title: Children's toothbrush contamination in day-care centers: how to solve this problem?
abstract: OBJECTIVE
  To evaluate the contamination level of toothbrushes by mutans streptococci (MS) and the efficacy of antimicrobial solutions: cetylpyridinium chloride 0.05 % (CPC; Cepacol™) and chlorhexidine 0.12 % (CHX; Periogard™), to disinfect toothbrushes of preschool-aged children in day-care centers.
  
  
  METHODS
  Fifty-two children were randomly divided into three groups, and a three-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 dentifrice, performed by a professional calibrated, followed by random spraying over the bristles of brushes. Process and microbiological analysis were realized, and four brushes of each group were analyzed by scanning electron microscopy (SEM).
  
  
  RESULTS
  Friedman's test at 5 % significance level revealed difference between the antimicrobial solutions (p < 0.01). MS were detected in 100 % cases of toothbrushes sprayed with sterile tap water (control) and in 66.7 % after spraying with CPC, but it was not detected formation of colonies/biofilms after spraying with CHX. The data were confirmed by SEM.
  
  
  CONCLUSIONS
  The toothbrushes were contaminated with MS after a single brushing.
  
  
  CONCLUSIONS
  Although CPC has shown good results in comparison with the control, CHX showed greater efficacy in disinfection bristles of toothbrushes.
authors.affiliation: Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil, nelson@forp.usp.br.
authors.forename: Paulo
authors.initials: P
authors.lastname: Nelson-Filho
authors.forename: Maristela Soares Swerts
authors.initials: MS
authors.lastname: Pereira
authors.forename: Andiara
authors.initials: A
authors.lastname: De Rossi
authors.forename: Raquel Assed Bezerra
authors.initials: RA
authors.lastname: da Silva
authors.forename: Késsia Suênia Fidelis
authors.initials: KS
authors.lastname: de Mesquita
authors.forename: Alexandra Mussolino
authors.initials: AM
authors.lastname: de Queiroz
authors.forename: Léa Assed Bezerra
authors.initials: LA
authors.lastname: da Silva
mesh_terms: D002594:Cetylpyridinium / Q000494:pharmacology*; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D002710:Chlorhexidine / Q000494:pharmacology*; D015169:Colony Count, Microbial; D004202:Disinfectants / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D013295:Streptococcus mutans / Q000187:drug effects / Q000302:isolation & purification*; D014099:Toothbrushing
chemical_list: D004202:Disinfectants; D002594:Cetylpyridinium; D002710:Chlorhexidine