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ORIGINAL ARTICLE
Year : 2017  |  Volume : 15  |  Issue : 1  |  Page : 8-10

Effectiveness of Vinegar, Lime, and Salt Water as Potential Household Decontaminants for Toothbrushes


1 Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
2 Department of Microbiology, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India

Date of Web Publication14-Mar-2017

Correspondence Address:
Vethakkan Bijivin Raj
Department of Public Health Dentistry, Ragas Dental College and Hospital, 2/102, East Coast Road, Uthandi, Chennai - 600 119, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaphd.jiaphd_120_16

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  Abstract 

Introduction: Toothbrushes play an essential role in oral hygiene. However, toothbrushes can become contaminated through contact with the environment, from the oral cavity, and by toothbrush storage containers. Aim: To evaluate the effectiveness of vinegar, lime, and salt water as potential household decontaminants for toothbrushes. Materials and Methods: In an in vitro study, 120 used toothbrushes were collected and divided into four groups comprising 30 samples each. Group I was treated with plain water alone after use. Group II was treated with salt water. Group III was treated with a solution which contained lime juice. Group IV was treated with vinegar. Treatment duration for the groups was set to be 12 h. After the treatment, the brush heads of the four groups were incubated in brain-heart infusion agar at 37°C for 24 h. Statistical analysis was performed using the Statistical Package for the Social Sciences version 20.0 software. One-way analysis of variance and Bonferroni post hoc analysis were performed for multiple comparisons. Results: Vinegar group showed statistically significant result for decontamination of toothbrushes when compared to other test and control agents. Conclusion: Commonly used household materials can be potential decontaminants for toothbrushes. The results of this study showed that vinegar was the most effective decontamination agent followed by lime and salt water.

Keywords: Antimicrobial, decontamination, household, toothbrush


How to cite this article:
Raj VB, Madan Kumar PD, Balaji S. Effectiveness of Vinegar, Lime, and Salt Water as Potential Household Decontaminants for Toothbrushes. J Indian Assoc Public Health Dent 2017;15:8-10

How to cite this URL:
Raj VB, Madan Kumar PD, Balaji S. Effectiveness of Vinegar, Lime, and Salt Water as Potential Household Decontaminants for Toothbrushes. J Indian Assoc Public Health Dent [serial online] 2017 [cited 2017 Apr 28];15:8-10. Available from: http://www.jiaphd.org/text.asp?2017/15/1/8/201928


  Introduction Top


Toothbrushes play a vital role in effective plaque removal and promotion of oral hygiene. Among the seven billion world population, 4.2 billion people are using toothbrushes for their daily oral hygiene maintenance.[1]

Studies have reported contamination of toothbrushes through contact with the environment, from the oral cavity, and by toothbrush storage containers.[2],[3] Dayoub et al.[4] found that toothbrushes placed in closed containers and exposed to contaminated surfaces of bathrooms yielded higher bacterial counts than those left open to air. Mehta et al.[5] found that the use of a cap for toothbrush storage increased bacterial survival. Increased bacterial survival on toothbrush when stored in moist environment was reported by Glass.[6]

Contaminated toothbrushes can be a vector for the transmission or reinfection of various bacteria, viruses, and fungus.[7] Studies stated that Aggregatibacter actinomycetemcomitans and herpes simplex virus-1 survive at least 3 days on toothbrushes.[8] Recent studies demonstrated that some periodontal pathogenic organisms and super-infecting Enterobacteriaceae and Pseudomonas species were cultured from toothbrushes.[9] Rinsing the toothbrushes using plain water after use may not eliminate all microorganisms present in the toothbrushes.[10] Hence, studies have been conducted on the potential of various agents for decontamination of toothbrushes.

A number of procedures have been described to reduce the microbiological load of toothbrushes, such as continuous replacement of toothbrushes, submerging the brush into microbicide solutions such as Chlorhexidine, sodium hypochlorite, Listerine, Dettol,[11] spraying antiseptic solutions, using ozone, ultraviolet radiation (UV) rays, and microwaves.[10] These procedures are successful in decontaminating the brushes, but are always expensive or not easy to perform. Hence, there is a need for a simple and inexpensive method for decontaminating toothbrushes. No study was found to date, which reported decontamination of toothbrushes using commonly used household materials with antibacterial effects.

Common salt, lime, and vinegar are the most commonly available household materials with antimicrobial activity. Common salt is an agent used as a food preservative and it has high antimicrobial values.[12] Studies have proven lime juice as a medicine for many infectious diseases, and it can prevent food contamination.[13] Vinegar is also a household material with antimicrobial activity, and it is also used to prevent bacterial contamination against food materials.[14]

Considering the availability, cost, and technique sensitivity of existing household decontamination solutions, this in vitro study was conceptualized to evaluate the effectiveness of common salt, lime, and vinegar as agents used for decontamination of toothbrushes.


  Materials and Methods Top


An in vitro study was conducted in the month of May 2016. The toothbrush samples were collected from Panayur, a fishing hamlet near Chennai, India. One hundred and twenty used toothbrushes were collected from people who belong to the age group of 20–30 years with no systemic disease. The study was explained to them before collecting the toothbrushes and a new toothbrush was given to them. They were using these toothbrushes for around 3 months. After daily use, they rinsed these brushes using plain water and stored it in their bathrooms or living rooms. On the day of sample collection after tooth brushing in the morning, the samples were collected, and the head part was separated aseptically using sterile blades and immersed in the wide-mouthed containers with 5 ml of saline and transported to the laboratory on the same day.

The samples were divided into four groups and each group comprised 30 samples. Group I was not treated with any household agents. They were rinsed with plain water alone after use. This group was considered as control group. Group II was treated with salt water. The treatment solution was prepared by dissolving two teaspoons of common salt in 100 ml of plain water. Group III was treated with lime juice, extracted by squeezing the cut, raw lemon. Two teaspoons of lime juice was diluted with 100 ml of plain water. Group IV was treated with 5 ml of commercially available vinegar (Neo Vinegar Company, Chennai, which contains 5–8% of glacial acetic acid). Treatment duration for the Groups II, III, and IV was set to be 12 h. For all test solutions, care was taken that the toothbrush head was completely submerged in the solution. After treatment, the brush heads of the four groups were transferred to new sterile wide mouth containers with 1 ml of saline and subjected to vigorous shaking for 5 min. With a 2-mm loop wire, the sample was taken from the container and streaked onto brain-heart infusion agar (standard loop technique).[15] The brain-heart infusion agar plates were inoculated at 37°C for 24 h. After inoculation, total colony count was calculated manually. Total colony count was calculated using the formulae: colony forming unit (cfu)/ml = total colony count × 1000.

Statistical analysis was performed using IBM Statistical Package for the Social Sciences Statistics for windows, version 20.0 software (IBM Corp., Armonk, NY). Prior to statistical analysis, total microbial counts were converted to log10. Descriptive statistics in the form of means and standard deviations were calculated. The normality of the data was checked using Shapiro–Wilk test, and it was found to be normally distributed. Comparisons of the four groups were conducted with one-way analysis of variance, and Bonferroni post hoc analysis was performed for multiple comparisons. The difference was considered statistically significant at P < 0.05.


  Results Top


The toothbrushes kept in the control group contained more than 30,000 colonies of microorganisms. [Table 1] shows the distribution of cfu of treatment solutions. Among the four groups, vinegar showed superior result for decontamination of the toothbrushes when compared to other test and control agents. Vinegar showed a statistically significant reduction in the microbial count compared to other test solutions among the test agents, which are given in [Table 2].
Table 1: Distribution of colony forming unit (cfu) of treatment solutions

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Table 2: Bonferroni post hoc test for colony forming unit (cfu) of treatment solutions

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  Discussion Top


The present study was conducted to analyze the microbial growth after the toothbrush decontamination using household agents. The toothbrushes kept in the control group contained more than 30,000 colonies of microorganisms, which were in accordance with the existing literature regarding the toothbrush contamination.[4],[9]

Researchers have found that there was an increased risk of spreading oral and systemic diseases from the contaminated toothbrushes. Fischer suggested that there was a relationship between pharyngitis and toothbrush contamination.[16] Brook and Gober[17] found that the contaminated toothbrushes may contain group A beta hemolytic streptococci of pharyngotonsillitis. Hence, it is postulated that microbial load in a toothbrush might have a significant impact in the risk for systemic diseases.

Many studies have highlighted that there was a need for tooth disinfection to reduce the number of microorganisms.[3],[5],[10] Existing literature shows there are many effective toothbrush decontamination methods available, which include UV radiation, microwave radiation,[10] boiling water, and chemical agents such as Listerine, Plax, Cepacol, and Chlorhexidine.[18],[19] Some authors have also included agents such as silver and Chlorhexidine to be coated over the bristles during manufacturing.[19]

Devive et al.[20] quoted that the decontamination method of the toothbrushes must be rapidly effective, cost effective, and non-toxic and can be easily implemented.

The present study showed that vinegar had statistically significant reduction in microbial load. Vinegar contains 5–8% glacial acetic acid, which is a potent bactericidal agent.[14] It inactivates the strains of bacteria such as  Escherichia More Details coli, thus inhibiting the growth of microbes. Another test solution, lime juice used in this study, also provided favorable results. Lime juice contains 8–10% of citric acid, which is also a bactericidal agent inhibiting the growth of strains of microorganisms. Salt was a traditionally used preservative agent which prevents contamination in food materials.[13] Salt absorbs the moisture content in food materials, thus preventing bacterial growth and helps to reduce the food contamination.[12]Our results suggested that vinegar was superior in decontamination of a toothbrush among household materials followed by lime and salt water. These results should be interpreted with the following limitations. In this study, microbial count of each group was not assessed before the treatment with various household agents. Furthermore, changes in the brush bristle pattern could have influenced our research. No standardized technique of preparation of the solution with concentration was performed, since it cannot be practiced in a household setting. In addition, this study aimed to assess microbial decontamination after 12 h treatment only; hence, the effect on various time intervals was not assessed. Further studies may be conducted with lesser treatment time and microscopic examination of toothbrush bristles after treatment.


  Conclusion Top


Commonly used household materials can be potential decontaminants for toothbrushes. Among the test agents, vinegar was the most effective decontamination agent followed by lime and salt water. However, further research is recommended on the effect of various concentrations of test agents at various time intervals.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Turner J. More-mobile-phones-than-toothbrushes; 2011. [Internet]. Available from: http://60secondmarketer.com/blog. [Last accessed on 2016 Jul 02].  Back to cited text no. 1
    
2.
ADA.org: ADA statement on toothbrush care: Cleaning, storage and replacement; 2009. [Internet]. Available from: http://www.ada.org/1887.aspx. [Last accessed on 2016 Jul 02].  Back to cited text no. 2
    
3.
Caudry SD, Klitorinos A, Chan EC. Contaminated toothbrushes and their disinfection. J Can Dent Assoc 1995;61:511-6.  Back to cited text no. 3
    
4.
Dayoub MB, Rusilko D, Gross A. Microbial contamination of toothbrushes. J Dent Res 1977;56:706.  Back to cited text no. 4
    
5.
Mehta A, Sequeira PS, Bhat G. Bacterial contamination and decontamination of toothbrushes after use. N Y State Dent J 2007;73:20-2.  Back to cited text no. 5
    
6.
Glass RT. The infected toothbrush, the infected denture, and transmission of disease: A review. Compendium 1992;13:592-8.  Back to cited text no. 6
    
7.
Glass RT, Carson SR, Barker RL, Peiper SC, Shapiro S. Detection of HIV proviral DNA on toothbrushes: A preliminary study. J Okla Dent Assoc 1994;84:17-20.  Back to cited text no. 7
    
8.
Sconyers JR, Crawford JJ, Moriarty JD. Relationship of bacteremia to toothbrushing in patients with periodontitis. J Am Dent Assoc 1973;87:616-22.  Back to cited text no. 8
    
9.
Morris DW, Goldschmidt M, Keene H, Cron SG. Microbial contamination of power toothbrushes: A comparison of solid-head versus hollow-head designs. J Dent Hyg 2014;88:237-42.  Back to cited text no. 9
    
10.
Gujjari SK, Gujjari AK, Patel PV, Subhasini PV. Comparative evaluation of ultraviolet and microwave sanitization techniques for toothbrush decontamination. J Int Soc Prev Community Dent 2011;1:20-6.  Back to cited text no. 10
    
11.
Warren DP, Goldschmidt MC, Thompson MB, Adler-Storthz K, Keene HJ. The effects of toothpastes on the residual microbial contamination of toothbrushes. J Am Dent Assoc 2001;132:1241-5.  Back to cited text no. 11
    
12.
Wijnker JJ, Koop G, Lipman LJ. Antimicrobial properties of salt (NaCl) used for the preservation of natural casings. Food Microbiol 2006;23:657-62.  Back to cited text no. 12
    
13.
Hindi NK, Chabuck ZA. Antimicrobial activity of different aqueous lemon extracts. J Appl Pharm Sci 2013;3:074-8.  Back to cited text no. 13
    
14.
Medina E, Romero C, Brenes M, De Castro A. Antimicrobial activity of olive oil, vinegar, and various beverages against foodborne pathogens. J Food Prot 2007;70:1194-9.  Back to cited text no. 14
    
15.
Cardoso CL, Muraro CB, Siqueira VL, Guilhermetti M. Simplified technique for detection of significant bacteriuria by microscopic examination of urine. J Clin Microbiol 1998;36:820-3.  Back to cited text no. 15
    
16.
Fischer H. Contaminated toothbrushes and pharyngitis. Arch Otolaryngol Head Neck Surg 1999;125:479.  Back to cited text no. 16
    
17.
Brook I, Gober AE. Persistence of group A beta-hemolytic streptococci in toothbrushes and removable orthodontic appliances following treatment of pharyngotonsillitis. Arch Otolaryngol Head Neck Surg 1998;124:993-5.  Back to cited text no. 17
    
18.
Caudry SD, Klitorinos A, Chan EC. Contaminated toothbrushes and their disinfection. J Can Dent Assoc 1995;61:511-6.  Back to cited text no. 18
    
19.
Suido H, Offenbacher S, Arnold RR. A clinical study of bacterial contamination of chlorhexidine-coated filaments of an interdental brush. J Clin Dent 1998;9:105-9.  Back to cited text no. 19
    
20.
Devine DA, Percival RS, Wood DJ, Tuthill TJ, Kite P, Killington RA et al. Inhibition of biofilms associated with dentures and toothbrushes by tetrasodium EDTA. J Appl Microbiol 2007;103:2516-24.  Back to cited text no. 20
    



 
 
    Tables

  [Table 1], [Table 2]



 

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