toothbrush bristles on bacterial contamination.
    • 3 research in contrast charcoal and non-charcoal brushes discovering a major discount in colony forming items with charcoal brushed, MD= -07 (95percentCI: -127.19 to -20.95).
    • 1 examine reported discount of bacterial load with nano-gold coated bristles.
    • 1 examine reported a diminished bacterial load with inexperienced tea extract infused bristles.
  • 3 RCTs reported diminished bacterial contamination following using chlorhexidine (CHX) mouthwash on toothbrush when in comparison with management.
  • 1 RCT reported diminished bacterial contamination following use of CHX.
  • The authors assessed the knowledge of proof as reasonable.


The authors concluded: –

The toothbrush turns into contaminated even after its first utilization, and the contamination degree rises with continued use. There are a selection of things that result in the contamination of brushes, similar to elevated humidity introduced on by a plastic cowl or a bathroom setting. Charcoal brushes present important efficacy as in comparison with common bristles in decreasing toothbrush contamination; nevertheless, extra RCTs are wanted to additional assess its efficacy. However, rinsing with chlorhexidine mouthwash after every day brushing exhibits beneficial outcomes.


This overview was performed to replace to an earlier overview revealed in 2012 (Dental Elf – 30th Mar 2012). A protocol for the overview was listed on the PROSPERO database though apparently it’s based mostly on a extra narrowly targeted query (‘Are toothbrushes with charcoal bristles efficient in decreasing microbial contamination of toothbrushes in comparison with brushes with non-charcoal bristles.’) than the revealed overview.

The authors have searched a number of main databases and have recognized 15 research, nevertheless, limiting the inclusion to English language papers could have excluded related research. Given the numerous variety of microorganisms which can be current within the mouth it’s of no nice shock that toothbrushes develop into contaminated after first utilization and that the extent of contamination rises with continued use. The findings recommend that the storage atmosphere could have an effect on ranges of contamination with discount when saved dry and will increase in damp atmosphere though the variety of research concerned was small. Whereas recognising that toothbrush contamination does happen and might be diminished by some actions there’s little proof of serious hostile occasions from present practices.


Main Paper  

Khan SA, Syed FA, Khalid T, Farheen N, Javed F, Kazmi SMR. An up to date systematic overview on toothbrush contamination: An neglected oral well being concern amongst basic inhabitants. Int J Dent Hyg. 2023 Sep 8. doi: 10.1111/idh.12740. Epub forward of print. PMID: 37680184.

Evaluation protocol on PROSPERO

Different references

Dental Elf – 30th Mar 2012

How clear is your toothbrush?




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