Microbes-contaminated Toothbrushes in Diabetic Patients: Correlation of Important Factors
DOI:
https://doi.org/10.3329/updcj.v15i2.86378Keywords:
Diabetes mellitus, Toothbrush contamination, Storage condition, Oral hygiene status, Glycemic controlAbstract
Background: Toothbrushes are essential for oral hygiene yet can harbor microorganisms that affect oral and systemic health, particularly in people with diabetes mellitus. This study compared microbial contamination of used toothbrushes from diabetic adults and age- and sex-matched non-diabetic controls and evaluated associated factors.
Materials and Methods: In this cross-sectional study, 120 participants (60 diabetics, 60 non-diabetics) provided used toothbrushes. Each brush head was immersed in 10 mL Brain-Heart Infusion (BHI) broth, incubated 24 h at 37°C, and streaked on Blood and MacConkey agar. Colonies were identified by Gram stain and biochemical tests (catalase, coagulase, oxidase, IMViC series, fermentation). Oral hygiene (Simplified Oral Hygiene Index; OHI-s), storage location, and HbA1c (within 1 month of sampling) were recorded. Percent prevalence and mean CFU/mL (95% CI) were compared using chi-square or t-tests, and multivariate regression identified independent predictors of high contamination adjusting for age and hygiene habits.
Results: Diabetic toothbrushes showed higher bacterial contamination than controls. Escherichia coli prevalence was 71.7% in diabetics versus 58.3% in controls (x², p =0.002); Pseudomonas spp. 78.3% versus 38.3% (x², p <0.001); Staphylococcus aureus 47% versus 18% (x², p =0.005). Poor glycemic control (HbA1c ≥9%) and washroom storage independently predicted heavy contamination (both p <0.01). Bathroom/washroom storage yielded higher contamination than non-bathroom storage E. coli: 86.6% vs 46.6%, p =0.002; Pseudomonas: 80.0% vs 53.3%, p=0.005). Diabetics had poorer oral hygiene (Good: 16.7% vs 31.7%; Poor/Very Poor: 63.3% vs 50.0%; x², p=0.046), and HbA1c >9% was associated with higher bacterial counts (ANOVA p <0.001; Tukey ≥9% vs ≤7%; p <0.001).
Conclusion: Bathroom storage, poor oral hygiene, and inadequate glycemic control were associated with increased toothbrush contamination. Diabetic patients should be advised to disinfect or replace brushes more frequently than the 3-month standard, store them in dry ventilated areas away from toilets, and maintain good glycemic control to reduce infection risk and integrate oral hygiene guidance into diabetes care.
Update Dent. Coll. j: 2025; 15(2): 1-6
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Copyright (c) 2025 Shaheen Ahamed
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