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SARS-CoV-2 can be transmitted, even by asymptomatic individuals, in a number of ways, 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 posted online in The Journal of Infectious Diseases.
As the authors point out in the text, published as a letter to the editor, people infected with SARS-CoV-2 have “high viral loads in saliva, nasopharynx and oropharynx”, which can occur even in asymptomatic people.
Considering that toothbrushes can act as reservoirs for microorganisms and promote the transmission of diseases like COVID-19, the authors believe that the disinfection of brushes would be important to control the transmission of the virus in shared spaces.
A recent study has shown that commercially available mouthwashes can inactivate SARS-CoV-2 in vitro. The results showed that antiseptic solutions containing ethanol and essential oils – exemplified by the brand Listerine Cool Mint, to name but one, had satisfactory effects on reducing viral load.
However, there are still no specific studies evaluating the effectiveness of different mouthwash solutions in disinfecting toothbrushes, nor any randomized trials showing that the use of such solutions would, in clinical practice. , a protective role against the transmission of COVID-19.
Disinfection protocol
As proposed 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 disinfect the surface of its handle again with 70% alcohol for 1 minute
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Leave the brush head immersed in a solution containing ethanol and essential oils for 20 minutes
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Store the brush individually after letting it dry
According to the authors, the steps of disinfecting the toothbrush with 70% alcohol are important when brushing in collective environments, such as at school or in the workplace, and do not require ‘be carried out in the home environment, if they are not desired.
Another important observation made by the authors: Brushes used by individuals known to be positive for SARS-CoV-2 should be discarded immediately after use. the in vitro the studies reviewed for the development of the protocol showed that it was possible to observe a satisfactory reduction in viral load with only 30 seconds of exposure to the test solution. However, it is important to consider that the toothbrush has retentive niches for microorganisms due to its design – hence the recommendation for a longer immersion.
More studies needed
“Toothbrushes play an essential role in oral hygiene, but they can also serve as reservoirs for microorganisms, promoting the transmission of disease in healthy and sick individuals,” write the authors.
Although the in vitro The effectiveness of the ethanol and essential oil solution – as well as that of alternative solutions such as povidone-iodine – has been demonstrated in more than one study, more research is still needed.
“[R]Omitted clinical trials are needed to verify the effectiveness of oral rinsing in preventing the spread of the virus, including evaluation of toothbrush disinfection, ”the authors conclude.
The authors did not reveal any relevant financial relationship.
J Infect Dis. Published online December 28, 2020. Full text
This article originally appeared in the Portuguese edition of Medscape.
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