title: Effects of easy-to-perform procedures to reduce bacterial colonization with Streptococcus mutans and Staphylococcus aureus on toothbrushes.
abstract: It is well known that dental caries and periodontitis are the consequence of bacterial colonization and biofilm formation on the enamel surface. The continuous presence of bacterial biofilms on the tooth surface results in demineralization of the tooth enamel and induces an inflammatory reaction of the surrounding gums (gingivitis). The retention and survival of microorganisms on toothbrushes pose a threat of recontamination especially for certain patients at risk for systemic infections originating from the oral cavity, e.g., after T-cell depleted bone marrow transplantation. Thus, the effects of different decolonization schemes on bacterial colonization of toothbrushes were analyzed, in order to demonstrate their applicability to reduce the likelihood of (auto-)reinfections. Toothbrushes were intentionally contaminated with standardized suspensions of Streptococcus mutans or Staphylococcus aureus. Afterwards, the toothbrushes were exposed to rinsing under distilled water, rinsing and drying for 24 h, 0.2% chlorhexidine-based decolonization, or ultraviolet (UV) radiation. The remaining colony forming units were compared with freshly contaminated positive controls. Each experiment was nine-fold repeated. Bi-factorial variance analysis was performed; significance was accepted at P < 0.05. All tested procedures led to a significant reduction of bacteral colonization irrespective of the toothbrush model, the brush head type, or the acitivity state. Chlorhexidine-based decolonization was shown to be superior to rinsing and slightly superior to rinsing and drying for 24 h, while UV radiation was similarly effective as chlorhexidine. UV radiation was slightly less prone to species-dependent limitations of its decolonizing effects by bristle thickness of toothbrushes than chlorhexidin. Reduction of bacterial colonization of toothbrushes might reduce the risk of maintaining bacterial infections of the upper respiratory tract. Accordingly, respective procedures are advisable, particularly as they are cheap and easy to perform.
authors.forename: Andreas Erich
authors.initials: AE
authors.lastname: Zautner
authors.forename: Annina
authors.initials: A
authors.lastname: Hage
authors.forename: Katja
authors.initials: K
authors.lastname: Schneider
authors.forename: Karolin
authors.initials: K
authors.lastname: Schlösser
authors.forename: Ortrud
authors.initials: O
authors.lastname: Zimmermann
authors.forename: Else
authors.initials: E
authors.lastname: Hornecker
authors.forename: Rainer F
authors.initials: RF
authors.lastname: Mausberg
authors.forename: Hagen
authors.initials: H
authors.lastname: Frickmann
authors.forename: Uwe
authors.initials: U
authors.lastname: Groß
authors.forename: Dirk
authors.initials: D
authors.lastname: Ziebolz
keywords: Staphylococcus aureus; Streptococcus mutans; bacterial colonization; decolonization; oral hygiene; toothbrush