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

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.