Is it safe to use a toothbrush?

Abstract

Aim. To systemically collect and summarize the literature on case reports concerning adverse events associated with the oral use of a toothbrush. Materials and methods. Two electronic databases were searched for articles published up to October 2013 to identify appropriate studies using focused search terms and ‘case reports’ as a filter. Results. A comprehensive search identified 419 unique titles and abstracts. Ninety-four studies met the eligibility criteria. In total, 118 subjects (age range = 1–60 years) presented adverse events related to the oral use of a toothbrush. Events could be summarized in five categories, of which ingestion was the most reported problem among the individuals (50 cases). This was followed by impaction of a toothbrush (27 cases). Reports more frequently involved females and children were more likely to have injuries compared to males and adults. Most of the cases that presented with adverse events of the oral use of a toothbrush were referred for treatment to a physician. Conclusions. The combined evidence related to serious adverse events as presented in case reports showed that the oral use of a toothbrush can be associated with ingestion, impaction, instant trauma, gingival traumatic injury and seizures. Given the incidence of reporting, important recommendations are that a toothbrush should not be used to induce vomiting, nor should people walk or run with this device in their mouths, especially children.

Key Words::

• toothbrushing
• adverse events
• trauma
• ingestion
• impaction

Acknowledgments

Sara Cioccari Oliveira received an educational grant from the Foundation for Post-Graduate Education (CAPES), grant number 12601128, Brasília, Brazil. Dagmar Else Slot and Fridus van der Weijden are funded by their own institution. The authors would like to thank Joost Bouwman, head librarian of the ACTA, for providing most of the papers used in this study, as well as Mauro Trein Leite for sharing his knowledge while preparing this manuscript.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.