A Pilot Study to Assess Bacteraemia Associated with Tooth Brushing Using Conventional, Electric or Ultrasonic Toothbrushes

  • S. MisraEmail author
  • R. S. Percival
  • D. A. Devine
  • M. S. Duggal


Aim: This was to compare the incidence of bacteraemia following toothbrushing using ultrasonic, powered or conventional manual children’s toothbrushes. Methods: Healthy subjects (11), aged 18 to 45 years, attending the Leeds Dental Institute were recruited. Subjects attended three separate appointments, during which they had their teeth brushed with a conventional manual toothbrush (CMT), a powered Braun-Oral B toothbrush (PBT) or a Sonicare Optima ultrasonic toothbrush (STB). Venous blood samples were taken immediately before, 30 secs and 2 mins after brushing. Blood and saliva samples collected prior to tooth brushing, all samples were immediately processed for microbiological analysis. Results: An increase in the incidence of bacteria in blood samples followed the use of all types of toothbrush. The highest incidence of bacteraemia (8/11 subjects) was following brushing with powered toothbrushes, which was significantly (p<.025) greater than that following brushing with ultrasonic (5/11) or manual (5/11) toothbrushes. There was no significant difference in salivary total bacterial counts comparing all individuals, so this had little bearing on subsequent development of bacteraemia. Conclusion: Brushing with a powered toothbrush resulted in a transient bacteraemia more frequently than brushing with a manual or ultrasonic toothbrush and may affect children with congenital heart defects at risk of bacterial endocarditis.

Key words

bacteraemia toothbrush dental 


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  1. Calfee DP, Farr BM. Comparison of four antiseptic preparations for skin in the prevention of contamination of percutaneously drawn blood cultures: a randomized trial. J Clinic Microbiol 2002;40:1660–5CrossRefGoogle Scholar
  2. Dajani. Bacterial Endocarditis Prophylaxis. J Americ Medical Assoc 1997;227: 1794–99CrossRefGoogle Scholar
  3. Everts RJ, Vinson EN, Adholla PO, Reller LB. Contamination of catheterdrawn blood cultures. J Clinical Microbiol 2001;39:3393–4CrossRefGoogle Scholar
  4. Heimdahl A, Hall G, Hedberg M, et al. Detection and quantitation by lysis-filtration of bacteraemia after different oral surgical procedures. J Clinical Microbiol 1990;28: 2205–9Google Scholar
  5. Hoover Cl, Newbrun E. Survival of bacteria from human dental plaque under various transport conditions. J Clinical Microbiol 1977;6:212–8.Google Scholar
  6. Mantokoudis D, Joss A, Christensen MM, et al. Comparison of the clinical effects and gingival abrasion aspects of manual and electric toothbrushes. J Clinical Periodontol 2001;28: 65–72CrossRefGoogle Scholar
  7. Morris T. Using antibiotics responsibly. Comparat Med 2000;50: 255Google Scholar
  8. Roberts GJ, Gardner P, Simmons NA. Optimum sampling time for detection of dental bacteraemia in children. Int J Cardiol 1992;35: 311–5CrossRefPubMedGoogle Scholar
  9. Roberts GJ, Holzel HS, Sury MR, et al. Dental bacteremia in children. Pediatc Cardiol 1997; 18: 24–7CrossRefGoogle Scholar
  10. Roberts GJ, Simmons NB, Longhurst P, Hewitt RB. Bacteraemia following local anaesthetic injections in children. Brit Dent J 1998;185: 295–8CrossRefPubMedGoogle Scholar
  11. Robinson PJ, Maddalozzo D, Breslin S. A six-month clinical comparison of the efficacy of the Sonicare and Braun Oral-B electric toothbrushes on improving periodontal health in adult periodontitis patients. J Clinical Dent 1997;8: 4–9.Google Scholar
  12. Samaranayake LP. General microbiology and Microbes of relevance to dentistry. In: Samarnayake LP, Jones BM, Scully C editors. Essential Microbiology for Dentistry 2nd ed. Churchill Livingstone; 2002. 1–53 and 93–148.Google Scholar
  13. Seymour RA, Lowry R, Whitworth JM, Martin MV. Infective endocarditis, dentistry and antibiotic prophylaxis; time for a rethink? Brit Dent J 2000;189:610–6.CrossRefPubMedGoogle Scholar
  14. Sharma NC, Galustians HJ, Qaqish J, Cugini M, Warren PR. A comparison of the Braun Oral-B 3D plaque remover and the Sonicare plus electric toothbrush removing naturally occurring extrinsic staining. Americ J Dent 2000;13:17–20.Google Scholar
  15. Steelman R, Einzig S, Balian A, et al. Increased susceptibility to gingival colonization by specific HACEK microbes in children with congenital heart disease. J Clinical Pediatr Dent 2000:25: 91–4.Google Scholar
  16. Van der Weijden GA, Timmerman MF, Versteeg PA, Piscaer M. High and low brushing force in relation to efficacy and gingival abrasion. J Clinical Periodontol 2004: 31(8):620–4.CrossRefGoogle Scholar

Copyright information

© European Archives of Paediatric Dentistry 2007

Authors and Affiliations

  • S. Misra
    • 1
    Email author
  • R. S. Percival
    • 2
  • D. A. Devine
    • 1
  • M. S. Duggal
    • 1
  1. 1.Dept Paediatric DentistryLeeds Dental InstituteLeedsEngland
  2. 2.Dept Oral BiologyLeeds Dental InstituteLeedsEngland

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