What is the BEST Way to Disinfect a Toothbrush?

In my previous blog article, I discussed the debate over whether a toothbrush becomes "contaminated" leading to the practice of throwing them out after a strep throat infection. Although the answer is still ambiguous whether it helps or not, the fact that even NEW toothbrushes contain harmful bacteria brings even more confusion on what to do.

Going on the assumption that bacteria on a toothbrush is harmful and if a new or old toothbrush contain such bacteria, perhaps the best practice would be to disinfect toothbrushes on a regular basis.

Would toothbrush disinfection work best by...

• Microwave
• Ultraviolet light (examples in this list from Amazon)
• Dishwasher
• Listerine
• Crest Pro-Health
• Air dry
• 3% Hydrogen Peroxide

Although the ultraviolet sanitization method is perhaps getting the most attention due to the high-tech nature, researchers have found that though this method did significantly decrease bacteria load, they also have found this method to be the least effective compared to other measures.

Rather, the best way to disinfect a toothbrush is by rinsing the toothbrush with Crest Pro-Health mouthwash for 20 minutes OR having it go through a normal dishwasher cleaning cycle.  3% Hydrogen Peroxide was also found helpful.

Interestingly, Listerine didn't work much better than air-dry alone and ultraviolet light didn't do much better.

Bottom line?

Don't waste your money on ultraviolet light toothbrush treatments.

Rather, if you already use a dishwasher regularly, stick the toothbrush in there. If you already like gargling with mouthwash, get Crest Pro-Health which can also disinfect toothbrushes effectively.


References:
Disinfection of toothbrushes contaminated with Streptococcus mutans. Am J Dent. 2011 Jun;24(3):155-8.

Germicidal activity of antimicrobials and VIOlight Personal Travel Toothbrush sanitizer: an in vitro study. J Dent. 2010 Aug;38(8):621-5. doi: 10.1016/j.jdent.2009.08.011. Epub 2009 Sep 23.

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Should Toothbrushes be Thrown Out After Strep Throat?

As with so many things with medicine, this question which sounds so straightforward unfortunately has no straightforward answer.

After all, there have only been a few studies that have specifically looked to answer this question.

And the answer is decidedly ambiguous as the few studies done so far either support or disprove this practice.

Two studies have found no difference in recurrent infections whether one keeps using an old toothbrush or replaces it with a new one after a strep throat. In one study, even NEW toothbrushes contained harmful bacteria.

Of course, there are several studies that support this practice.

In fact, environmental hygiene in general is also disputed with studies supporting for as well as against this practice after an illness.

Check out a few references below to add more mud to the confusion.

Of course, with multiple recurrent episodes of strep throat, tonsillectomy surgery is quite helpful.

Also given the confusion, perhaps the safe course would be to disinfect a toothbrush regularly.


References Against Throwing Toothbrushes Out:
Recurrence rate of streptococcal pharyngitis related to hygienic measures. Scand J Prim Health Care. 1998 Mar;16(1):8-12.

How dirty is your toothbrush? Answer: Not as much as you think. NBC News 5/4/13


References in Support:
Contamination of toothpaste and toothbrush by Streptococcus mutans. Scand J Dent Res. 1978 Sep;86(5):412-4.

Persistence of group A beta-hemolytic streptococci in toothbrushes and removable orthodontic appliances following treatment of pharyngotonsillitis. Arch Otolaryngol Head Neck Surg. 1998 Sep;124(9):993-5.

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