title: How clean is your toothbrush?
abstract: METHODS
  PubMed, CINAHL, Cochrane Library, National Guidelines Clearinghouse, Web of Science and Google Scholar databases were searched.
  
  
  METHODS
  Experimental and non-experimental English language studies in adults in hospitalised and non-hospitalised patients were included.
  
  
  METHODS
  A qualitative summary of the included studies was presented.
  
  
  RESULTS
  Seven experimental and three descriptive studies were included. All of the studies examined toothbrush contamination and found significant bacterial retention and survival on toothbrushes after use. A number of decontamination techniques were studied and a range of active agents reduced bacterial load. Closed storage containers generally increased bacterial load or survival times. Toothbrush design was also seen to have varying impact on bacterial load.
  
  
  CONCLUSIONS
  The selected studies found that toothbrushes of healthy and oral diseased adults become contaminated with pathogenic bacteria from dental plaque, design, environment or a combination of factors. There are no studies that specifically examine toothbrush contamination and the role of environmental factors, toothbrush contamination, and vulnerable populations in the hospital setting (eg critically ill adults) and toothbrush use in nursing clinical practice.
authors.affiliation: Centre for Evidence-based Dentistry, Oxford, UK.
authors.forename: Derek
authors.initials: D
authors.lastname: Richards