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SARS-CoV-2 can be transmitted, even from asymptomatic people, 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 published online in The journal of infectious diseases.
As the authors emphasize in the text, published as 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 favor the transmission of diseases such as COVID-19, the authors estimate that disinfecting brushes would be important to control the transmission of the virus in shared spaces.
A recent study showed 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 Fresh Listerine MintTo name one, it had satisfying effects in reducing viral load.
However, there are still no specific studies evaluating the effectiveness of different mouthwash solutions in disinfection of toothbrushes, nor randomized trials that demonstrate that the use of such solutions would have, in clinical practice, a protective role against the transmission of COVID-19.
Disinfection protocol
As the authors propose after a review of the available data on the subject, disinfection of toothbrushes should follow the following steps:
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Wash your hands with soap and water or disinfect with 70% alcohol
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Disinfect the surface of the toothbrush handle with 70% alcohol for 1 minute.
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Brushing teeth
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Wash the brush and perform a new disinfection of the handle surface with 70% alcohol for 1 minute.
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Leave the brush head immersed in a solution with ethanol and essential oils for 20 minutes.
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Store the brush individually after allowing it to dry.
According to the authors, the steps to disinfect the toothbrush with 70% alcohol are important when brushing is performed in collective settings, such as schools or the workplace, and it is not necessary to perform them in the home environment, if not wanted.
Another important observation made by the authors: Brushes used by people known to be SARS-CoV-2 positive 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 tested solution. However, it is important to consider that the toothbrush has retentive niches for microorganisms due to its design, hence the recommendation of immersion for a longer time.
More studies are needed
“Toothbrushes play a fundamental role in oral hygiene, but they can also act as reservoirs for microorganisms, favoring the transmission of diseases in healthy and sick individuals,” the authors write.
Although the in vitro The efficacy 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]Andomized clinical trials are needed to verify the efficacy of mouthwash in preventing the spread of the virus, including the evaluation of toothbrush disinfection, “the authors conclude.
The authors have declared no conflict of interest.
J Infect Dis. Published online December 28, 2020. Full text
This article originally appeared in the Portuguese edition of Medscape.
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