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Open Access 10-05-2022 | Influenza Virus | Original Article

The role of toothbrush in the transmission of corona- and influenza viruses — results of an in vitro study

Authors: Gerhard Schmalz, Laura Feindt, Franziska Tanneberger, Rainer Haak, Ahmed Abd El Wahed, Uwe Truyen, Dirk Ziebolz

Published in: Clinical Oral Investigations | Issue 9/2022

Abstract

Objectives

The aim of this in vitro study was to investigate viruses’ stabilities on manual toothbrushes using feline coronavirus (FeCoV) as representative of coronaviruses and an Avian influenza A virus H1N1 for influenza viruses.

Material and methods

Two viruses, FeCoV (Strain Munich; titer 107.5 TCID50/ml) and H1N1 (RE 230/90; titer 106.5 TCID50/ml), were used in this study. Manual toothbrushes were disassembled into bristles, bristle fixation, and back of the toothbrush head, contaminated with the viruses and air-dried for 24 h. In a second experiment, whole toothbrush heads were contaminated, rinsed with water (5 ml for 15 s) and then air-dried.

Results

For FeCoV, immediately after contamination, the following average titers were recovered: fixation: 10^6.41, back of head: 10^6.81 and bristles: 10^6.63 TCID₅₀/ml. Following air-drying of 12 (fixation) and 24 h, titers of ≤ 10^2.5, 10^3.75, and 10^2.72 TCID₅₀/ml were found in the respective groups, with a detection limit of 10^2.5 TCID₅₀/ml. For H1N1, immediately after contamination, the following average titers could be recovered: fixation: 10^5.53, back of head: 10^5.97 and bristles: 10^5.75 TCID₅₀/ml. Following air-drying of 8 (fixation) and 24 h, titers were ≤ 10^2.5, 10^3.63, and 10^3.53 TCID₅₀/ml in the respective group, again with 10^2.5 TCID₅₀/ml being the detection limit. In case of water rinse, no infectious virus could be recovered after 12 h.

Conclusion

Viral load of both viruses is reduced by air-drying, especially following water rinsing.

Clinical relevance

The toothbrush itself plays an insignificant role in the self-transmission of coronavirus and influenza virus.

Wu KY, Wu DT, Nguyen TT, Tran SD (2021) SARS-COV2's impact on private practice and academic dentistry in North America. Oral Dis 27(Suppl 3):684–687. https://doi.org/10.1111/odi.13444CrossRefPubMed

Callahan C, Ditelberg S, Dutta S, Littlehale N, Cheng A, Kupczewski K, McVay D, Riedel S, Kirby JE, Arnaout R (2021) Saliva is comparable to nasopharyngeal swabs for molecular detection of SARS-CoV-2. Microbiol Spectr 9(1):e0016221. https://doi.org/10.1128/Spectrum.00162-21CrossRefPubMed

Vergara-Buenaventura A, Castro-Ruiz C (2020) Use of mouthwashes against SARS-COV2 in dentistry. Br J Oral Maxillofac Surg 58(8):924–927. https://doi.org/10.1016/j.bjoms.2020.08.016CrossRefPubMedPubMedCentral

González-Olmo MJ, Delgado-Ramos B, Ruiz-Guillén A, Romero-Maroto M, Carrillo-Díaz M (2020) Oral hygiene habits and possible transmission of SARS-COV2 among cohabitants. BMC Oral Health 20(1):286. https://doi.org/10.1186/s12903-020-01274-5CrossRefPubMedPubMedCentral

Nascimento AP, Watanabe E, Ito IY (2010) Toothbrush contamination by Candida spp. and efficacy of mouthrinse spray for their disinfection. Mycopathologia 169(2):133–138. https://doi.org/10.1007/s11046-009-9239-zCrossRefPubMed

do Nascimento C, Trinca NN, Pita MS, Pedrazzi V. (2015) Genomic identification and quantification of microbial species adhering to toothbrush bristles after disinfection: A cross-over study. Arch Oral Biol. 60(7):1039–1047. https://doi.org/10.1016/j.archoralbio.2015.03.012CrossRefPubMed

Ankola AV, Hebbal M, Eshwar S (2009) How clean is the toothbrush that cleans your tooth? Int J Dent Hyg 7(4):237–240. https://doi.org/10.1111/j.1601-5037.2009.00384.xCrossRefPubMed

Zinn MK, Schages L, Bockmühl D (2020) The toothbrush microbiome: impact of user age, period of use and bristle material on the microbial communities of toothbrushes. Microorganisms 8(9):1379. https://doi.org/10.3390/microorganisms8091379CrossRefPubMedCentral

Frazelle MR, Munro CL (2012) Toothbrush contamination: a review of the literature. Nurs Res Pract 2012:420630. https://doi.org/10.1155/2012/420630CrossRefPubMedPubMedCentral

10.

Bhoil R, Bhoil R (2016) Toothbrush contamination: often neglected health hazard. J Family Med Prim Care 5(1):186. https://doi.org/10.4103/2249-4863.184664CrossRefPubMedPubMedCentral

11.

Agrawal SK, Dahal S, Bhumika TV, Nair NS (2019) Evaluating sanitization of toothbrushes using various decontamination methods: a meta-analysis. J Nepal Health Res Counc 16(41):364–371CrossRef

12.

Basman A, Peker I, Akca G, Alkurt MT, Sarikir C, Celik I (2016) Evaluation of toothbrush disinfection via different methods. Braz Oral Res 30:S1806–S83242016000100203. https://doi.org/10.1590/1807-3107BOR-2016.vol30.0006CrossRefPubMed

13.

Patcas R, Zbinden R, Schätzle M, Schmidlin PR, Zehnder M (2018) Whisky, microwave or hairdryer? Exploring the most efficient way to reduce bacterial colonisation on contaminated toothbrushes. Br Dent J 225(11):1007–1010. https://doi.org/10.1038/sj.bdj.2018.1030CrossRefPubMed

14.

Zautner AE, Hage A, Schneider K, Schlösser K, Zimmermann O, Hornecker E, Mausberg RF, Frickmann H, Groß U, Ziebolz D (2013) Effects of easy-to-perform procedures to reduce bacterial colonization with Streptococcus mutans and Staphylococcus aureus on toothbrushes. Eur J Microbiol Immunol (Bp) 3(3):204–210. https://doi.org/10.1556/EuJMI.3.2013.3.9 Epub 2013 Sep 23CrossRef

15.

Marquès M, Domingo JL (2021) Contamination of inert surfaces by SARS-CoV-2: persistence, stability and infectivity. A review. Environ Res 193:110559. https://doi.org/10.1016/j.envres.2020.110559CrossRefPubMed

16.

van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, Tamin A, Harcourt JL, Thornburg NJ, Gerber SI, Lloyd-Smith JO, de Wit E, Munster VJ (2020) Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 382(16):1564–1567. https://doi.org/10.1056/NEJMc2004973CrossRefPubMed

17.

Aboubakr HA, Sharafeldin TA, Goyal SM (2021) Stability of SARS-CoV-2 and other coronaviruses in the environment and on common touch surfaces and the influence of climatic conditions: a review. Transbound Emerg Dis 68(2):296–312. https://doi.org/10.1111/tbed.13707CrossRefPubMed

18.

Arweiler NB, Grelle F, Sculean A, Heumann C, Auschill TM (2018) Antibacterial effect and substantivity of toothpaste slurries in vivo. Oral Health Prev Dent 16(2):175–181. https://doi.org/10.3290/j.ohpd.a40310CrossRefPubMed

19.

Schmidt JC, Bux M, Filipuzzi-Jenny E, Kulik EM, Waltimo T, Weiger R, Walter C (2014) Influence of time, toothpaste and saliva in the retention of Streptococcus mutans and Streptococcus sanguinis on different toothbrushes. J Appl Oral Sci 22(3):152–158. https://doi.org/10.1590/1678-775720130017CrossRefPubMedPubMedCentral

20.

International Committee on Taxonomy of Viruses, ICTV, https://talk.ictvonline.org, accessed on 21st of April 2022

21.

Rewar S, Mirdha D, Rewar P (2015) Treatment and prevention of pandemic H1N1 influenza. Ann Glob. Health 81(5):645–653. https://doi.org/10.1016/j.aogh.2015.08.014CrossRef

22.

Van Reeth K (2007) Avian and swine influenza viruses: our current understanding of the zoonotic risk. Vet Res 38(2):243–260. https://doi.org/10.1051/vetres:2006062CrossRefPubMed

23.

Iuliano AD, Roguski KM, Chang HH, Muscatello DJ, Palekar R, Tempia S, Cohen C, Gran JM, Schanzer D, Cowling BJ, Wu P, Kyncl J, Ang LW, Park M, Redlberger-Fritz M, Yu H, Espenhain L, Krishnan A, Emukule G et al (2018) Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. Lancet 391(10127):1285–1300. https://doi.org/10.1016/S0140-6736(17)33293-2CrossRefPubMed

24.

Chotpitayasunondh T, Fischer TK, Heraud JM, Hurt AC, Monto AS, Osterhaus A, Shu Y, Tam JS (2021) Influenza and SARS-COV2: what does co-existence mean? Influenza other respir viruses. 15(3):407-412. doi: https://doi.org/10.1111/irv.12824.

25.

Oxford J, Berezin EN, Courvalin P, Dwyer DE, Exner M, Jana LA, Kaku M, Lee C, Letlape K, Low DE, Madani TA, Rubino JR, Saini N, Schoub BD, Signorelli C, Tierno PM, Zhong X (2014 Apr) The survival of influenza A(H1N1)pdm09 virus on 4 household surfaces. Am J Infect Control 42(4):423–425. https://doi.org/10.1016/j.ajic.2013.10.016CrossRefPubMed

Title: The role of toothbrush in the transmission of corona- and influenza viruses — results of an in vitro study
Authors: Gerhard Schmalz
Laura Feindt
Franziska Tanneberger
Rainer Haak
Ahmed Abd El Wahed
Uwe Truyen
Dirk Ziebolz
Publication date: 10-05-2022
Publisher: Springer Berlin Heidelberg
Keywords: Influenza Virus
Coronavirus
Influenza
Published in: Clinical Oral Investigations / Issue 9/2022
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-022-04530-w

At a glance: The STEP trials

Springer Medicine

The role of toothbrush in the transmission of corona- and influenza viruses — results of an in vitro study

Abstract

Objectives

Material and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Material and methods

Results

Conclusion

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