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PubMed1989

[Studies on bacterial contamination of chlorhexidine coated filaments of the toothbrush].

The purpose of the present investigation was to determine bacterial contamination of chlorhexidine coated and uncoated (normal) nylon filaments of toothbrushes. Ten healthy subjects were employed in this study and the test toothbrush of four lines and thirty-eight tufts were used twice a day. Test periods were 1, 8, and 20 days for each filaments of toothbrush and after they brushed the used toothbrush was kept at the constant condition (20 degrees C, 65% RH). After each test period, those toothbrushes were immediately collected and kept at the same condition for drying. After 0, 3, 6, 9, and 24 hours of drying, two tufts of filaments were pulled out from the toothbrush and cutted into two parts (end- and root-side of tufts) by sterile scissors. Each cutted part of filaments was washed with PBS and the aliquots was incubated on Brucella blood agar plate at 37 degrees C for 48 hours. The number of bacteria attached to filaments was enumerated. The results were as follows: 1. The number of bacteria attached to both end- and root-sides of chlorhexidine coated filaments decreased with the time of drying. 2. At the root-side of the normal filaments, the number of contaminated bacteria increased with the test periods. 3. The isolated bacteria from tested toothbrushes were mainly gram positive at shorter period, however, gram negative rods were also found at longer period. 4. The anti-bacterial activity of the end-side of chlorhexidine coated filaments diminished at eight days of the use, however, their activity at the root-side still remained even at twenty days. From these results, it was clear that the bacterial contamination of toothbrush was affected by several factors such as the condition of drying, the site of tufts, the using period of toothbrush and so on. To prevent this problem, it is important to keep it at good storage condition and to change it periodically. The developed chlorhexidine coated filaments of the toothbrush also indicates to be one of the useful way for prevention of bacterial contamination of toothbrush.

Chlorhexidine↗

PubMed1992

Clinical studies regarding the plaque removal efficacy of manual toothbrushes.

Two independent cross-over design studies were performed to compare two toothbrushes for their ability to remove plaque. In Study I, the Colgate Precision toothbrush was compared to the Oral-B 40 toothbrush; in Study II, the Colgate Precision toothbrush was compared to the Reach Full-Head soft toothbrush. A total of 54 and 72 adult male and female subjects who met the inclusion/exclusion criteria completed Study I and Study II, respectively. In each study, subjects refrained from brushing for 24 hours, and were screened for dental plaque on the facial and lingual surfaces of all natural teeth, using the Rustogi, et al. index. Based on mean scores and number of teeth, qualifying subjects were randomly assigned to one of two groups. Subjects were then scheduled to return one week later, having again abstained from all oral hygiene procedures for a 24-hour period. At this visit, each subject was evaluated for plaque, then brushed with his/her assigned toothbrush for sixty seconds, and was again scored for plaque after brushing. Subjects were instructed to resume their normal routine and return to the clinical site one week later. At this visit, a different test toothbrush was assigned to each group in a cross-over design. Plaque evaluations and toothbrushing procedures were again performed. In both studies, the Colgate Precision toothbrush was significantly more effective (p < 0.01) than either the Oral-B 40 toothbrush or the Reach Full-Head soft toothbrush in reducing whole mouth plaque scores, plaque scores at the gumline, and plaque scores at interproximal areas.

Adult↗

PubMed1993

Laboratory and clinical evaluations of the Jordan Exact toothbrush.

A new toothbrush, the Jordan Exact, has been compared with a flat multitufted toothbrush, the Oral-B 35 toothbrush. In a laboratory study the Jordan Exact toothbrush had significantly higher interproximal access, compared to the Oral-B 35, combining all toothbrushing pressures tested, using either vertical or horizontal brushing motions on simulated molar teeth. Clinical safety and efficacy were evaluated in a 30-day single blind study. Evaluations of plaque mean scores were recorded before and after a one minute brushing at baseline, day 15 and day 30. At the same time periods, assessments of irritation, gingivitis and bleeding on probing were conducted. No oral irritation from either toothbrush was observed or reported throughout the test period. At all examinations there were no significant differences in overnight plaque scores. After brushing, an analysis of covariance on plaque area scores revealed that the Jordan Exact toothbrush removed significantly more plaque than the Oral-B 35 toothbrush. By day 30, the Jordan Exact toothbrush significantly reduced gingivitis on buccal surfaces but no significant change was observed in the Oral-B 35 group. Subjects using the Jordan Exact toothbrush had a significant decline in bleeding on probing; subjects in the Oral-B 35 toothbrush group had no significant change over the 30 days of the study.

Adolescent↗

PubMed1996

A six-month clinical evaluation of the Dentrust toothbrush.

Clinical study guidelines have been established by the American Dental Association for assessing plaque and gingivitis reductions with chemotherapeutic agents. Two six-month studies are required. While the toothbrush is also instrumental in plaque and gingivitis reduction, there are currently no study requirements by the ADA for manual brush efficacy. It was thought to apply the long-term efficacy requirements for chemotherapeutic agents to two manual toothbrushes to assess their efficacy for comparative purposes. Forty-eight subjects using the Dentrust toothbrush and forty-five subjects using the Oral-B toothbrush completed a six-month study to assess safety, plaque removal and gingivitis reduction. The subjects were randomly assigned to use either the newly designed (three sided) Dentrust toothbrush or the traditional flat-headed toothbrush. The subjects took their respective toothbrushes home following a baseline evaluation, and were subsequently assessed at three and six months by the same examiners with the same indices in this single-blind trial. There were no significant differences between the two groups on plaque removal during the study. At six months, the Dentrust group removed a significant amount of both buccal and lingual plaque and the flat-headed toothbrush removed a significant amount of buccal plaque only. On gingivitis the groups had no significant differences at baseline; however, by six months the Dentrust group was significantly better than the flat-headed toothbrush on gingivitis reduction. Long-term use of the Dentrust toothbrush can be said to significantly contribute to gingival health overall, and especially in the hard to reach lingual areas compared to long-term use of a traditional flat-head toothbrush.

Adolescent↗

PubMed1998

Effect of brushing with sonic and counterrotational toothbrushes on the bond strength of full veneer crowns.

STATEMENT OF PROBLEM: Earlier studies on orthodontic brackets have shown a loss of bond strength after a sonic toothbrush was used. PURPOSE: This in vitro study evaluated the difference in bond strength of single complete veneer crowns after being subjected to the equivalent of 2 years of brushing with sonic and counterrotational toothbrushes. MATERIAL AND METHODS: Complete gold crowns were fabricated with a conventional indirect technique for 30 extracted, intact, prepared human premolar teeth. Castings were then luted to the teeth with glass ionomer cement. Teeth were randomly divided into 3 groups of 10 teeth each, 1 group to be brushed with Sonicare sonic toothbrush, 1 group to be brushed with Interplak counterrotational mechanical toothbrush, and 1 group as the control. Groups 1 and 2 were then brushed for the equivalent of 2 years per tooth. A uniform force of 50 g for the sonic toothbrush and 120 g for the counterrotational toothbrush was used. Control specimens were not brushed. Brush heads and sample teeth in contact with the toothbrush were kept moist at all times. Tensile dislodgment force was determined with an Instron universal testing machine. RESULTS: The castings brushed with a sonic toothbrush required a mean of 43.22 kg (+/- 11.16) force to remove the crowns from the teeth, whereas the counterrotational group required a mean of 42.87 kg (+/- 10.42) and the control group a mean of 42.12 kg (+/- 6.61). Analysis of variance on the force data indicated no differences among the 3 groups in the force needed to remove the castings (F[2,24] = 0.031, P = .97). CONCLUSION: This in vitro study demonstrated no significant differences between groups in the amount of tensile dislodgment force required to remove cemented full veneer crowns from prepared teeth after brushing for the equivalent of 2 years time with a sonic toothbrush or a counterrotational toothbrush.

Analysis of Variance↗

PubMed1990

Comparative analysis of the plaque removal ability of .007 and .008 toothbrush bristles.

A two-phase study was conducted to compare the plaque-removal effectiveness of a .007 toothbrush and a .008 toothbrush when used in an unsupervised home-care program. In the first phase of the study, two children's toothbrushes, a .007 toothbrush (POH Junior #8) and a .008 toothbrush (Allie-Croc), were compared in a population of third through sixth grade children. The .007 group had a greater reduction of plaque from pretest to post-test than the .008 group in all grades, with statistically significant differences favoring the .007 toothbrush for fourth and sixth grades. In phase two a .007 adult toothbrush (POH #4) was compared to a .008 adult toothbrush (Oral B 40) in a population of nursing and dental hygiene students. Both toothbrushes performed equally well with a significant decrease in plaque and gingival inflammation observed from pretest to post-test regardless of toothbrush used. Any changes in soft-tissue abrasion were negligible and not statistically significant. Based on the results of this study, both brushes appear to be safe and effective and can be recommended with confidence.

Adult↗

PubMed1996

The clinical effect of a newly designed electric toothbrush on supragingival plaque, gingivitis and gingival bleeding.

A clinical study was carried out in an attempt to assess the efficacy of a newly designed electric toothbrush compared to a conventional manual toothbrush using the American Dental Association's protocol for evaluating toothbrushes. An Oral-B 35 manual toothbrush, which served as the control, was compared to the Plaq & White125 electric toothbrush. Examinations were performed by two calibrated examiners at baseline, day 15 and day 30. Examinations included the gingival index, plaque index and bleeding index. Mean indices were calculated and compared between the two brushes using the repeated measures multiple analysis of variance. No statistically significant differences between the mean indices on the three examination days were observed following the use of the manual or the electric toothbrushes. The results of this study demonstrate that the electric toothbrush was numerically more effective than the manual toothbrush in reducing supragingival plaque levels, either before or after brushing, at each examination date compared to baseline plaque values. However, this difference was not statistically significant. This and other findings concluded that the Plaq & White toothbrush is comparable to the control ADA-accepted toothbrush.

Adult↗

PubMed1983

Toothbrush pressures of orthodontic patients.

The intention of this study was to determine whether toothbrushing pressures varied significantly between groups of orthodontic patients who were good toothbrushers and those who were poor toothbrushers. Seventy-two patients undergoing full-banded orthodontic treatment were selected from the author's practice and were subjectively paired by him according to their habitual oral hygiene. One group of thirty-six patients who habitually displayed poor oral hygiene was compared to a group of thirty-six patients who habitually displayed good oral hygiene. A specially designed strain gauge with a force-averaging feedback mechanism was attached to each patient's manual toothbrush, and the force with which that patient brushed was averaged and recorded in pounds. The poor brushers averaged 0.20 pound, whereas the average pressure of the good brushers was 0.89 pound. The statistical evidence indicates that the difference between the two groups is highly significant and is unlikely to be due to chance alone. This study has shown that toothbrush pressures can be easily and accurately measured. The attempt to objectify a single characteristic of toothbrushing behavior in an orthodontic population is an effort to avoid the medical model explanation of behavior vis-a-vis the nonspecific and subjective word attitude. Future studies will determine whether poor toothbrushers can be changed into good toothbrushers through the progressive acquisition of greater toothbrushing forces.

Humans↗

PubMed1996

Effectiveness of three different types of electric toothbrushes compared with a manual technique in orthodontic patients.

Patients undergoing orthodontic treatment with fixed appliances are at risk of developing carious white spot lesions and gingival inflammation because of the challenge of oral hygiene. The purpose of this study was to evaluate under home conditions the effectiveness of three different types of electric toothbrushes during active appliance therapy: Interplak (Bausch & Lomb, Berlin, Germany), Rota-dent (Rota-dent, Kusnacht, Switzerland), and Braun Oral-B Plaque Remover (Braun/Oral-B, Kronberg, Germany). A manual technique, which included normal toothbrush, interdental brush, and dental floss, served as reference. The study was structured as a single-blind "Latin square design" study. Thirty-eight orthodontic patients were randomly allocated to groups who, within the test period, alternately used the toothbrushes. Before getting a new toothbrush that was to be used for a period of 4 weeks, each patient received video and written instructions. For another 4 weeks, the patient returned to the usual oral hygiene procedures before receiving the next new toothbrush. Oral hygiene was evaluated at the start of a new test period and after 2 and 4 weeks. Clinical scores included a modified O'Leary Plaque Index and Ainamo Gingival Bleeding Index. Wilcoxon rank testing for aggregated surfaces revealed statistically significantly lower plaque scores for Rota-dent than for the manual technique (p < 0.01). For all other toothbrushes, no differences were found in comparison to the manual technique. For Plaque Indices of specific sites, statistical analysis revealed all electric toothbrushes to be equal to the manual technique. No differences in Gingival Bleeding Indices were found after 4 weeks with either toothbrush. Patients with poor oral hygiene who used Rota-dent and Braun Oral-B Plaque Remover OD5 had statistically significantly lower plaque scores compared with the manual technique (p < 0.01; p < 0.05); for patients with good oral hygiene, these differences were neutralized. It may be concluded that electric toothbrushes of the new generation are a real alternative to the often laborious manual tooth cleaning procedures used during active appliance therapy. Patients with poor oral hygiene may benefit from them especially because plaque removal can be achieved easier and faster.

Adolescent↗

PubMed1996

Effect of toothbrush wear on plaque control.

The purpose of this study was to investigate the effect of progressive toothbrush wear on plaque control. At baseline (week 0), each of 20 subjects was given a new toothbrush which they used for the 9-week period of the study. At weeks 0, 3 and 6, all plaque was professionally removed. The amount of plaque which accumulated in each of the 3 successive 3-week experimental periods was assessed at weeks 3, 6 and 9. Toothbrush wear was evaluated by measuring the increase in the brushing surface area of toothbrushes at weeks 3, 6 and 9 as compared with week 0. The brushing surface area was measured by computer analysis of tracings of the brushing surface outlines obtained from standardized photographs. Despite progressive toothbrush wear, the amount of plaque which accumulated in each successive 3-week period decreased. The decrease in plaque scores between weeks 3 and 6 and between weeks 3 and 9 were found to be highly significant (p < 0.001). Toothbrush wear varied widely amongst the subjects. When plaque scores were evaluated for the 10 subjects with highest toothbrush wear, and the 10 with lowest wear, no significant differences were found between the 2 subgroups. Under the experimental conditions of this study, progressive toothbrush wear did not lead to a decrease in plaque control. The improvement in plaque scores may have been due to motivational effects resulting from study participation and anticipation of oral examinations. It was concluded that the wear status of a toothbrush may not be critical in ensuring optimal plaque control.

Adult↗

PubMed1996

Toothbrushing force in relation to plaque removal.

This was a 2-part study. The purpose of the 1st part was to examine the relationship between brushing force and plaque removal efficacy comparing a regular manual toothbrush (M) with an electric toothbrush the Braun/Oral-B Plak Control (B). The study consisted of a single oral prophylaxis followed by 5 experiments which differed solely in respect to toothbrushing force. At baseline (after 24-h plaque accumulation), the amount of dental plaque was evaluated and subsequently, the subject's mouth was brushed by a dental hygienist. Brushing was carried out in a random split-mouth order. Either the 1st and 3rd quadrants or the 2nd and 4th quadrants were brushed with 1 toothbrush and the 2 remaining quadrants with the other. The available time for the brushing procedure was 2 min. After brushing, the amount of remaining dental plaque was assessed. The force used in experiment 1 through 5 was 100, 150, 200, 250, 300 g, respectively. The results show that when brushing force is increased, more plaque is removed with either of the two brushes. Except for the high brushing force (300 g), the electric toothbrush removed more plaque than the manual brush. The purpose of the 2nd part was to evaluate the habitual brushing force which individuals use with various toothbrushes. Besides a manual toothbrush (M), 3 electric toothbrushes were examined, the Rotadent (R), Interplak (I) and Braun (B). 20 subjects were selected on the basis of being 'good brushers' (plaque score at screening < 25%). At baseline, each subject randomly received 1 of the 4 brushes. They were allowed a training period of 3 weeks at the end of which they were asked to abstain from brushing for at least 24 h. The plaque (Turesky modification of the Quigley & Hein) was scored, after which the subjects brushed their teeth (2 min) with the assigned toothbrush equipped with a strain gauge. A computer set-up measured (100 Hz) and calculated the mean brushing force. After brushing, the amount of remaining plaque was assessed. The design of the study was a 4-way cross-over. The results show that with a manual brush, considerably more force is used than with the electric brushes (R = 96, I = 119, B = 146, M = 273). No significant relation between brushing force and plaque removal was demonstrated for any of the brushes.

Cross-Over Studies↗

PubMed1996

Comparative single-use plaque removal by toothbrushes of different designs.

Overall literature reviews have concluded that no one design of the manual toothbrush is superior for plaque removal. More recently, a toothbrush with filaments angled away from the head was shown to be more effective in several single-use studies than conventional designs. The aim of this study was to compare plaque removal by this new toothbrush and 3 other toothbrushes which had more conventional filament arrangements. 36 volunteers participated in this single-blind, randomised, 4-cell, crossover single use toothbrushing study. On day 1 of each period, volunteers brushed with a standard toothbrush and toothpaste for 60 s and then suspended oral hygiene for 48 h. On day 3, volunteers were scored for plaque by area and then brushed with the allocated test toothbrush with toothpaste for 60 s and plaque area was rescored. A washout of 4 days was allowed between test periods. The plaque areas were used to record the binary scores of the Rustogi et al. modification of the modified Navy plaque index but away from the clinic employing the Claydon and Addy procedural method for the index. Plaque removal scored by area and site were not significantly different between the brushes. This study is at variance with previous similar investigations which suggested that the new design of toothbrush head was superior for plaque removal. It is concluded again that there are no data which demonstrate unequivocally that any one manual toothbrush design is superior to any other for plaque removal.

Adult↗

PubMed1998

A comparison of two electric toothbrushes with respect to plaque removal and subject preference.

PURPOSE: To compare the safety and plaque removal efficacy, and subject preference of two electric toothbrushes in a single-blind, randomized, split-mouth study. MATERIALS AND METHODS: The devices studied were the Braun Oral-B 3D Plaque Remover and the sonicare electric toothbrush. The 3D toothbrush combines the clinically proven oscillating/rotating action of the D9 with a sonic frequency pulsating action in the direction of the long axis of the bristles, giving a three-dimensional cleaning action. At an initial visit, the subjects (n = 44) were given a baseline examination of the oral soft tissues and a full mouth prophylaxis and instructed in the use of the two products, which was followed by a 4-week training period. After 2 weeks of using each toothbrush on alternate days, brushing technique was checked. After a further 2 weeks, having abstained from oral hygiene for 48 hours, two contralateral quadrants of the mouth were randomly assigned to be cleaned by the subjects with each toothbrush. Plaque assessments and soft tissue examinations were made before and after brushing. Plaque was evaluated according to a refinement of the Modified Navy Plaque Index. At the end of the study, subjects completed a product evaluation questionnaire. RESULTS: Plaque levels were significantly reduced by both toothbrushes (P = 0.001), but the efficacy of the 3D electric toothbrush was significantly greater than that of the sonicare toothbrush (P = 0.001) for all comparisons. Plaque reduction was particularly marked in the interproximal areas, reaching 87% with the 3D product, compared with 68% for sonicare (P = 0.001). In the responses to the questionnaire, the majority of subjects stated that they preferred the 3D toothbrush (88% vs 12%), mainly because of the smaller size of the brush, ease of control and overall maneuverability.

Adult↗

PubMed1989

[Toothbrush holder for a day-care center].

A recent investigation of the various oral hygiene activities in 23 day-care centers located in the district administered by the Verdun Community Health Department has highlighted the need for a standardized hygienic method of storing toothbrushes. The study proposed to identify the main criteria related to hygiene that must be observed in order to prevent the transmission of contagious diseases within a day-care center, through the use of toothbrushes or toothbrush holders. Furthermore, the toothbrush holder has to meet four requirements: (1) be inexpensive; (2) be easy to build or manufacture; (3) allow the storage of 15 toothbrushes at the same time; (4) permit easy identification of the toothbrush by the child or teacher. A review of the literature, together with an assessment of toothbrush holders presently used by day-care centers in the district administered by the Verdun Community Health Department, showed that there were none which completely satisfied the required criteria. Under these circumstances, the authors of the study propose a detailed plan for the construction of a toothbrush holder that will satisfy these requirements. The toothbrush holder can be used to promote dental health to the very young. A sponsor could present it as a gift to one or more day-care centers in order to demonstrate their interest in the prevention of dental disease among these children.

Child Day Care Centers↗

PubMed1989

[Effectiveness of power toothbrushes].

Three power toothbrushes with different mechanical principles (blend-a-dent master-vertical oscillating system, blend-a-dent medic electric elliptical oscillating system, interplak-contra-rotationsystem of the bristle-tuft) and a conventional hand toothbrush were investigated in 60 oral hygiene-motivated persons in a three-month-study. Efficiency was tested by two parameters (plaque index, papillary-bleeding index) under statistically identical conditions. The study showed no major differences in efficiency between the power toothbrushes and the manual toothbrush. --For the whole study the power toothbrush with an elliptical oscillating system showed the best results. --Power toothbrushes are not more effective in plaque removal than a manual toothbrush. The great statistical variation of the investigated parameters in each group shows that an optimal brushing technique was more important than the choice of a certain toothbrush. --The investigation of the interproximal areas showed that a toothbrush alone is not effective enough. The additional use of dental floss and/or interdental cleaners for optimal oral hygiene is essential.

Analysis of Variance↗

PubMed1994

Laboratory evaluations of toothbrush interproximal penetration ratios.

Access to interproximal tooth surfaces by toothbrush bristles has been associated with plaque removal. The ability of toothbrushes to assess the interproximal area was assessed with a new laboratory apparatus by measuring the extent of bristle-to-tooth contact in simulated toothbrushing with ink-coated toothbrush bristles. Toothbrush types evaluated were the bi-level trim Advanced Design Reach Soft, the ripple trim Crest Complete Large Soft, the flat trim Colgate Plus Full Head Adult Soft, and the flat trim Oral-B 35. Six replicates of each toothbrush were tested. Denture teeth in a Columbia Dentoform, mounted at 45 degrees, were brushed at a 300 g brushing weight for 15 horizontal strokes. Tooth #15 (upper left second molar) was then removed for measurement and the interproximal distance of ink deposition was determined under 10x magnification from the plane of the buccal contour, along the mesial side of the tooth in the lingual direction at the approximate vertical midpoint of the proximal surface. This was compared in ratio to the same measurement from the buccal contour to the midline. Mean penetration ratios were 0.84 for the Advanced Design Reach, 0.79 for Crest Complete, and 0.78 for both Colgate Plus and Oral-B 35 (overall standard error = 0.01). A one-way ANOVA showed a highly significant difference (p < 0.001) demonstrating that Advanced Design Reach penetrated significantly farther than the toothbrushes with flat or ripple trim bristle patterns. The data suggest the bi-level trim in the Advanced Design Reach toothbrush offers better penetration into the area between teeth, and may provide superior clinical or plaque removal compared to the other toothbrushes tested.

Analysis of Variance↗

PubMed1993

A clinical comparison of plaque removal performance of three manual toothbrushes.

A clinical study was performed to evaluate and compare the plaque-removal performance of a recently introduced, computer-designed manual toothbrush with that of two commercially available products; the Oral-B 40 and the Reach Full-Head soft toothbrushes. Seventy-five adult male and female subjects participated, each refraining from toothbrushing for twenty-four hours. Plaque was scored according to the Rustogi, et al. refinement of the Modified Navy Plaque Index. Following screening, the subjects were divided into three balanced groups on the basis of initial plaque scores. Each group, in an alternate weekly cross-over design, used each of the three toothbrushes. At Visit 1, each group, having refrained from toothbrushing for twenty-four hours, was evaluated for plaque before brushing for sixty seconds with the assigned toothbrush, after which plaque was again scored. At Visit 2 one week later, the same procedure was followed except for the assignment of a different toothbrush. The same procedure was employed for Visit 3. On completion of the study, the data were subjected to statistical analyses which indicated that the Colgate Precision Full Head soft toothbrush removed significantly more plaque than either of the other two toothbrushes.

Adult↗

PubMed1998

Persistence of group A beta-hemolytic streptococci in toothbrushes and removable orthodontic appliances following treatment of pharyngotonsillitis.

OBJECTIVE: To investigate the persistence of group A beta-hemolytic streptococci (GABHS) in toothbrushes and removable orthodontic appliances (ROAs) in children who suffer from acute GABHS pharyngotonsillitis and the association with penicillin treatment failure. SETTING: Private practice setting. PATIENTS AND METHODS: Pharyngotonsillar and toothbrush cultures were obtained from 104 children with acute GABHS pharyngotonsillitis before and after 10 days of penicillin V potassium therapy. Cultures of ROAs were also obtained from 21 children. The persistence of GABHS in 10 daily rinsed and 10 nonrinsed toothbrushes was studied in vitro. RESULTS: Group A beta-hemolytic streptococci were isolated from 11 (11%) of the toothbrushes and 18 (17%) of the patients after the completion of penicillin therapy. Toothbrushes of 5 (28%) of the 18 children who harbored GABHS were colonized with the organism. Group A beta-hemolytic streptococci were also isolated from 4 (19%) of 21 ROAs after therapy. In vitro studies illustrated the persistence of GABHS in nonrinsed toothbrushes for up to 15 days. In contrast, the organism was not isolated from rinsed toothbrushes beyond day 3. CONCLUSION: Toothbrushes and ROAs that harbor GABHS may contribute to the persistence of GABHS in the oropharynx and may account for the failure of penicillin therapy in some cases of pharyngotonsillitis.

Child↗