Good oral health is a key part of staying healthy and is a sign of overall well-being. Therefore, maintaining good oral hygiene is very important. The oral cavity is free of microorganisms at birth because the fetus develops in sterile conditions. Gradually, the oral cavity is colonized by various groups of microorganisms. ¹
Toothbrushes play an important role in maintaining oral hygiene by removing plaque which helps to prevent gum disease and dental caries. Despite its benefits, toothbrushes can become contaminated from multiple sources like, the oral cavity itself, environment in which the brush is kept, human hands, and the container in which the brush is stored. Thus, many individuals are left wondering if a toothbrush cover offers any real hygienic benefit. Although toothbrush covers are widely available, it remains unclear if they provide any benefit or is simply a marketing strategy.
The toothbrush becomes contaminated after we use it for the first time, and the level of contamination increases when we use it continuously.2 There are many factors that lead to contamination of brushes, including humidity, environment in bathroom, and if not properly stored. When we use plastic cover it increases the humidity around the bristles which makes the condition favorable for bacterial growth.
Toothbrush bristles require exposure with air to dry properly and covering them immediately after use prevents this natural drying process. If a toothbrush cover is used, it should be removed after brushing, rinsed thoroughly, and allowed to dry completely before being reused.
Placing a cap on a wet toothbrush immediately after use is not recommended because it creates a moist, enclosed environment that promotes the growth and survival of bacteria and fungi. The cap traps moisture, which prevents the bristles from air drying properly.
Research has shown that toothbrushes kept in closed containers or placed on contaminated surfaces have more bacteria than those left open to air. Using a cap to cover toothbrushes also helps bacteria survive. Studies have found that high humidity and moisture increase bacterial survival, with bacteria living for more than 24 hours in moist conditions. Toothbrush storage plays an important role in bacterial growth, as toothbrushes kept in open, well-ventilated areas have fewer bacteria, while those stored in plastic or moist, covered environments can show up to 70% more bacterial growth.3
These findings highlight the importance of proper storage conditions in reducing microbial contamination.
A toothbrush cap is acceptable only when the toothbrush is completely dry and for short-term use, such as during travel. For everyday use at home, storing the toothbrush upright and uncovered to air-dry is the healthiest option.
According to research, infected toothbrushes could endanger the health of those who are immunosuppressed, reinfect those who already have chronic periodontal disease, and possibly even reintroduce bacteria into healthy mouths of individuals. Centers for Disease Control and Prevention guidelines state that those with compromised immune systems would need to look for different ways to maintain their oral hygiene because even after giving toothbrushes a full rinse with tap water, some potentially harmful organisms may still be present. Researchers have proposed a relationship between the flu, sore throats, recurrent colds, and infected toothbrushes. It makes sense to consider methods to reduce or stop microorganisms from growing and spreading on toothbrushes, given the research that suggests oral bacteria may contribute to heart attacks, diabetes, and preterm delivery.4
In addition to proper storage, toothbrushes should never be shared, as sharing can transfer harmful bacteria and viruses and spread infections or dental disease among family members. Toothbrushes should be rinsed thoroughly with water after each use to remove debris and toothpaste residue. Regular replacement of toothbrushes every three months, or sooner after illness, is also recommended to maintain optimal oral hygiene.
1. Filho PN, Macari S, Faria G, et al. Microbial contamination of toothbrushes and their decontamination. https://www.aapd.org/globalassets/media/publications/archives/filho-22-05.pdf. Pediatr Dent. 2000;22(5):381–384.
2. Manohar R, Venkatesan K, Raja S, Ganesh A, Kanakasabapathy BS. Assessment of Microbial Contamination of a Toothbrush Head with and without a Protective Cover: An Ex Vivo Study. Int J Clin Pediatr Dent. 2022 Jul-Aug;15(4):455-457. doi: 10.5005/jp-journals-10005-2403. https://ijcpd.com/abstractArticleContentBrowse/IJCPD/5/15/4/31047/abstractArticle/Article
3. Frazelle MR, Munro CL. Toothbrush contamination: a review of the literature. Nurs Res Pract. 2012;2012:420630. doi: 10.1155/2012/420630. https://pubmed.ncbi.nlm.nih.gov/22315679/
4. Sharma S, Tandon S, Rai TS, Mathur R, Rathore AS, Gupta S. Don't Rush with Your Brush: An In Vitro Study on Toothbrush Hygiene. Int J Clin Pediatr Dent. 2024 Feb;17(2):162-167. doi: 10.5005/jp-journals-10005-2776. https://pubmed.ncbi.nlm.nih.gov/39184888/
