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Evaluation of two alternative methods for disinfection of toothbrushes and tongue scrapers
Abstract
The aim of this study was to investigate the effectiveness of two alternatives methods for the disinfection of oral cleaning devices.
One type of toothbrush and two types of tongue scrapers (steel and plastic) were tested in this study. Sixteen specimens of each group were cut with standardized dimensions, contaminated separately with Candida albicans, Streptococcus mutans and Staphylococcus aureus and incubated for 24 h. After this, oral cleaning devices were washed in saline solution to remove non-adhered cells and divided into two groups (n = 8), one irradiated in microwave and other immersed in 3.78% sodium perborate solution, and evaluated for microbial recovery. The values of cfu of each group of microorganism after disinfection were compared by Kruskal-Wallis and Dunn non-parametric test, considering 95% of confidence.
The toothbrush harboured a significant larger number of viable organisms than the tongue scrapers. The steel tongue scraper was less susceptible to adhesion of the three oral microorganisms. The time required to inactivate all contaminating microorganisms using microwave oven was 1 min and, for the immersion in 3.78% sodium perborate solution, was 2 and 3 h, respectively, for C. albicans and S. mutans/S. aureus.
Microwave irradiation proved to be an effective alternative method to the disinfection of tongue cleaners and toothbrushes.
... 15 Cuka sari apel memiliki sifat antibakteri dan antifungi karena memiliki kandungan tanin berkonsentrasi tinggi dan katekin. 16 Pemakaian pembersih gigi tiruan dapat menyebabkan hilangnya plasticizer dan menyebabkan terjadinya penyerapan air pada permukaan basis gigi tiruan. Hal ini dapat menimbulkan perubahan warna dan penurunan sifat mekanis. ...
... Variasi nilai kekuatan fleksural yang terjadi pada masing-masing sampel di setiap kelompok menujukkan nilai kekuatan fleksural terkecil pada perendaman 4 hari dan 8 hari yaitu cuka sari apel konsentrasi 5% (Tabel 2) disebabkan karena cuka sari apel mengandung flavonoid yang termasuk ke dalam tanin atau senyawa polifenol. 16 larutan cuka apel dan mempunyai berat molekul yang lebih kecil dari berat molekul polimer resin. Hal ini menyebabkan ikatan polimer nilon termoplastik mengalami degradasi sehingga terjadi penurunan kekuatan fleksural. ...
... Cuka sari apel konsentrasi 5% mengandung flavonoid yang termasuk ke dalam tanin atau senyawa polifenol. 16 Apabila fenol berkontak dengan basis gigi tiruan dapat menyebabkan kerusakan kimia pada permukaaan basis gigi tiruan. Perusakan secara kimia menimbulkan kekasaran pada permukaan basis gigi tiruan nilon termoplastik sehingga dapat menyebabkan retak atau crazing dan penurunan kekuatan. ...
... The efficacy of different methods for disinfecting toothbrushes has been investigated in in vitro and in vivo studies. Methods such as chemical agents, brush sprays, UV light toothbrush sanitizers, modified brushes, MW ovens, and dishwashers have been suggested for disinfecting toothbrushes [7,9,12,13]. ...
... Several microorganisms, including E. coli, have been found on toothbrushes kept in the bathroom for 3 months [17]. The efficacy of different toothbrush disinfection methods for S. mutans, S. aureus, and E. coli was investigated in previous studies [12,18]. According to our knowledge, the influence of the toothbrush disinfection method for L. rhamnosus has not been studied. ...
... The antimicrobial effect of MW irradiation has been shown for removable dentures contaminated with Streptococcus epidermidis, S. aureus, Klebsiella pneumonia, Bacillus subtilis, and C. albicans for 6-10 minutes [23]. There are a few studies on the efficiency of MW irradiation for toothbrushes [12,18]. Bélanger-Giguére et al. studied MW irradiation on high power for 5 minutes to disinfect toothbrushes contaminated with S. mutans, and they reported that the method was effective but could not completely eradicate the microorganisms. ...
Objective:
This study aimed to evaluate the effectiveness of alternative methods for toothbrush disinfection.
Methods:
Two-hundred eighty toothbrushes were included in the study. The toothbrushes were divided into 7 groups and were contaminated by standardized suspensions of Lactobacillus rhamnosus (L. rhamnosus), Streptococcus mutans (S. mutans), Staphylococcus aureus (S. aureus), and Escherichia coli (E. coli). The following disinfectants were tested: 1% sodium hypochlorite (NaOCl), 100% and 50% white vinegar, microwave (MW) oven, ultraviolet (UV) sanitizer, and mouth rinse-containing propolis (MCP). Data were analyzed with Kruskal Wallis and Dunn's tests.
Results:
Statistically significant differences were found between different methods and control group for all tested bacteria. There were statistically significant differences between all test groups for all microorganisms. MW was the most effective for L. rhamnosus and 100% white vinegar was the most effective method for S. mutans and S. aureus. NaOCl was the most effective for E. coli.
Conclusion:
This study showed that 100% white vinegar was considered to be effective for tested microorganisms. Similarly, 1% NaOCl is cost-effective, easily accessible, and comparatively effective for toothbrush disinfection. Because these agents are nontoxic, cost-effective and easily accessible, they may be appropriate for household use.
... Hence, interest in this area has been maintained and in 1985 the technology was applied to the sterilization of dental appliances (Rohrer & Bulard, 1985). In dentistry, microwave irradiation has been used for several purposes, including disinfection of toothbrushes (Nelson-Filho et al., 2011;Spolidorio et al., 2011), tongue scrapers (Spolidorio et al., 2011), instruments (Tarantino, 1997), contaminated gauze (Border & Rice-Spearman, 1999;Cardoso et al., 2007), dental burs (Fais et al., 2009;Rizzo, 1993), composite polishing instruments (Tate et al., 1995(Tate et al., , 1996, molds made from elastomers (Abdelaziz et al., 2004), and gypsum casts (Berg et al., 2005;Davis et al., 1989). Furthermore, microwave irradiation has been widely accepted for polymerizing acrylic resin (Ilbay et al., 1994), drying gypsum products and investment materials (Hersek et al., 2002;Luebke & Chan, 1985;Luebke & Schneider, 1985;Tuncer et al., 1993), and as a post-polymerization treatment for reducing the residual monomer contents of polymerized acrylic resins and its cytotocixity Nunes de Mello et al., 2003). ...
... Hence, interest in this area has been maintained and in 1985 the technology was applied to the sterilization of dental appliances (Rohrer & Bulard, 1985). In dentistry, microwave irradiation has been used for several purposes, including disinfection of toothbrushes (Nelson-Filho et al., 2011;Spolidorio et al., 2011), tongue scrapers (Spolidorio et al., 2011), instruments (Tarantino, 1997), contaminated gauze (Border & Rice-Spearman, 1999;Cardoso et al., 2007), dental burs (Fais et al., 2009;Rizzo, 1993), composite polishing instruments (Tate et al., 1995(Tate et al., , 1996, molds made from elastomers (Abdelaziz et al., 2004), and gypsum casts (Berg et al., 2005;Davis et al., 1989). Furthermore, microwave irradiation has been widely accepted for polymerizing acrylic resin (Ilbay et al., 1994), drying gypsum products and investment materials (Hersek et al., 2002;Luebke & Chan, 1985;Luebke & Schneider, 1985;Tuncer et al., 1993), and as a post-polymerization treatment for reducing the residual monomer contents of polymerized acrylic resins and its cytotocixity Nunes de Mello et al., 2003). ...
... Hence, the prevention of colonization of the oropharynx is critically important in preventing systemic infections due to Candida. A recent study has shown that pathogenic microorganisms can adhere in toothbrushes and tongue scrapers made from stainless steel-and polystyrene-based injection-moulded plastic (Spolidorio et al., 2011). Thus, toothbrushes and tongue scrapers become contaminated after use and, if not properly disinfected, may be a reservoir of microorganisms that maintain their viability for a significant amount of time, ranging 24 hours to 7 days (Nelson-Filho et al., 2006). ...
... However, this issue has received little attention from many researchers because most clinicians only consider toothbrushes from the perspective of their role in caries and plaque prevention. 5 Furthermore, although some laboratory studies related to toothbrush disinfection have been carried out, 10,11,12,13,14 few such studies have been performed with volunteers. 15,16,17 Therefore, the aim of this study was to compare the efficacy of using a dishwasher or different chemical agents, including 0.12% chlorhexidine gluconate, 2% sodium hypochlorite (NaOCl), a mouthrinse containing essential oils and alcohol and 50% white vinegar, for bacterial disinfection of toothbrushes. ...
... Further studies should test the efficacy of dishwasher use for toothbrush disinfection. Previous papers 13,25 have studied the efficacy of different toothbrush disinfection methods against S. mutans, S. aureus, and E. coli. However, to our knowledge, the influence of the toothbrush disinfection method for L. rhamnosus has not been studied, except for our previous in vitro study. ...
The aim of this study was to compare the efficacy of using a dishwasher or different chemical agents, including 0.12% chlorhexidine gluconate, 2% sodium hypochlorite (NaOCl), a mouthrinse containing essential oils and alcohol, and 50% white vinegar, for toothbrush disinfection. Sixty volunteers were divided into five experimental groups and one control group (n = 10). Participants brushed their teeth using toothbrushes with standard bristles, and they disinfected the toothbrushes according to instructed methods. Bacterial contamination of the toothbrushes was compared between the experimental groups and the control group. Data were analyzed by Kruskal-Wallis and Duncan's multiple range tests, with 95% confidence intervals for multiple comparisons. Bacterial contamination of toothbrushes from individuals in the experimental groups differed from those in the control group (p < 0.05). The most effective method for elimination of all tested bacterial species was 50% white vinegar, followed in order by 2% NaOCl, mouthrinse containing essential oils and alcohol, 0.12% chlorhexidine gluconate, dishwasher use, and tap water (control). The results of this study show that the most effective method for disinfecting toothbrushes was submersion in 50% white vinegar, which is cost-effective, easy to access, and appropriate for household use.
... Antimicrobial activity was performed as described by Spolidorio et al. (2011) and Taji & Rogers (1998) with modifications to the final reading. The standard strain Streptococcus mutans ATCC 25175™ was used. ...
... After the drying time, toothbrushes of each stage were placed individually in Falcon tubes type (TPP Trasadingen, Switzerland) containing 50 mL of CaSaB20 culture medium in an upright position, having the bristles being totally submerged in the culture medium, incubated for four days at 37 °C. After the incubation period, aliquots from each tube were analyzed for viability of the biofilm by means of the MTT colorimetric assay, according to Spolidorio et al. (2011) and Taji & Rogers (1998), with modifications. Afterward, toothbrushes were incubated for another 26 days at 37 °C for analysis of the number of colonies on the bristles. ...
Guaco Mikania glomerata Spreng. and M. laevigata Sch. Bip. ex Baker, Asteraceae, has antimicrobial activity and may be helpful in reducing the incidence of oral diseases. This double-blinded randomized clinical trial aimed to evaluate the efficacy of guaco mouthwashes on the disinfection of toothbrushes used by preschool children, tested positive for mutans streptococci (MS), as well as the quantification of its coumarin contents by high performance liquid chromatography. Ethanol extracts were obtained by percolation. The mouthwashes were prepared with 2.5% g/mL M. glomerata and M. laevigata ethanol extracts, standardized for their coumarin content (% mg/mg). Antimicrobial effect of the mouthwashes and extracts were assessed in vitro against Streptococcus mutans (ATCC 25175TM), using 2.4 to 500 µg/mL to calculate the minimum inhibitory concentration (MIC). For the in vivo study, 24 patients were randomly assigned to a 4-stage changeover system with a one-week interval between each stage. All solutions were used in all stages by a different group of children. After brushing without toothpaste, toothbrushes (n=96) were sprayed with water and solutions of M. glomerata (2.5%), M. laevigata (2.5%) and chlorhexidine (0.12%). Microbiological analysis was carried out after 4 h and 30 days, respectively. MIC values were 400, 125 and 14 µg/mL, respectively, for both crude ethanol extracts, mouthwashes of M. glomerata and M. laevigata. Statistical analysis showed that all solutions decreased contamination of toothbrushes by mutans streptococci (chlorhexidine 50.7±17.7%; M. glomerata 37.3±23.7% and M. laevigata 28.7±25.1% of inhibition). Treatment with chlorhexidine and M. glomerata were statistically similar (p>0.05). M. glomerata mouthwash could be useful in herbal strategy programs against mutans streptococci and the marker coumarin may be not related to the activity observed.
... After use, cleaning devices become contaminated and, if not disinfected, can be a reservoir of microorganisms [9] (including bacteria, viruses and fungi) that maintain their viability for a significant amount of time, ranging from 24 h to 7 days. Microbial survival promotes the reintroduction of potential pathogens into the oral cavity or the spread to other individuals when cleaning devices are stored together or shared [10]. ...
Background
To find out whether misuse of dental hygiene, in terms of certain dental habits, may facilitate the spread of COVID-19 among cohabiting individuals.
Methods
302 COVID-19 infected (PCR +) subjects cohabiting with someone else at home were selected for an observational cross-sectional study. An anonymous online questionnaire was developed using Google forms to avoid person-to-person contact. The structured questionnaire consisted of questions covering several areas: sociodemographic data, cross transmission to another person living together, oral hygiene habits during confinement, care and disinfection control behaviours in the dental environment like sharing toothbrush, sharing toothbrush container, sharing toothpaste, placing brush vertically, placing cap with hole for brush, disinfecting brush with bleach, closing toilet lid before flushing.
Results
Tongue brushing was more used in the group where there was no transmission of the disease to other members (p < 0.05). Significant differences were found for shared toothbrush use (p < 0.05), although shared use was a minority in this group (4. 7%), significant differences were also found for the use of the same container (p < 0.01), shared use of toothpaste (p < 0.01), toothbrush disinfection with bleach (p < 0.01), brush change after PCR + (p < 0.05). The women performed significantly more disinfection with toothbrush bleach (p < 0.01), closing the toilet lid (p < 0.05) and changing the brush after PCR + (p < 0.05).
Conclusions
The use of inappropriate measures in the dental environment could contribute to the indirect transmission of COVID-19 between cohabitants.
... Characterizing nano-enabled, antimicrobial toothbrushes is important because toothbrushes are a vector for oral human exposure to bacteria (Frazelle and Munro, 2012;Ferreira et al., 2012;Okafor et al., 2016;Oluwole and Olumuyiwa, 2016;Karibasappa et al., 2011;Naik et al., 2015), which makes them an ideal candidate for antimicrobial technologies. While there are many proven techniques for disinfecting toothbrushes Patcas et al., 2018;Balappanavar et al., 2009;Sato et al., 2004;NanjundaSwamy et al., 2011;Spolidorio et al., 2011;do Nascimento et al., 2015), antimicrobial toothbrushes can be viewed as a consumer convenience, as no additional maintenance should be needed. Previous studies have attempted to characterize the antimicrobial properties of various nano-Ag enabled antimicrobial toothbrushes and these studies have come to conflicting conclusions (Cadena et al., 2017;do Nascimento et al., 2014;Camargo et al., 2013;Baygin et al., 2017). ...
Over the past two decades, Ag and Zn nanoparticles have been integrated into various consumer products as a biocide. While some nano-enabled consumer products have been shown to have antibacterial properties, their antibacterial efficacy as well as the human and environmental health outcomes are not fully known. In this study, we examine a nanoparticle-enabled product that also serves as a conduit for human exposure to bacteria: toothbrushes. We utilize a combination of chemical analyses, laboratory experiments, and microscopy to characterize the nano-enabled toothbrush bristles. Our analysis showed the majority of measured Ag and Zn particles ranged from approximately 50 to 100 nm in size and were located on the surface and within bristles. During simulated brushing, antimicrobial bristles released both Ag and Zn, the majority of which was released in particulate form. While our results demonstrate that antimicrobial bristles have enhanced bactericidal properties compared to control samples, we also show that the surface topography influences nanoparticle retention, microbial adhesion, and bactericidal activity. We thus conclude that Ag or Zn content alone is insufficient to predict antimicrobial properties, which are further governed by the bioavailability of Ag or Zn at the bristle surface.
... Methods of decontamination or sanitization of toothbrushes have been questioned. The literature has demonstrated that the use of chemical agents, such as sodium hypochlorite, chlorhexidine gluconate, hydrogen peroxide, cetylpyridinium chloride, sodium perborate, essential oils, Brushtox (40% activated ethanol with biocide parabens), is considered an efficient and inexpensive method of decontamination 2,[4][5][6] . In this context, phytoplants have demonstrated to be a good alternative to synthetic chemical antimicrobial agents, because they do not produce side effects and acquire antimicrobial resistance 7,8 . ...
Introduction
Methods of decontamination or sanitization of toothbrushes have been questioned.
Objective
This study assessed the effectiveness of pomegranate peels infusion as a disinfectant of toothbrushes against Streptococcus mutans.
Material and method
A sample of 16 schoolchildren aged between 7 and 9 years performed brushing 5 days/week, with a careful brushing once a day. After each day of brushing, the toothbrushes were washed and sprayed with one disinfectant solution. This procedure was repeated for 4 weeks using one of the different solutions per week: distilled water (G1; negative control), pomegranate (Punica granatum Linn) peels infusion (G2), 1% sodium hypochlorite (G3) and 0.12% chlorhexidine digluconate (G4). After the fifth day, toothbrushes were collected for laboratory analysis. Toothbrushes heads were subjected to agitation in saline dilution of 10–1, 10–2,10–3, and 25 μL of each dilution were seeded in mitis salivarius agar culture medium for S. mutans colony-forming unit (CFU) counting. One calibrated examiner (Kappa = 0.91) performed the CFU (mL–1 × 10⁴) counts. Kruskal-Wallis and Dunn Multiple Comparison tests were used at a significance level of 5%.
Result
G1 presented the highest number of CFU (3.9 ± 8.4), followed by G2 (3.2 ± 4.0). No S. mutans growth was observed in G3 and G4. There was no statistically significant difference between G1 and G2 and between G3 and G4 (p>0.05).
Conclusion
Pomegranate infusion was completely ineffective for the disinfection of toothbrushes against S. mutans when compared with 1% sodium hypochlorite and 0.12% chlorhexidine digluconate solutions.
Objectives:
The aim of this in vivo study was to evaluate the efficacy of three antimicrobial solutions on the disinfection of toothbrushes after storage in closed containers.
Materials and methods:
Sixteen healthy subjects were enrolled in this randomized cross-over clinical investigation. The study was conducted in four phases, in which mouthrinses (chlorhexidine gluconate-based or cetilpiridinium-based) and sterile tap water (control group) were used to individually store used toothbrushes in closed containers during 7 days of toothbrushing. Five toothbrushes were used as negative control for bacterial colonisation before contact with oral cavity. Conventional culture and DNA Checkerboard hybridization were used to detect bacterial contamination on the toothbrushes. Subsequently, the number of bacterial species on the bristles was estimated by the DNA Checkerboard method.
Results:
One toothbrush presented bacterial contamination in the negative control test. Both culture and DNA Checkerboard showed positive signals of bacterial contamination in the toothbrushes with no differences in the frequency of detection. The control group showed higher total bacterial counts when compared with the mouthrinse groups. Porphyromonas gingivalis had the highest bacterial count followed by Parvimonas micra.
Conclusion:
Culture and DNA Checkerboard showed positive signals of bacterial contamination. Mouthrinses that contains 0.12% of chlorhexidine gluconate were more effective in reducing bacterial colonisation on the toothbrushes.
ABSTRACT: Background: It is estimated that approximately 85% of all halitosis cases have their origin within the mouth; of these, 50% are caused by tongue residues. Previous studies have established that hydrogen sulfide and mercaptans are the primary components of halitosis. Thus, tongue cleaning gains importance as a means for halitosis management. Methods: This investigation compared the efficacy of two mechanical methods for tongue cleaning through a handheld sulfide monitor. This crossover trial was carried out with 10 healthy subjects, 20 to 50 years old. Before the baseline measurement of the volatile sulfur compounds (VSCs), the subjects were instructed to refrain from any tongue cleaning method for 48-hours. The 10 participants were then placed in one of two groups (five each): 1) first week: new tongue scraper, second week: soft-bristle toothbrush; 2) first week: toothbrush, second week: tongue scraper, with a 48-hour wash-out period between each week. Results: The baseline measurements were compared with those of the end of each week using the Dunn method (=0.01). The tongue scraper showed a 75% reduction in VSCs, while the toothbrush only achieved a 45% reduction in VSCs. Conclusion: Although the tongue coating was removed by both methods, the tongue scraper performed better in reducing the production of volatile sulfur compounds (VSCs). J Periodontol 2004; 75(7):1009-1012.
Accepted for publication on November 21 2003.
The aim of this study was to evaluate alternative methods for the disinfection of toothbrushes considering that most of the previously proposed methods are expensive and cannot be easily implemented. Two-hundred toothbrushes with standardized dimensions and bristles were included in the study. The toothbrushes were divided into 20 experimental groups (n = 10), according to microorganism considered and chemical agent used. The toothbrushes were contaminated in vitro by standardized suspensions of Streptococcus mutans, Streptococcus pyogenes, Staphylococcus aureus or Candida albicans. The following disinfectants were tested: 0.12% chlorhexidine digluconate, 50% white vinegar, a triclosan-containing dentifrice solution, and a perborate-based tablet solution. The disinfection method was immersion in the disinfectant for 10 min. After the disinfection procedure, the number of remaining microbial cells was evaluated. The values of cfu/toothbrush of each group of microorganism after disinfection were compared by Kruskal-Wallis ANOVA and Dunn's test for multiple comparisons (5%). The chlorhexidine digluconate solution was the most effective disinfectant. The triclosan-based dentifrice solution promoted a significant reduction of all microorganisms' counts in relation to the control group. As to the disinfection with 50% vinegar, a significant reduction was observed for all the microorganisms, except for C. albicans. The sodium perborate solution was the less effective against the tested microorganisms. Solutions based on triclosan-containing dentifrice may be considered effective, nontoxic, cost-effective, and an easily applicable alternative for the disinfection of toothbrushes. The vinegar solution reduced the presence of S. aureus, S. mutans and S. pyogenes on toothbrushes.
With an automated computerized temperature control and a specialized temperature measurement system, dry spores of Bacillus subtilis subsp. niger were treated with heat simultaneously in a convection dry-heat oven and a microwave oven. The temperature of the microwave oven was monitored such that the temperature profiles of the spore samples in both heat sources were nearly identical. Under these experimental conditions, we unequivocally demonstrated that the mechanism of sporicidal action of the microwaves was caused solely by thermal effects. Nonthermal effects were not significant in a dry microwave sterilization process. Both heating systems showed that a dwelling time of more than 45 min was required to sterilize 10(5) inoculated spores in dry glass vials at 137 degrees C. The D values of both heating systems were 88, 14, and 7 min at 117, 130, and 137 degrees C, respectively. The Z value was estimated to be 18 degrees C.
The objective was to determine the level of contamination of toothbrushes by mutans streptococci using microbiological identification, to access the bacterial contamination using scanning electron microscopy (SEM) and to evaluate the efficacy of two toothbrush disinfectants.
Nineteen children used their toothbrushes once a day, for five consecutive days. The toothbrushes were then immersed into disinfectant solutions for 20 h: Group I--0.12% chlorhexidine gluconate; Group II--1% sodium hypochlorite; Group III--sterile tap water. They were then placed into test tubes containing CaSa B, for 3 to 4 days at 37 degrees C. The number of MS cfu was counted and the toothbrushes were submitted to SEM analysis.
There was no bacterial growth in Groups I and II; Group III showed MS growth (range, 21 to 120 cfu). Scanning electron microscopy showed biofilm formation on toothbrush bristles.
Immersion in 0.12% chlorhexidine gluconate and 1% sodium hypochlorite are efficient methods for toothbrush disinfection.
The purpose of this study was to determine the bacterial diversity in the human subgingival plaque by using culture-independent molecular methods as part of an ongoing effort to obtain full 16S rRNA sequences for all cultivable and not-yet-cultivated species of human oral bacteria. Subgingival plaque was analyzed from healthy subjects and subjects with refractory periodontitis, adult periodontitis, human immunodeficiency virus periodontitis, and acute necrotizing ulcerative gingivitis. 16S ribosomal DNA (rDNA) bacterial genes from DNA isolated from subgingival plaque samples were PCR amplified with all-bacterial or selective primers and cloned into Escherichia coli. The sequences of cloned 16S rDNA inserts were used to determine species identity or closest relatives by comparison with sequences of known species. A total of 2,522 clones were analyzed. Nearly complete sequences of approximately 1,500 bases were obtained for putative new species. About 60% of the clones fell into 132 known species, 70 of which were identified from multiple subjects. About 40% of the clones were novel phylotypes. Of the 215 novel phylotypes, 75 were identified from multiple subjects. Known putative periodontal pathogens such as Porphyromonas gingivalis, Bacteroides forsythus, and Treponema denticola were identified from multiple subjects, but typically as a minor component of the plaque as seen in cultivable studies. Several phylotypes fell into two recently described phyla previously associated with extreme natural environments, for which there are no cultivable species. A number of species or phylotypes were found only in subjects with disease, and a few were found only in healthy subjects. The organisms identified only from diseased sites deserve further study as potential pathogens. Based on the sequence data in this study, the predominant subgingival microbial community consisted of 347 species or phylotypes that fall into 9 bacterial phyla. Based on the 347 species seen in our sample of 2,522 clones, we estimate that there are 68 additional unseen species, for a total estimate of 415 species in the subgingival plaque. When organisms found on other oral surfaces such as the cheek, tongue, and teeth are added to this number, the best estimate of the total species diversity in the oral cavity is approximately 500 species, as previously proposed.
It is estimated that approximately 85% of all halitosis cases have their origin within the mouth; of these, 50% are caused by tongue residues. Previous studies have established that hydrogen sulfide and mercaptans are the primary components of halitosis. Thus, tongue cleaning gains importance as a means of halitosis management.
This investigation compared the efficacy of two mechanical methods for tongue cleaning through a handheld sulfide monitor. This crossover trial was carried out with 10 healthy subjects, 20 to 50 years old. Before the baseline measurement of the volatile sulfur compounds (VSCs), the subjects were instructed to refrain from any tongue cleaning method for 48 hours. The 10 participants were then placed in one of two groups (five each): 1) first week: tongue scraper, second week: soft-bristle toothbrush; 2) first week: toothbrush, second week: tongue scraper, with a 48-hour wash-out period between each week.
The baseline measurements were compared with those of the end of each week using the Dunn method (alpha = 0.01). The tongue scraper showed a 75% reduction in VSCs, while the toothbrush only achieved a 45% reduction in VSCs.
Although the tongue coating was removed by both methods, the tongue scraper performed better in reducing the production of volatile sulfur compounds.
The purpose of this study was to evaluate: (1) in vivo the contamination by mutans streptococci (MS) of toothbrushes after use on 52 children (24-48 months old) by a single dentist; (2) in vivo the efficacy of 3 solutions (Periogard, Brushtox, and a Cosmocil CQa and Myacide pharma BPa-based experimental solution) in the disinfection of these toothbrushes through a randomized clinical trial; and (3) in vitro the antimicrobial activity of the solutions by the agar diffusion test using 15 microbial strains.
In the in vivo trial, children were randomly assigned to 1 of 4 groups (N=13) and a 4-stage changeover system was used with a 1-week interval between each stage. Solutions were used by a different group of children in each stage. Children were submitted to a 1-minute brushing (without toothpaste) performed by a single professional, followed by random spraying of the test solutions and microbiological analysis.
Brushtox, Periogard, and the experimental solution reduced/prevented the formation of MS colonies/biofilms on the toothbrush bristles compared to the control (sterile tap water; P<.001). Periogard and the experimental solution showed significantly greater reduction of colonies/biofilms compared to Brushtox (P<.01). In the in vitro experiment, Periogard exhibited the greatest inhibition halo average, followed by the experimental solution, Brushtox, and sterile tap water (P<.05).
After a single brushing, severe contamination by mutans streptococci colonies/biofilms was observed on all toothbrushes sprayed with sterile tap water (control). Although Brushtox presented better results than sterile tap water, Periogard and the experimental solution showed greater efficacy against formation of MS colonies/ biofilms on the toothbrush bristles and exhibited larger microbial growth inhibition halos.
Single serving (i.e. 200 ml) portions of tomato soup, vegetable soup, and broth inoculated with Escherichia coli or Salmonella typhimurium at about 107 organisms/ml were exposed to 915 MHz microwaves. After various timed exposures the temperature of the top, middle, and bottom regions as indicated by changes in previously positioned assemblies of temperature sensitive paper strips were noted and aliquots were removed from the same regions for standard plate count determination of survivors. For any given exposure time, the temperature of the middle region was warmest; that of the bottom, intermediate; and the temperature of the top, coolest. Despite the relative temperatures of the regions, however, the consistent finding was that, for any exposure time, the closer the sampled organisms were to the top, the lower their level of survival. In terms of temperature, it was noted that organisms in the top had declined to a given level of survival at a temperature lower than the temperature corresponding to the same survival level in the middle or bottom soup regions. These data suggest that the heat generated during the microwave exposure alone is inadequate to fully account for the nature of the lethal effects of microwaves for microorganisms.
Microwave irradiation at 2450 MHz inactivated the cells of Escherichia coli, Staphylococcus aureus and Candida albicans suspended in a phosphate buffer. The rate of cell inactivation was proportional to that of the increase in temperature accompanied by microwave irradiation. The inactivation rates of E. coli and C. albicans were affected by addition of NaCl and KCl, but not by sucrose. The maximal inactivation effect was exerted at concentrations of 0·5–1·0 mol l−1, and the end-point temperature was the highest at the same salt concentrations. Correlation of both the electroconductivity and di-electric loss of ionic solutions with the heating by microwave irradiation was discussed.
The aim of this study was to investigate bacterial survival and biofilm formation on toothbrushes. Fifteen healthy volunteers each used a normal toothbrush and an antibacterial toothbrush of the same design for two separate 5 week periods. Bacteria were removed from the brush head by swabbing and mechanical agitation in 10ml of tryptone soya broth, cultured aerobically on selective and non-selective media, and classified by Gram staining, catalase and oxidase tests. Survival of Staphylococcus
epidermidis and Pseudomonas
aeruginosa was monitored in the laboratory on both types of brush over 8 days. Scanning electron microscopy was used to observe biofilm formation on antibacterial and conventional brushes used for various times. Numbers of bacteria isolated from conventional and antibacterial brushes from different individuals ranged from 8.3×103 to 4.7×106 and from 1×102 to 1.2×106 colony-forming units/ml, respectively. A larger number of bacteria were isolated from conventional brushes than from antibacterial brushes used by the same individuals but no statistically significant difference was demonstrated. No differences in the relative proportions of Gram-negative and Gram-positive rods or cocci were seen. Staphylococci, presumptive coliforms and pseudomonads were isolated from 48%, 28% and 16% of brushes, respectively. Pseudomonas
aeruginosa was viable for at least 4 days on conventional, and 2–3 days on antibacterial, brushes, whilst S.
epidermidis survived for 6–8 days on antibacterial and more than 8 days on conventional brushes. Biofilms formed on the heads and bristles of both conventional and antibacterial brushes. Extensive, mixed community biofilms developed after several months of use. We conclude that toothbrushes may be a reservoir of opportunistic pathogens including staphylococci and pseudomonad-like organisms and must be considered as a potential source of haematogenous infections and cross-infection.
The isolation of Candida albicans from the 58% of the toothbrushes of 57 oral cavity carriers of the same fungus took us to study the in vitro survival of Candida albicans in the nylon (PROR and CaravelleR brands) and bristle tooth brushes available in this market.
We found that: 1) C. albicans survived for 2 weeks in all toothbrushes (nylon and bristle) previously immersed for 1 minute in a suspension containing 4×109 elements/ml of the yeast. 2) C. albicans survived 72 hours in all toothbrushes previously immersed for 1 minute in a suspension of the yeast containing 4×106 elements/ ml, and until 2 weeks in the bristle brushes, immersed in the same suspension during the same time; it did not survive upon the nylon brushes.
The bristle toothbrush seems to favor the survival of C. albicans.
Under the same conditions C. albicans could not be eradicated by immersing the PROR bristle and CaravelleR nylon toothbrushes in a 4/100 boric acid solution during 10 minutes. The PROR nylon toothbrushes were sterilized by a moments immersion in the same solution. A 2/1000 salicilic acid solution eradicated C. albicans from all the toothbrushes (nylon and bristle) after a 5 minutes immersion.
To prevent the surviving of C. albicans on the toothbrushes the author suggest: 1) the use of nylon toothbrushes, 2) the desinfection of them by a momentaneous immersion in a 4/100 boric acid solution of 2/1000 salicilic acid solution. When the bristle brushes are used, the desinfection must be done by 5 minutes immersion in the 2/1000 salicilic acid solution. These recommendations are specially valid when dealing with patients presenting oral chronical candidiasis.
Until recently, little attention has been directed towards the role the toothbrush may play in human health, even though a report of toothbrush as a significant factor in the infection appeared in 1920. It is common knowledge that the human mouth harbours a wide variety of microorganisms, some of which, at any given time, can be assumed to be potential pathogens. This was not known when toothbrushes were originally designed, yet the common toothbrush has been used in basically the same form for about 200 years. In today's world of organ transplantation and alteration of the immune system, it is important to consider the toothbrush as a source of potential pathogens. Given the fact that very often people will traumatize themselves with their toothbrush, this trauma may become a potential portal of entry for organisms. In this article, we have attempted to demonstrate the importance of toothbrush disinfection, given tips on home toothbrush care and hope to motivate the dentists to educate the patients on the importance of toothbrush disinfection.
Bacterial adhesion to biomaterial surfaces constituting the bracket-adhesive-enamel junction represents a growing problem in orthodontics, because bacteria can adversely affect treatment by causing demineralization of the enamel surface around the brackets. It is important to know the forces with which bacteria adhere to the surfaces of these junction materials, as the strength of these forces will determine how easy it will be to remove the bacteria. We compared the adhesion forces of five initially colonizing and four cariogenic strains of bacteria to an orthodontic adhesive, stainless steel, and enamel, with and without a salivary conditioning film. Adhesion forces were determined using atomic force microscopy and a bacterial probe. In the absence of a salivary conditioning film, the strongest bacterial adhesion forces occurred to the adhesive surface (-2.9 to -6.9 nN), while adhesion forces to the enamel surfaces were lowest (-0.8 to -2.7 nN). In the presence of a salivary conditioning film, adhesion forces were reduced strongly, to less than 1 nN, and the differences between the various materials were reduced. Generally, however, initial colonizers of dental hard surfaces presented stronger adhesion forces to the different materials (-4.7 and -0.6 nN in the absence and presence of a salivary conditioning film, respectively) than cariogenic strains (-1.8 and -0.5 nN).
The aim of this study was to evaluate the effect of three denture hygiene methods against different microbial biofilms formed on acrylic resin specimens.
The set (sterile stainless steel basket and specimens) was contaminated (37 degrees C for 48 hours) by a microbial inoculum with 10(6) colony-forming units (CFU)/ml (standard strains: Staphylococcus aureus, Streptococcus mutans, Escherichia coli, Candida albicans, Pseudomonas aeruginosa, and Enterococcus faecalis; field strains: S. mutans, C. albicans, C. glabrata, and C. tropicalis). After inoculation, specimens were cleansed by the following methods: (1) chemical: immersion in an alkaline peroxide solution (Bonyplus tablets) for 5 minutes; (2) mechanical: brushing with a dentifrice for removable prostheses (Dentu Creme) for 20 seconds; and (3) a combination of chemical and mechanical methods. Specimens were applied onto a Petri plate with appropriate culture medium for 10 minutes. Afterward, the specimens were removed and the plates incubated at 37 degrees C for 48 hours.
Chemical, mechanical, and combination methods showed no significant difference in the reduction of CFU for S. aureus, S. mutans (ATCC and field strain), and P. aeruginosa. Mechanical and combination methods were similar and more effective than the chemical method for E. faecalis, C. albicans (ATCC and field strain), and C. glabrata. The combination method was better than the chemical method for E. coli and C. tropicalis, and the mechanical method showed intermediate results.
The three denture hygiene methods showed different effects depending on the type of microbial biofilms formed on acrylic base resin specimens.
Proper hygienic care of removable dentures is an important means of maintaining a healthy oral mucosa in denture wearers. Denture cleanliness is often poor due to improper mechanical cleansing and the relative inefficiency of most commercial products for chemical cleansing of dentures. Dentists and patients should realize that microbial plaque on dentures may be harmful to both the oral mucosa and the patient's general health. It is the responsibility of the patient to maintain oral hygiene through a daily home care routine. It is the obligation of the dentist to motivate and instruct the patient and provide the means and methods for plaque control. Future research should be directed to developing solution cleansers which can maintain plaque-free dentures with a daily soaking period of 15 to 30 minutes and not affect the color and surface luster of the denture acrylic resin.
Toothbrushes and toothpaste tubes used by persons infected with S. mutans were examined for the presence of this microorganism. Fifteen minutes after brushing greater than 10(6) S. mutans were isolated from the toothbrushes and after ordinary storage for 24 h 10(4) were recovered. From two out of 10 toothpaste tubes S. mutans was isolated from the orifice of the tube. The implications of these findings for the spread of the microorganism are discussed.
Besides using all possible techniques to increase host resistance (fluoride, sealants) and decrease exposure to fermentable carbohydrates (for example, use of sugar substitutes), dentists must treat caries as infectious and transmissible. Antimicrobial agents are recommended.
It has been shown that early establishment of mutans streptococci in the mouth of infants increases risk of caries. Extensive studies on the timing of infection, and on sources and routes of transmission of the organism have been performed. Results of many studies suggest that the source of mutans streptococci is the mother, especially her saliva. Methods used to attempt to verify this hypothesis have developed considerably in recent years. Recent research and work in progress using methods based on DNA analysis have increased and will extend knowledge about transmission. This review summarizes the results obtained by different methods of transmission of mutans streptococci. The final goal of studies is to accumulate adequate information for prevention strategies of mutans streptococcal infection.
The purpose of the present investigation was to determine bacterial contamination of chlorhexidine coated and uncoated (normal) nylon filaments of toothbrushes.
Ten healthy subjects were employed in this study and the test toothbrush of four lines and thirty-eight tufts were used twice a day. Test periods were 1, 8, and 20 days for each filaments of toothbrush and after they brushed the used toothbrush was kept at the constant condition (20°C, 65% RH). After each test period, those toothbrushes were immediately collected and kept at the same condition for drying. After 0, 3, 6, 9, and 24 hours of drying, two tufts of filaments were pulled out from the toothbrush and cutted into two parts (end- and root-side of tufts) by sterile scissors. Each cutted part of filaments was washed with PBS and the aliquots was incubated on Brucella blood agar plate at 37°C for 48 hours. The number of bacteria attached to filaments was enumerated.
The results were as follows:
1. The number of bacteria attached to both endand root-sides of chlorhexidine coated filaments decreased with the time of drying.
2. At the root-side of the normal filaments, the number of contaminated bacteria increased with the test periods.
3. The isolated bacteria from tested toothbrushes were mainly gram positive at shorter period, however, gram negative rods were also found at longer period.
4. The anti-bacterial activity of the end-side of chlorhexidine coated filaments diminished at eight days of the use, however, their activity at the rootside still remained even at twenty days.
From these results, it was clear that the bacterial contamination of toothbrush was affected by several factors such as the condition of drying, the site of tufts, the using period of toothbrush and so on. To prevent this problem, it is important to keep it at good storage condition and to change it periodically. The developed chlorhexidine coated filaments of the toothbrush also indicates to be one of the useful way for prevention of bacterial contamination of toothbrush.
This study has shown that representative fungi, viruses, and aerobic and anaerobic bacteria, including spore formers, can easily be killed in a conventional microwave oven with proper modifications. Metal instruments, including air turbine handpieces and burs, and acrylic dentures can be sterilized in short periods. Consistent sterilization can be accomplished only if the items to be sterilized are rotated in a three-dimensional manner throughout the microwave cavity. Arcing back to the magnetron and damage to the microwave oven are prevented by placing a radar absorbent material within the oven and with proper insulation of the item to be sterilized.
The efficacy of a protease preparation (Alcalase, Novo, Denmark) in preventing accumulation of plaque on the fitting surface of complete upper dentures was examined in a double-blind study. Seventeen denture wearers with clinically healthy oral mucosae participated in the study. The protease was dispensed in dissolvent tablets containing 15, 30, 60, 100, 300, 500, or 1000 mg of the enzyme. Enzyme tablets or placebo tablets were dissolved in 150 ml water at 50 degrees C, and the dentures were soaked once daily for 15 min. Denture soaking was performed with or without brushing. The study consisted of 14 1-week periods. At the start of each period the dentures were cleaned by brushing until they showed no visible plaque after staining. At the end of each period plaque was stained and the dentures were photographed. The photographs were projected, and the percentage area of the fitting surface showing plaque deposits was scored with 10% intervals. Statistical analysis showed that there was a significant reduction of plaque scores with increasing enzyme concentration. The most marked reduction in plaque formation was seen when mechanical cleansing was combined with immersion in a 500-mg enzyme solution. At a concentration of 300 mg (or more) the enzyme immersion was as efficient as mechanical cleansing in preventing denture plaque accumulation.
Twenty toothbrushes used by healthy subjects were screened for the presence of microorganisms. Microbes were dislodged from the brushes by vortexing, and an average of 4 x 10(3) CFU/mL were recovered from the suspending fluid. Bristles removed from the vortexed brushes still yielded confluent bacterial growth on brain-heart infusion agar medium. Virkon (one per cent), Listerine, Cepacol, Scope, and Plax were tested for their bactericidal effects on microorganisms sedimented from the suspending fluid, on toothbrush bristles and proxabrushes, and on various test species including Candida albicans, Mycobacterium smegmatis, M. bovis, and Streptococcus mitis. Virkon and Listerine killed all the test species and virtually all the microorganisms on the toothbrush bristles and proxabrushes. Six volunteers tested the efficacy of a Listerine soaking regime to prevent the bacterial contamination of toothbrushes. Soaking the toothbrush head (bristles) in Listerine for 20 minutes after brushing was sufficient to eliminate bacterial contamination.
Sixty-six sterile toothbrushes were exposed to one of the following microorganisms: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Bacillis subtilis, Serratia marcescens and Baker's yeast. The Pollenex DS60 Daily Dental Sanitizer was found to be effective in substantially reducing the number of retained bacteria and yeasts as compared to contaminated toothbrushes not treated with such a device. Different toothbrush types had different response rates. Seventy-two sterile toothbrushes were exposed to Herpes Simplex Virus, Type I and seventy-two sterile toothbrushes were exposed to Parainfluenza Virus, Type III. The Pollenex DS60 Daily Dental Sanitizer consistently killed both viruses on all of the toothbrushes treated. Both viruses were consistently retained on non-treated toothbrushes for at least 24 hours.
To investigate the persistence of group A beta-hemolytic streptococci (GABHS) in toothbrushes and removable orthodontic appliances (ROAs) in children who suffer from acute GABHS pharyngotonsillitis and the association with penicillin treatment failure.
Private practice setting.
Pharyngotonsillar and toothbrush cultures were obtained from 104 children with acute GABHS pharyngotonsillitis before and after 10 days of penicillin V potassium therapy. Cultures of ROAs were also obtained from 21 children. The persistence of GABHS in 10 daily rinsed and 10 nonrinsed toothbrushes was studied in vitro.
Group A beta-hemolytic streptococci were isolated from 11 (11%) of the toothbrushes and 18 (17%) of the patients after the completion of penicillin therapy. Toothbrushes of 5 (28%) of the 18 children who harbored GABHS were colonized with the organism. Group A beta-hemolytic streptococci were also isolated from 4 (19%) of 21 ROAs after therapy. In vitro studies illustrated the persistence of GABHS in nonrinsed toothbrushes for up to 15 days. In contrast, the organism was not isolated from rinsed toothbrushes beyond day 3.
Toothbrushes and ROAs that harbor GABHS may contribute to the persistence of GABHS in the oropharynx and may account for the failure of penicillin therapy in some cases of pharyngotonsillitis.
Despite the simplicity and convenience of microwave heating, descriptions in the current literature of attempts to provide a thorough sterilization process have not been encouraging nor has any manufacturer of sterilization equipment introduced such a device to the market. Trials conducted at Providence Hospital using a commercial microwave oven operating at 2450 MHz resulted in a satisfactory sterilization process, that is, the destruction of heat-resisting spore forms (B. stearothermophilus), provided that the materials undergoing sterilization were placed in sealed containers with sufficient water present to provide steam during the heating process. Suggestions are made for further investigation involving the microwave spectrum of the molecule of dipicolinic acid as well as the possibilities of practical applications which could result in reducing hospital costs.
Volatile sulfur compounds (VSC) are a family of gases which are primarily responsible for halitosis, a condition in which objectionable odors are present in mouth air. Although most patients perceive this condition as primarily a cosmetic problem, an increasing volume of evidence is demonstrating that extremely low concentrations of many of these compounds are highly toxic to tissues. VSC may, therefore, play a role in the pathogenesis of inflammatory conditions such as periodontitis. Since these compounds result from bacterial putrefaction of protein, investigations have been conducted to determine whether specific bacteria are associated with odor production. Two members of this family, hydrogen sulfide (H2S) and methyl mercaptan (CH3SH), are primarily responsible for mouth odor. Although many bacteria produce H2S, the production of CH3SH, especially at high levels, is primarily restricted to periodontal pathogens. Direct exposure to either of these metabolites adversely affects protein synthesis by human gingival fibroblasts in culture. However, methyl mercaptan has the greatest effect. Other in vitro experiments have demonstrated that cells exposed to methyl mercaptan synthesize less collagen, degrade more collagen, and accumulate collagen precursors which are poorly cross-linked and susceptible to proteolysis. CH3SH also increases permeability of intact mucosa and stimulates production of cytokines which have been associated with periodontal disease. VSC, and in particular methyl mercaptan, are therefore capable of inducing deleterious changes in both the extracellular matrix and the local immune response of periodontal tissues to plaque antigens. This article reviews these data and emphasizes the potential importance of VSC in the transition of periodontal tissues from clinical health to gingivitis and then to periodontitis.
Staphylococcus aureus (NCTC 6571; Oxford strain) on stainless steel discs was exposed to microwave radiation at 2450 MHz and up to 800 W. Cell viability was reduced as the exposure time increased, with complete bacterial inactivation at 110 s, attaining a temperature of 61.4 degrees C. The low rate of temperature rise, RT, of the bacterial suspension as compared with sterile distilled water or nutrient broth suggests a significant influence of the microwave sterilization efficacy on the thermal properties of the micro-organisms. The heat transfer kinetics of thermal microwave irradiation suggest that the micro-organism has a power density at least 51-fold more than its surrounding liquid suspension. When the inoculum on the stainless steel disc was subjected to microwave radiation, heat conduction from the stainless steel to the inoculum was the cause of bacteriostasis with power absorbed at 23.8 W for stainless steel and 0.16 W for the bacteria-liquid medium. This report shows that the microwave killing pattern of Staph. aureus on stainless steel was mainly due to heat transfer from the stainless steel substrate and very little direct energy was absorbed from the microwaves.
Microwave irradiation at 2450 MHz inactivated the cells of Escherichia coli, Staphylococcus aureus and Candida albicans suspended in a phosphate buffer. The rate of cell inactivation was proportional to that of the increase in temperature accompanied by microwave irradiation. The inactivation rates of E. coli and C. albicans were affected by addition of NaCl and KCl, but not by sucrose. The maximal inactivation effect was exerted at concentrations of 0.5-1.0 mol l-1, and the end-point temperature was the highest at the same salt concentrations. Correlation of both the electroconductivity and di-electric loss of ionic solutions with the heating by microwave irradiation was discussed.
Microbially contaminated contact lens cases are a predisposing risk factor for Acanthamoeba keratitis. Several findings have shown that microwave irradiation kills the six Food and Drug Administration test challenge microorganisms. We aimed to determine what effect microwave irradiation has on Acanthamoeba trophozoites and cysts.
Different types of contact lens cases were contaminated with trophozoites and cysts of three different Acanthamoeba species (A. comandoni, A. castellanii, A. hatchetti) and were exposed to microwave irradiation for 3, 5, and 8 minutes, respectively.
Trophozoites, as well as cysts of the different Acanthamoeba strains, were effectively killed, even by only 3 minutes of microwave irradiation, and there were no negative effects of irradiation on the contact lens cases themselves.
We demonstrate that microwave treatment is a very effective, easy, and cheap method to keep contact lens cases free of Acanthamoeba, thus considerably reducing the risk of an Acanthamoeba keratitis.
Mechanical tongue cleaning may be an effective method for decreasing oral levels of volatile sulfur compounds, or VSC, and oral malodor. The authors conducted a study to compare the effectiveness of a specially designed tongue cleaner (One Drop Only Tongue Cleaner, One Drop Only, Berlin), a tongue scraper and a toothbrush in reducing oral VSC levels.
In this balanced, crossover study, 30 subjects had four morning appointments each with a waiting period of one week between appointments. At each appointment, a dental professional performed a single standardized tongue cleaning procedure using one of the cleaning tools. The authors monitored the subjects' oral VSC values using a portable sulfide monitor until their baseline VSC values were reached.
The baseline values showed no significant difference between the three groups. The tongue cleaner and the tongue scraper (42 percent and 40 percent, respectively) reduced oral VSC levels more than the toothbrush (33 percent) did. Reduced VSC values could be detected significantly longer after using the tongue cleaner than after using the tongue scraper or the toothbrush. The authors, however, could not detect a significant VSC reduction for more than 30 minutes in any of the subjects.
The tongue cleaner, a combination brush and scraper, was slightly more effective in reducing oral VSC levels than were the tongue scraper and a regular toothbrush. Because of the limited duration of the effect, however, the clinical efficacy on the reduction of oral malodor remains questionable.
The prevalence of oral malodor is probably high in the United States, although precise epidemiological data are missing. The many thousands of individuals who experience oral malodor from the overgrowth of proteolytic, anaerobic bacteria on their tongue surfaces can be successfully treated by a regimen that includes tongue brushing, toothbrushing and possibly the usage of mouthrinses containing various agents. Several candidate mouthrinses containing essential oils (Listerine), ZnCl2, or an oil, water and cetylpyridum chloride mouthrinse have reduced the organoleptic scores of individuals with moderate levels of oral malodor in the absence of tongue brushing. Very few long-term data beyond 6 weeks of usage are available. Anecdotal evidence suggests that other agents such as chlorine dioxide may be helpful. These mouthrinses should be marketed as oral deodorants that are analogous in purpose to the usage of deodorant soaps to control and/or eliminate body malodors. In this way the mouthrinse could be considered as a cosmetic by the FDA, provided that there are data on the safety of the various ingredients in the mouthrinse. Mouthrinses containing zinc ions are able to reduce the levels of volatile sulfur compounds by converting these volatile compounds to non-volatile, and therefore, non-malodorous zinc sulfides, and this mode of action would appear to support a cosmetic claim.
This investigation evaluated the effectiveness of an infection control protocol for cleansing and disinfecting removable dental prostheses. Sixty-four dentures were rubbed with sterile cotton swab immediately after they had been taken from patients' mouths. Samples were individually placed in the culture medium and immediately incubated at 37 +/- 2 degrees C. The dentures were scrubbed for 1 min with 4% chlorhexidine, rinsed for 1 min in sterile water and placed for 10 min in one of the following immersion solutions: 4% chlorhexidine gluconate, 1% sodium hypochlorite, Biocide (iodophors) and Amosan (alkaline peroxide). After the disinfection procedures, the dentures were immersed in sterile water for 3 min, reswabbed and the samples were incubated. All samples obtained in the initial culture were contaminated with micro-organisms. All the lower dentures immersed in Biocide showed positive growth, and the upper dentures were positive for growth in six of eight dentures. The 4% chlorhexidine gluconate, 1% sodium hypochlorite and Amosan solutions have been proved effective to reduce the growth of the micro-organisms in the 10 min immersion period. The protocol evaluated in this study seems to be a viable method to prevent cross-contamination between dental personnel and patients.
The objective of this study was to evaluate the viability of the microorganism Streptococcus mutans on toothbrushes made of opaque and transparent materials.
Twenty-eight toothbrushes (14 opaque and 14 transparent) were inoculated in tubes with brain heart infusion (BHI) broth of a standard strain of S. mutans and incubated in candle jars at 37 degrees C for 24 hours. Both the opaque and transparent toothbrushes were removed at T = 0 h (control); T = 0.5 h; T = 1 h; T = 2 h; T = 4 h; T = 8 h; and T = 24 h. Individual toothbrushes were subjected to agitation in a saline solution and samples of the solution were diluted and inoculated in Bacitracin Sucrose Agar--SB-20.
After half an hour (T2) there was a significant decrease in the number of microorganisms on the transparent and opaque toothbrushes, respectively 6.0 x 10(5) and 9.4 x 10(5), when compared to the control. After the T3 = 1 hour, T4 = 2 hours, T5 = 4 h, the number of microorganisms decreased from 4.1 x 10(5); 2.1 x 10(5); 1.4 x 10(5); and 9.2 x 10(5); 5.7 x 10(5); 1.2 x 10(5) to zero (0.0) in T6 = 8 h, respectively on the transparent and opaque toothbrushes. The reduction in viable microorganisms was more obvious with the transparent toothbrushes, although the number of viable microorganisms was not significantly different for the two types of toothbrushes at the end of the experiment, T5 = 1.4 x 10(5) (transparent) and T5 = 1.2 x 10(5) (opaque).
With both opaque and transparent toothbrushes, the number of microorganisms decreased with time. A reduction in the number of microorganisms on the transparent toothbrushes was observed following inoculation and incubation. This suggests the transparent toothbrushes inhibit the viability of the S. mutans.
The aim of this study was to evaluate the effectiveness of microwave irradiation sterilization on hard chairside reline resins.
Specimens of three reline resins (Kooliner, Tokuso Rebase, and Ufi Gel Hard) were fabricated and subjected to ethylene oxide sterilization. The specimens were then individually inoculated (10(7) cfu/mL) with Tryptic Soy Broth media containing one of the tested microorganisms (C albicans, S aureus, B subtilis, and P aeruginosa). After 48 hours at 37 degrees C, the samples were vortexed for 1 minute and allowed to stand for 9 minutes, followed by a short vortex to resuspend any organisms present. After inoculation, 40 specimens of each material were immersed in 200 mL of water and subjected to microwave irradiation at 650 W for 6 minutes. Forty non-irradiated specimens were used as positive controls. Replicate specimens (25 microL) of suspension were plated at dilutions of 10(-3) to 10(-6) on plates of selective media appropriate for each organism. All plates were incubated at 37 degrees C for 48 hours. After incubation, colonies were counted, and the data were statistically analyzed by the Kruskal-Wallis test. Twelve specimens of each material were prepared for SEM.
All immersed specimens showed consistent sterilization of all the individual organisms after microwave irradiation. SEM examination indicated an alteration in cell morphology after microwave irradiation.
Microwave sterilization for 6 minutes at 650 W proved to be effective for the sterilization of hard chairside reline resins.
The purpose of this study was to evaluate the effectiveness of microwave irradiation on the disinfection of simulated complete dentures.
Eighty dentures were fabricated in a standardized procedure and subjected to ethylene oxide sterilization. The dentures were individually inoculated (10(7) cfu/mL) with tryptic soy broth (TSB) media containing one of the tested microorganisms (Candida albicans, Streptoccus aureus, Bacillus subtilis, and Pseudomonas aeruginosa). After 48 hours of incubation at 37 degrees C, 40 dentures were individually immersed in 200 mL of water and submitted to microwave irradiation at 650 W for 6 minutes. Forty nonirradiated dentures were used as positive controls. Replicate aliquots (25 microL) of suspensions were plated at dilutions of 10(-3) to 10(-6) on plates of selective media appropriate for each organism. All plates were incubated at 37 degrees C for 48 hours. TSB beakers with the microwaved dentures were incubated at 37 degrees C for 7 more days. After incubation, the number of colony-forming units was counted and the data were statistically analyzed by Kruskal-Wallis test (alpha = .05).
No evidence of growth was observed at 48 hours for S. aureus, B. subtilis, and C. albicans. Dentures contaminated with P. aeruginosa showed small growth on 2 plates. After 7 days incubation at 37 degrees C, no growth was visible in the TSB beakers of S. aureus and C. albicans. Turbidity was observed in 3 broth beakers, 2 from P. aeruginosa and 1 from B. subtilis.
Microwave irradiation for 6 minutes at 650 W produced sterilization of complete dentures contaminated with S. aureus and C. albicans and disinfection of those contaminated with P. aeruginosa and B. subtilis.
The Cochrane systematic review promotes evidence-based outcome studies. This review was conducted to determine reliable evidence concerning the effectiveness of tongue scraping or cleaning, compared with other interventions for controlling halitosis. A competent search strategy was developed and used across several databases--including the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Google Scholar--to identify randomized controlled trials that compared different methods of tongue cleaning to reduce mouth odor in adults with halitosis. Methodological quality of studies was assessed based on criteria defined by the Cochrane Collaboration. Clinical outcome (expressed in terms of a reduction in mouth odor in adults with halitosis) was examined. The review included two trials involving a total of 40 participants. Based on the independent data from these two trials, the tongue cleaner or the tongue scraper demonstrated a statistically significant difference in reducing levels of volatile sulfur compounds (VSCs) when compared with the toothbrush. The findings indicate a small but statistically significant difference in reduction of VSC levels when tongue scrapers or cleaners, rather than toothbrushes, are used to reduce halitosis in adults.
To assess the extent and duration of the effect of tongue cleaning procedures on bacterial load on the dorsal surface of the tongue.
19 subjects participated in this blinded crossover study. Subjects abstained from oral hygiene, eating and drinking from 22:00 h the previous evening. Tongue samples were collected at baseline and within 15 minutes of one of three procedures: teeth brushing alone; teeth brushing plus tongue scraping; teeth brushing plus tongue cleaning using a high speed vacuum ejector and irrigation with 20 ml antibacterial mouthwash. Subjects then brushed twice daily for 3 days apart from the second group who additionally scraped their tongue twice daily. On day 4, baseline and post-treatment samples were collected as per day 1. Bacteria (total anaerobes, Gram-negative anaerobes, VSC-producing bacteria and Streptococcus saliuarius) were enumerated using appropriate selective media.
The tongue dorsum was colonized by all 4 bacterial categories (log(10) 6-8 cfu/sample). For subjects who brushed their teeth only, there was a significant reduction from baseline for S. saliuarius only. In contrast, tooth brushing plus tongue scraping resulted in statistically significant reductions from baseline for all bacterial categories (range log(10) 0.11-0.40 cfu/sample). Highly statistically significant reductions (log(10) 1.11-1.96 cfu/sample) were observed for subjects who underwent thorough tongue cleaning with the saliva ejector/mouthwash. To determine longevity of treatment effects, baseline bacterial loads for days 1 and 4 were compared. Only daily tongue scraping resulted in statistical significant reduction in baseline microbial loads on day 4.
While mechanical tongue cleaning with or without chemical intervention can reduce bacterial load on the tongue, this effect is transient, and regular tongue cleaning is required to provide a long lasting (overnight) reduction in bacterial numbers. Nevertheless, tongue cleaning is an oral hygiene procedure that is little practiced due to discomfort and/or lack of awareness on the part of dental professionals and their patients.
Unlabelled:
The effectiveness of microwave disinfection of maxillary complete dentures on the treatment of Candida-related denture stomatitis was evaluated. Patients (n = 60) were randomly assigned to one of four treatment groups of 15 subjects each;
Control group:
patients performed the routine denture care; Mw group: patients had their upper denture microwaved (650 W per 6 min) three times per week for 30 days; group MwMz: patients received the treatment of Mw group in conjunction with topical application of miconazole three times per day for 30 days; group Mz: patients received the antifungal therapy of group MwMz. Cytological smears and mycological cultures were taken from the dentures and the palates of all patients before treatment at day 15 and 30 of treatment and at follow-up (days 60 and 90). The effectiveness of the treatments was evaluated by Kruskal-Wallis and Mann-Whitney tests. Microbial and clinical analysis of the control group demonstrated no significant decrease in the candidal infection over the clinical trial. Smears and cultures of palates and dentures of the groups Mw and MwMz exhibited absence of Candida at day 15 and 30 of treatment. On day 60 and 90, few mycelial forms were observed on 11 denture smears (36.6%) from groups Mw and MwMz, but not on the palatal smears. Miconazole (group Mz) neither caused significant reduction of palatal inflammation nor eradicated Candida from the dentures and palates. Microwaving dentures was effective for the treatment of denture stomatitis. The recurrence of Candida on microwaved dentures at follow-up was dramatically reduced.
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