Sept. 30, 2004 -- Four out of five dentists may be surprised: Toothbrushes, dentures, dental floss, and athletic mouthguards may be responsible for recurring health problems ranging from asthma attacks to herpes outbreaks.
The problem: Bacteria, yeast, fungi, and viruses live on these dental devices and when used and stored as they usually are, they transmit these disease-causing organisms into the bloodstream, promoting infection, says R. Thomas Glass, DDS, PhD, professor of dentistry and pathology at Oklahoma State University Center for Health Sciences.
"We have done several studies with large groups of patients, in which we looked at their disease processes and then examined their toothbrush or dentures," he tells WebMD. "Low and behold, the same organisms producing the disease are found on these devices."
A specialist in oral microbiology and disease transmission for 20 years, Glass presented research today at the annual meeting of the American Dental Association in Orlando, Fla., on how various infections may result from proper oral hygiene and recommended dental protection -- and ways to lower risk. In his research, he notes that scores of different bugs can survive on dental devices.
How Hygiene Hurts
"The action of brushing your teeth, especially with an electric toothbrush, actually pushes these organisms beneath the skin in your mouth," says Glass. "Dentures add another dimension. Because of hydraulic pressure, every time you chew, you are pushing these organisms into [the skin of] your mouth."
Since many of these germs got on these devices because they were already in your mouth, they may not cause new disease unless shared with others. But he says they play a role in recurring illness.
"When your resistance is low, that's when this becomes clinically important," he says. "In essence, you are re-infecting yourself."
The herpes simplex virus, for instance, can remain active on a toothbrush for up to 12 days and live on dentures for up to three, he finds. Cold and flu germs can also survive for weeks under the right breeding conditions.
"These bugs need food, water, darkness and to not be disturbed -- and the bathroom provides all of that," he says. "And when you flush your toilet, there is aeration coming from the toilet to the rest of the bathroom that may also contribute to these organisms. So one key issue is where you store your toothbrush. My advice is to keep your toothbrush in the bedroom, not the bathroom."
What else does he recommend?
"As a routine, get a new toothbrush every two weeks," he says. "Personally, I throw mine out on the first and 15th of every month." In addition, you should also replace your toothbrush at the beginning of an illness, and again when symptoms subside. The American Dental Association and CDC recommend replacing toothbrushes about every three months, but that advice is based on the expected wear of bristles and not on its bacterial contamination.
Clear brush heads and bristles are less conducive for organism life and growth than those that are darker. "If your brush allows light to be transmitted through, you're ahead of the game," says Glass.
He also recommends against electric toothbrushes, which he says "spin" organisms into tissue more forcibly than manual brushes.
Sanitizing dentures is the key to killing organisms, and he provided his colleagues a tested recipe.
For those with dentures, he suggests a solution of equal parts of bleach, dishwashing liquid, and water. Soak dentures in that solution for two hours, then soak dentures for another hour in another solution of equal parts of water and vinegar. Finally, soak dentures for the rest of the night in a mixture of 1/4 teaspoon of baking soda and 4 ounces of water. Before trying the recipe, however, he advises that you speak to your dentist.
If you or your child plays contact sports, replace athletic mouthguards once a week. "What we're now finding is that organisms that can trigger asthmatic attacks live on these mouthguards," he says.
Football players may be especially susceptible to infection. "Often, the mouthguard hangs from the helmet, and helmets may sit in a locker, next to moldy shoes or other environments for germs."
Unless the same piece of floss is repeatedly used, the risk of infection is minimal. But with newer floss holders, Glass is concerned that people will not change dental floss after each use. "That may promote the same type of problems we're seeing with toothbrushes," he says.