SARS-CoV-2 can be transmitted in various ways, even from asymptomatic individuals, including droplets, aerosols, and, to a lesser extent, fomites.
Now Brazilian researchers have evaluated the use of these products in a toothbrush disinfection protocol, they report in an article published online in The Journal of Infectious Diseases.
As emphasized by the authors in the text, published as a letter to the editor, individuals infected with SARS-CoV-2 have ‘high viral load in saliva, nasopharynx and oropharynx’, which can occur even in asymptomatic people.
Since toothbrushes can serve as reservoirs for microorganisms and favor the transmission of diseases such as COVID-19, the authors estimate that disinfection of the brushes will be important in controlling the transmission of the virus in shared spaces.
A recent study showed that commercially available mouthwashes can deactivate SARS-CoV-2 in vitro. The results showed that antiseptic solutions containing ethanol and essential oils were illustrated by the brand Listerine Cool Mint, to name one – had satisfactory effects in reducing the virus load.
However, there are no specific studies evaluating the efficacy of different mouthwash solutions for toothbrush disinfection, nor are there any randomized trials showing that the use of such solutions in clinical practice will play a protective role against COVID transmission. 19 not.
Disinfection protocol
As suggested by the authors after a review of the available data on the subject, the disinfection of toothbrushes should follow the following steps:
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Wash your hands with soap and water or disinfect them with 70% alcohol
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Disinfect the surface of the toothbrush handle with 70% alcohol for 1 minute
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Brush your teeth
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Wash the brush and re-disinfect its handle surface with 70% alcohol for 1 minute
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Immerse the brush head in a solution containing ethanol and essential oils for 20 minutes.
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Store the brush separately after drying
According to the authors, the steps for disinfecting the toothbrush with 70% alcohol are important when brushing in collective environments, such as in schools or in the workplace, and do not need to be performed in the domestic environment.
Another important note by the authors: brushes used by individuals known to be positive for SARS-CoV-2 should be discarded immediately after use. The in vitro studies checked for the effect of the protocol showed that it was possible to observe a satisfactory reduction in viral load with only 30 seconds of exposure to the tested solution. However, it is important to keep in mind that the toothbrush has a conservative niche of microorganisms due to its design – hence the recommendation to immerse it longer.
More studies needed
“Toothbrushes play an essential role in oral hygiene, but they can also serve as reservoirs for microorganisms, which benefit the transmission of diseases to healthy and sick individuals,” the authors write.
Although the in vitro Efficacy of the solution of ethanol and essential oils – as well as that of alternative solutions such as povidone-iodine – has been shown in more than one study, more research is still needed.
“[R]”Chartered clinical trials are needed to verify oral flushing effectiveness to prevent the spread of the virus, including evaluating the brushing of toothbrushes,” the authors conclude.
The authors did not disclose any relevant financial relationships.
J Infected Dis. Published online on December 28, 2020. Full text
This article originally appeared in the Portuguese edition of Medscape.
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