EVALUATION OF MICROBIAL CONTAMINATION OF TOOTHBRUSHES USED BY STUDENTS
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CHAPTER ONE
INTRODUCTION
- Background to the Study
Tooth brushing plays an important everyday role for personal oral hygiene and effective plaque removal. It is the most commonly recommended and performed oral hygiene behaviour and is done ubiquitously in both developed and developing world. The toothbrush is used on a daily basis to clean the oral cavity. A new toothbrush is usually not a favourable habitat for bacteria and fungi but in some cases, toothbrushes are already slightly infected before use (Downes et al., 2019). The oral cavity contains a teaming population of different types of microorganisms (Mehta et al., 2017), some of which are transferred to a toothbrush during use.
Toothbrushes are shown to be contaminated at the oral cavity environment and from hands, aerosols and the storage environments. The typical storage conditions of toothbrushes may act as a reservoir for the re-introduction of potential pathogens to the oral cavity and for the introduction of other potential pathogens from the bathroom environment. These microorganisms have the potential to colonize the oral cavity due to the micro-trauma that toothbrushing can cause. Bacteria which attach to, accumulate and survive on toothbrushes may be transmitted to the individual, causing disease (Caudry et al., 2015).
Several authors have done works on bacterial and fungal contamination of brushes, with higher or lower contamination being associated with numerous interferences placed between the brush and the handle (Mehta et al., 2017). Toothbrush has been characterized as a means of microbial transport, retention and growth and highly contaminated brushes may cause a possible constant re-infection which is a risk factor for periodontal disease (Goldschmidt et al., 2014). Toothbrushes play an essential role in oral hygiene and are generally found in community and hospital settings. They have been reported to be heavily contaminated with microorganisms when in regular use and may play significant role in disease transmission and increase the risk of infection since they serve as a reservoir for in healthy, oral-diseased and medically-ill adults (Glass, 2012). Contaminated toothbrushes have been suggested to play a role in both systemic and localized diseases. The possibility of toothbrushes being associated with the transmission of heart diseases, arthritis, bacteremia and stroke have also been reported (Sammons et al., 2014). The aim of this study was to isolate, characterize and identify the bacterial contaminants on used manual toothbrushes obtained from some students of the University of Africa, Toru-orua, Bayelsa State, Nigeria.
1.2 Statement of Problem
Recently, the toothbrush has been characterized as a means of microbial transport, retention and growth (Mehta et al., 2017), and highly contaminated brushes may cause a possible constant “reinfection,” which is a risk factor for periodontal disease (Efstratiou et al., 2007) such as bacterial endocarditis, respiratory pneumonia, osteomyelitis in children, preterm low birth weight, and cardiovascular disease (Jørn et al., 2005). This study was carried out to investigate bacterial contamination of used toothbrushes.
1.3 Aims and Objectives of the Study
This study evaluated microbial contamination of toothbrushes used by students.
The objectives of the study is to
- To identify bacteria regularly associated with used toothbrushes
- To determine the microbial load of used toothbrushes.
- To make a recommendation on remedial measures.
1.4 Scope and Limitation
This research worked is based on the isolation and identification of bacteria associated with used toothbrushes. This study covers the total bacteria count, isolation and identification of bacteria. However, it is limited to very few samples and bacterial studies only, because of limited resources.
1.5 Significance of the Study
This study will be useful to all users of toothbrushes by creating awareness of the presence of microorganisms in used toothbrushes. The outcome of this research will guide users on how to avoid contacting micro-organism mostly from used toothbrushes. It is hoped that the result of this study will educate the public on the need for sound oral hygiene through adequate care of their toothbrushes.
This study provides practical guidance which aimed at supporting all health professionals, teachers, pupils, and all users of toothbrushes.
CHAPTER FIVE
5.1. DISCUSSION
A total of thirty used toothbrushes obtained from thirty students of University of Africa, Bayelsa State, Nigeria were examined bacteriologically. The result showed that all of them were contaminated with bacteria as well as the unused toothbrush which served as control. The contamination of the used toothbrushes by bacteria may come from the oral cavity, storage containers, storage environments, the water used for rinsing and the users. Fifty bacterial isolates were identified from the used toothbrushes. The bacteria were Streptococcus mutans, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Enterobacter aerogenes (Table 4.1).
Similarly to organisms isolated from this work, Sammons et al. (2014) isolated Staphylococci, and Pseudomonas from the toothbrushes they examined. While Osho et al. (2013) isolated Escherichia coli, Enterobacter, Staphylococcus aureus, and Pseudomonas aeruginosa from toothbrushes after use. In addition, Malmberg et al. (2014) isolated Streptococci and Staphylococcus epidermidis from toothbrushes after use, while Glass (2014) reported that toothbrushes from both healthy patients and patients with oral disease contained potentially pathogenic bacteria such as Staphylococcus spp, Escherichia coli and Pseudomonas spp. Bello et al. (2013) reported Staphylococcus, Escherichia, and Pseudomonas in used toothbrushes while Contreras et al. (2010) reported that the most frequent microorganisms found in toothbrushes used by parents and children for one month were Enterobacteriaceae and Pseudomonadaceae. Kozai et al. (2019) also reported that Streptococcus mutans and pathogenic microorganisms can be transferred readily when a toothbrush is used, increasing the risk of dental caries and infectious diseases while Nelson et al. (2019) also isolated Streptococcus mutans from used toothbrushes using microbiological identification.
Staphylococcus aureus was most frequently isolated from the used toothbrushes, with a percentage occurrence of 30 % while Enterobacter aerogenes had the lowest percentage occurrence of 6 % on the used toothbrushes examined. Sammons et al. (2014) however isolated Staphylococci (48 %) and Pseudomonas (16 %) from used toothbrushes while (Osho et al., 2013) isolated Escherichia coli (10 %), Enterobacter (10 %), Staphylococcus aureus (20%), Staphylococcus saprophyticus (20 %) and Pseudomonas aeruginosa (40 %). Malmberg et al. (2013) isolated Streptococci (50 %) and Staphylococci (86 %) from used toothbrushes.
Staphylococcus aureus was detected in 30 % of the used toothbrushes examined while Enterobacter aerogenes was isolated from 6 % of the samples studied. Staphylococci are common skin inhabitants. Their presence on the used toothbrushes in high numbers may come from handling and rinsing of the toothbrushes after use. They are known to produce potent toxins which are injurious to health. They are also capable of producing many oral infectious diseases (Tong et al., 2015).
Pseudomonas aeruginosa are opportunistic pathogens responsible for many nosocomial infections. They are also ubiquitous in nature including water. Their presence in used toothbrushes may be attributable to the storage environment such as the bathroom, toilet and washing sinks, rinsing water and the air. The bathroom provides a hum id environment that encourages the growth of Pseudomonas aeruginosa (Abdul-Hassan et al., 1990).
Escherichia coli and Enterobacter aerogenes are coliforms and members of the family Enterobacteriaceae. They are also pathogenic to humans in significant numbers. The presence of Escherichia coli on the toothbrushes examined was indicative of fecal contamination. The used toothbrushes must have been stored in unhygienic environments such as toilet and bathroom sinks. These bacteria may also have entered the toothbrushes through the rinsing water (Caudry et al.,1995).
Streptococci are aetiological agents of tooth decay and are important bacteria found on the teeth, buccal cavity and throat. Streptococcus mutans are known to cause dental caries by metabolizing different carbohydrates on the teeth (Sakamoto et al.,2005). Since they are of oral origin, their presence on used toothbrushes is not surprising. Improper rinsing of the used toothbrushes may have accounted for the growth of the bacteria on the samples. Different brands of toothbrushes are marketed to the public every year with little information on their contamination by bacteria with use. The use of uncontaminated toothbrushes will assist in the maintenance of sound oral hygiene and reduce the health risk posed by the contaminating bacteria to humans (Holt et al., 1994).
5.2. CONCLUSION
It became clear that contamination of toothbrushes occurs often, even in individuals who should know the ideal conditions for the storage of toothbrushes. All the used toothbrushes examined in this study were contaminated with bacteria which are known to cause serious health problems in humans.
5.3. RECOMMENDATIONS
Since toothbrushes serve as reservoirs for microorganisms and play a major role in disease transmission and increase in risk of infections, their care should be given adequate attention. It is recommended that adequate rinsing with sterile water and allowing drying in air before storage in hygienic dry containers. In addition sharing of toothbrushes should be discouraged.
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CHAPTER THREE: The complete chapter three of"evaluation of microbial contamination of toothbrushes used by students "is available. Order full work to download. Chapter three of"evaluation of microbial contamination of toothbrushes used by students "consists of the methodology. In this chapter all the method used in carrying out this work was discussed.
CHAPTER FOUR: The complete chapter four of"evaluation of microbial contamination of toothbrushes used by students "is available. Order full work to download. Chapter four of"evaluation of microbial contamination of toothbrushes used by students "consists of all the test conducted during the work and the result gotten after the whole work
CHAPTER FIVE: The complete chapter five of"evaluation of microbial contamination of toothbrushes used by students "is available. Order full work to download. Chapter five of"evaluation of microbial contamination of toothbrushes used by students "consist of conclusion, recommendation and references.
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