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{{for|a song by [[DNCE]]|Toothbrush (DNCE song)}}

[[File:Toothbrush x3 20050716 001.jpg|thumb|Toothbrushes]]

The '''toothbrush''' is an [[oral hygiene]] instrument used to clean the [[teeth]], [[gums]], and [[tongue]]. It consists of a head of tightly clustered [[bristle]]s mounted on a [[handle (grip)|handle]] which facilitates the cleaning of hard to reach areas of the mouth.

Toothbrushes are available with different bristle textures, sizes, and forms. Most [[dentist]]s recommend using a soft toothbrush since hard bristled toothbrushes can damage [[tooth enamel]] and irritate the [[gingiva|gums]].<ref>[http://www.ada.org/sections/publicResources/pdfs/orallongevity_brochure.pdf "Oral Longevity," American Dental Association brochure (PDF), page 2] Retrieved June 12, 2008</ref>

==History==
[[File:Napoleon’s toothbrush, c 1795. (9660576547).jpg|thumb|right| The [[horsehair]] toothbrush was said to have been used by [[Napoleon Bonaparte]] (1769-1821)]]
Before the invention of the toothbrush a variety of [[oral hygiene]] measures had been used.<ref name=sammons-223>{{cite book | last=Sammons | first=R. | chapter=Control of dental plaque | title=Medical biofilms detection, prevention and control | year=2003 | publisher=John Wiley & Sons | location=Chichester | page=223 | isbn=978-0-471-98867-0}}</ref> This has been verified by excavations in which [[chew stick]]s, tree [[twig]]s, bird [[feather]]s, animal [[bone]]s and [[porcupine]] quills were recovered.

The predecessor of the toothbrush is the [[teeth cleaning twig|chew stick]]. Chew sticks were twigs with frayed ends used to brush the teeth<ref name="origins"/> while the other end was used as a toothpick.<ref name="dentalb">{{cite book|last=Yu|first=Hai-Yang|last2=Qian|first2=Lin-Mao|last3=Zheng|first3=Jing|title=Dental Biotribology|url=https://books.google.com/books?id=tsSqVeaHUv0C&pg=PA19|year=2013|publisher=Springer|isbn=978-1-4614-4550-0|pages=18–19}}</ref> The earliest chew sticks were discovered in Babylonia in 3500 BC,<ref name="dentalb"/> an Egyptian tomb dating from 3000 BC,<ref name="origins"/> and mentioned in Chinese records dating from 1600 BC. The Greeks and Romans used toothpicks to clean their teeth and toothpick like twigs have been excavated in [[Qin Dynasty]] tombs.<ref name="dentalb"/> Chew sticks remain common in Africa<ref> ''[[salvadora persica]]''</ref> the rural Southern United States<ref name="origins">{{cite book|last=Panati|first=Charles|title=Extraordinary Origins of Everyday Things|url=https://books.google.com/books?id=U662rR2VInQC&pg=PA208|year=2013|publisher=HarperCollins|isbn=978-0-06-227708-4|pages=208–209}}</ref> and in the Islamic world the use of chewing stick [[Miswak]] is considered a pious action and has been prescribed to be used before every prayer five times a day.<ref name="IslamKotob">IslamKotob, ''Muslims and Science'', (Islamic Books), p.30.</ref> Miswaks have been used by Muslims since 7th century.

The first bristle toothbrush resembling the modern one was found in China. Used during the [[Tang Dynasty]] (619–907), it consisted of hog bristles.<ref name=kumar-412413>{{cite book | last=Kumar | first=Jayanth V. | title=Textbook of preventive and community dentistry | year=2011 | publisher=Elsevier | isbn=978-81-312-2530-1 | pages=412–413 | edition=2nd | chapter=Oral hygiene aids}}</ref><ref>{{cite book | title=Primary preventive dentistry | year=1999 | publisher=Appleton & Lange | location=Stamford | isbn=978-0-8385-8129-2 | edition=5th |editor1=Harris, Norman O. |editor2=García-Godoy, Franklin }}</ref> The bristles were sourced from hogs living in Siberia and northern China because the colder temperatures provided firmer bristles. They were attached to a handle manufactured from bamboo or bone, forming a toothbrush.<ref name="origins"/> In 1223, Japanese [[Zen]] master [[Dōgen|Dōgen Kigen]] recorded on [[Shōbōgenzō]] that he saw monks in [[China]] clean their teeth with brushes made of horsetail hairs attached to an oxbone handle. The bristle toothbrush spread to Europe, brought from China to Europe by travellers.<ref name="The Library of Congress">{{cite web|publisher=The Library of Congress|date=2007-04-04|url=http://www.loc.gov/rr/scitech/mysteries/tooth.html|title=Who invented the toothbrush and when was it invented?|accessdate=2008-04-12}}</ref> It was adopted in Europe during the 17th century.<ref name="stay">{{cite book | last=Stay | first=Flora Parsa | title=The fibromyalgia dental handbook: A practical guide to maintaining peak dental health | year=2005 | publisher=Marlowe & Company | location=New York | isbn=978-1-56924-401-2 | page=118}}</ref> The earliest identified use of the word toothbrush in English was in the autobiography of [[Anthony Wood]] who wrote in 1690 that he had bought a toothbrush from J. Barret.<ref>{{cite book|last=Olmert|first=Michael|title=Milton's teeth & Ovid's umbrella : curiouser and curiouser adventures in history|publisher=Simon & Schuster|location=New York|isbn=0-684-80164-7|year=1996|page=62}}</ref> Europeans found the hog bristle toothbrushes imported from China too firm and preferred softer bristle toothbrushes made from horsehair.<ref name="origins"/> Mass produced toothbrushes made with horse or boar bristle continued to be imported to England from China until the mid 20th century.<ref name=sammons-223/>
[[File:'Indexo' finger toothbrush, New York, United States, 1901-19 Wellcome L0058113.jpg|thumb|'Indexo' finger toothbrush, New York, United States, 1901-19.
It is made entirely of rubber, which has been shaped to fit over the index finger.
]]
[[Image:Toothbrush1899Paris.jpg|thumb|left|upright|A photo from 1899 showing the use of a toothbrush.]]

In Europe, [[William Addis (entrepreneur)|William Addis]] of England is believed to have produced the first mass produced toothbrush in 1780.<ref name="The Library of Congress"/><ref name=Dentistry>{{cite web|url=http://inventors.about.com/od/dstartinventions/a/dentistry_2.htm|title=History of the Toothbrush and Toothpaste|author=Mary Bellis|work=About.com Money}}</ref> In 1770, he had been jailed for causing a riot. While in prison he decided that using a [[textile|rag]] with [[soot]] and [[salt]] on the teeth was ineffective and could be improved. After saving a small [[bone]] from a meal, he drilled small holes into it and tied in tufts of bristles that he had obtained from one of the guards, passed them through the holes in the bone, and sealed with glue. After his release, he became wealthy after starting a business manufacturing toothbrushes. He died in 1808 leaving the business to his eldest son. It stayed in family ownership until 1996.<ref>{{cite web|url=http://www.addis.co.uk/our-history|title=History of ADDIS|work=addis.co.uk}}</ref> Under the name Wisdom Toothbrushes, the company now manufactures 70 million toothbrushes per year in the UK.<ref>[http://www.cambridge-news.co.uk/Cambridge/New-jobs-joy-in-toothbrushes.htm "New jobs joy in toothbrushes"], cambridge-news.co.uk</ref> By 1840 toothbrushes were being mass produced in England, France, Germany, and Japan.<ref name=Addis>[http://www.wisdom-toothbrushes.co.uk/learning-centre/history.html The company founded by Addis in 1780]</ref> Pig bristles were used for cheaper toothbrushes and badger hair for the more expensive ones.<ref name=Addis/>

The first [[patent]] for a toothbrush was granted to H.N. Wadsworth in 1857 (US Patent No. 18,653) in the United States, but mass production in the United States did not start until 1885. The rather advanced design had a bone handle with holes bored into it for the Siberian [[boar]] hair bristles. Unfortunately, animal bristle was not an ideal material as it retained [[bacteria]], did not dry well, and the bristles often fell out. In addition to bone, handles were made of wood or ivory.<ref>{{cite web|url=http://www.ada.org/1321.aspx |title=Toothbrushes - American Dental Association |publisher=ADA.org |date=2010-02-04 |accessdate=2013-05-03}}</ref> In the United States, brushing teeth did not become routine until after [[World War II]], when American soldiers had to clean their teeth daily.<ref name=Dentistry/>
[[Image:Toothbrush teaching 1.jpg|thumb|right|A child being shown how to use a toothbrush.]]

During the 1900s, celluloid gradually replaced bone handles.<ref name=kumar-412413/> Natural animal bristles were also replaced by [[synthetic fiber]]s, usually [[nylon]], by [[DuPont]] in 1938. The first nylon bristle toothbrush made with nylon yarn went on sale on February 24, 1938. The first [[electric toothbrush]], the Broxodent, was invented in Switzerland in 1954.<ref>{{cite web|url=http://www.loc.gov/rr/scitech/mysteries/tooth.html|title=Who invented the toothbrush and when was it? (Everyday Mysteries: Fun Science Facts from the Library of Congress)|work=loc.gov}}</ref> By the turn of the 21st century nylon had come to be widely used for the bristles and the handles were usually molded from [[thermoplastic]] materials.<ref name=sammons-223/>

[[Johnson & Johnson]], a leading medical supplies firm, introduced the "[[Reach (brand)|Reach]]" toothbrush in 1977.<ref name="tribune1991">{{cite news|last=Lazarus |first=George |date=1991-08-13 |title=P&G Puts Its Crest On A Toothbrush |url=http://articles.chicagotribune.com/1991-08-13/business/9103280368_1_toothbrush-market-procter-gamble-crest |dead-url=no |newspaper=[[Chicago Tribune]] |location=[[Chicago]] |archive-url=http://www.webcitation.org/6ekMoEePo?url=http%3A%2F%2Farticles.chicagotribune.com%2F1991-08-13%2Fbusiness%2F9103280368_1_toothbrush-market-procter-gamble-crest |archive-date=2016-01-23 |access-date=2016-01-23 |df= }}</ref> It differed from previous toothbrushes in three ways: it had an angled head, similar to dental instruments, to reach back teeth; the bristles were concentrated more closely than usual to clean each tooth of potentially [[Dental caries|cariogenic]] (cavity-causing) materials; and the outer bristles were longer and softer than the inner bristles {{cn-span|to better clean between teeth|date=March 2017}}.
The Reach toothbrush was the first to have a specialized design intended to increase its effectiveness. Other models from other manufacturers soon followed. Each of these had unique design features intended to be more effective than the previous design.

In January 2003, the toothbrush was selected as the number one invention [[United States|Americans]] could not live without according to the [[Jerome H. Lemelson|Lemelson]]-[[Massachusetts Institute of Technology|MIT]] Invention Index.<ref>{{cite web|url=http://web.mit.edu/invent/n-pressreleases/n-press-03index.html|title=2003 Invention Index|accessdate=2009-05-20|date=2003-01-21}}</ref>

==Types of toothbrush==

===Electric toothbrush===
{{main article|Electric toothbrush}}
[[File:So Many Choices (11693539025).jpg|thumb|Various electric toothbrush heads]]

It has been discovered that compared to a manual brush, the multi-directional power brush does the better job in reducing gingivitis and plaque. These brushes tend to be more costly but can be more effective in reducing plaque and gingivitis. {{citation needed|date=September 2015}}
An [[electric toothbrush]] performs rotations of its bristles and cleans hard to reach places. Most studies report a performance equal to that of a manual brush,<ref name="pmid21154357">{{cite journal|last=Deacon|first=SA|author2=Glenny, AM |author3=Deery, C |author4=Robinson, PG |author5=Heanue, M |author6=Walmsley, AD |author7= Shaw, WC |title=Different powered toothbrushes for plaque control and gingival health.|journal=The Cochrane database of systematic reviews|date=Dec 8, 2010|issue=12|pages=CD004971|doi=10.1002/14651858.CD004971.pub2|pmid=21154357 |volume=56}}</ref> the electric version can be more comfortable. An additional timer and pressure sensors can encourage a more efficient cleaning process.<ref name="pmid21985880">{{cite journal|last=Kallar|first=S|author2=Srivastava, N |author3=Pandit, IK |author4= Gugnani, N |title=Plaque removal efficacy of powered and manual toothbrushes under supervised and unsupervised conditions: A comparative clinical study|journal=Journal of Indian Society of Pedodontics and Preventive Dentistry|date=1 January 2011|volume=29|issue=3|pages=235–8|doi=10.4103/0970-4388.85832|pmid=21985880}}</ref>
Electric toothbrushes can be classified, according to the speed of their movements as: standard power toothbrushes, sonic toothbrushes, or [[ultrasonic toothbrush]]es. Any electric toothbrush is technically a power toothbrush. If the motion of the toothbrush is sufficiently rapid to produce a hum in the [[audible frequency]] range (20&nbsp;Hz to 20,000&nbsp;Hz), it can be classified as a sonic toothbrush. Any electric toothbrush with movement faster than this limit can be classified as an ultrasonic toothbrush. Certain ultrasonic toothbrushes, such as the Megasonex and the Ultreo, have both sonic and ultrasonic movements.

===Interdental brush===
[[Image:TePe Interdental Brushes original.jpg|thumb|Interdental Brushes]]
An interdental or interproximal ("proxy") brush is a small brush, typically disposable, either supplied with a reusable angled plastic handle or an integral handle, used for cleaning between [[teeth]] and between the wires of [[dental brace]]s and the teeth.

There is evidence that after tooth brushing with a conventional tooth brush, interdental brushes remove more plaque than [[dental floss]].<ref name="pmid22726785">{{cite journal|title=As an Adjunct to Tooth Brushing, Interdental Brushes (IDBs) are More Effective in Removing Plaque as Compared with Brushing Alone or the Combination Use of Tooth Brushing and Dental Floss|year=2012|last1=Gluch|first1=Joan I.|journal=Journal of Evidence Based Dental Practice|volume=12|issue=2|pages=81–3|doi=10.1016/j.jebdp.2012.03.016|pmid=22726785|issn=1532-3382}}</ref>

The size of interdental brushes is standardized in [[ISO]] 16409.<ref name="ISO 16409:2010">ISO 16409:2006 + Amd.1:2010, ''Dentistry - Oral hygiene products - Manual interdental brushes''</ref><ref name="ISO 16409:2014">ISO/[[Draft International Standard|DIS]] 16409:2014, ''Dentistry - Oral hygiene products - Manual interdental brushes'' (draft standard)</ref> The brush size,<ref>Different versions of the standard specify different brush sizes.</ref> which is a number between 0 (small space between teeth) and 8 (large space), indicates the ''passage hole diameter''. This corresponds to the space between two teeth that is just sufficient for the brush to go through without bending the wire. The color of the brushes differs between producers. The same is the case with respect to the wire diameter.<ref>In contrast to wrong information on several websites (as well as in old editions of Wikipedia) neither the brush color nor the wire diameter are specified in ISO 16409:2010 or ISO/DIS 16409:2014. Just some general properties of the wire (e.g., should not bend) or specifications of the packaging (e.g., the brush size must be noted) can be found there.</ref>

{| class="wikitable"
|+Brush size according to ISO 16409<ref name="ISO 16409:2010" />
|-
! Brush size
| 0<ref>Brush size 0 still can be found in ISO 16409:2010, however, it is no more specified in ISO/DIS 16409:2014 (as of December 2015).</ref> || 1<ref>Brush size 1 has passage hole diameter ≤&nbsp;0,8 according to ISO/DIS 16409:2014 (as of December 2015).</ref> || 2 || 3 || 4 || 5 || 6 || 7<ref name = "according to ISO 16409:2014">Sizes 7 and 8 according to ISO/DIS 16409:2014 (as of December 2015).</ref> || 8<ref name="according to ISO 16409:2014" />
|-
! Passage hole diameter in mm
| ≤&nbsp;0,6 || 0,7–0,8 || 0,9–1,0 || 1,1–1,2 || 1,3–1,5 || 1,6–1,8 || 1,9–2,3 || 2,4–2,8 || ≥&nbsp;2,8
|}

===Sulcabrush===

A Sulcabrush is a type of toothbrush used specifically for cleaning along the gumline adjacent to the [[tooth|teeth]]. The bristles are usually shaped in a pointed arrow pattern to allow closer adaptation to the gums. A Sulcabrush is ideal for cleaning specific difficult-to-reach areas, such as between crowns, bridgework and crowded teeth. End-tufted brushes may also be used around fixed orthodontic appliances, such as [[dental braces|braces]].

===End-tuft brush===

The small round brush head comprises seven tufts of tightly packed soft nylon bristles, trimmed so the bristles in the center can reach deeper into small spaces. The brush handle is ergonomically designed for a firm grip, giving the control and precision necessary to clean where most other cleaning aids cannot reach.<ref>{{cite web|url=http://www.gumbrand.com/end-tuft-toothbrush-308rqb.html|title=GUM® End-Tuft Toothbrush - Official Site for GUM® Toothbrushes|work=GUM® Brand}}</ref> These areas include the posterior of the wisdom teeth (third molars), orthodontic structures (braces), crowded teeth, and tooth surfaces that are next to missing teeth. It can also be used to clean areas around implants, bridges, dentures and other appliances.<ref>{{cite web|url=https://sites.google.com/site/flossingandinterdentalaids/end-tuft-brush|title=End Tuft Brush - Flossing and interdental aids|work=google.com}}</ref>

===Chewable toothbrush===
[[Image:chewabletoothbrush.jpg|thumb|Chewable toothbrushes]]
A chewable toothbrush is a miniature plastic moulded toothbrush which can be placed inside the mouth. While not commonly used they are useful to travelers and are sometimes available from [[bathroom]] [[vending machine]]s. They are available in different flavors such as mint or bubblegum and should be disposed of after use. Other types of disposable toothbrushes include those that contain a small breakable plastic ball of toothpaste on the bristles, which can be used without water. {{citation needed|date=March 2016}}

===Ecological toothbrushes===
Commonly, toothbrushes are made of plastic. Such brushes constitute a source of pollution.<ref>{{cite web|url=http://www.greenecoservices.com/green-and-healthy-mouths-toothbrushes/|title=Green and Healthy Mouths- Toothbrushes|author=Cathy|work=greenecoservices.com}}</ref><ref>{{cite web|url=http://environment.about.com/od/earthtalkcolumns/a/toothbrush.htm|title=Can You Recycle Your Toothbrush?|author=Larry West|work=About.com News & Issues}}</ref> In order to reduce the environmental impact, some manufacturers have switched to using [[biodegradable]] materials and/or use replaceable heads.<ref>{{cite web|url=http://www.bostonglobe.com/business/2012/09/26/building-better-toothbrush/ATlyLiQdE4LMIenqoliQQL/story.html|title=Building a better toothbrush - Business - The Boston Globe|work=BostonGlobe.com}}</ref> In order to avoid plastic altogether alternative toothbrushes on offer consist of wooden handles (often bamboo) and bristles of [[bamboo viscose]] or pig bristles.

==Adversity of toothbrushes==
Teeth can be damaged by several factors including poor oral hygiene, but also by wrong oral hygiene. Especially for sensitive teeth, damage to dentin and gums can be prevented by several measures<ref name="PreventiveMeasures">{{cite journal|last=Magalhães|first=AC|author2=Wiegand, A |author3=Rios, D |author4=Honório, HM |author5= Buzalaf, MA |title=Insights into preventive measures for dental erosion.|journal=Journal of applied oral science : revista FOB|date=Mar–Apr 2009|volume=17|issue=2|pages=75–86|doi=10.1590/S1678-77572009000200002|issn=1678-7757|pmid=19274390}}{{open access}}</ref> including a correct brushing technique.

It is beneficial not to scrub horizontally over the necks of teeth, not to press the brush too hard against the teeth, to choose a toothpaste that is not too abrasive,<ref>{{cite journal | last1 = Lussic | first1 = A. | last2 = Jaeggi | first2 = T. | year = 2008 | title = Erosion—diagnosis and risk factors | url = | journal = Clin Oral Investig | volume = 12 | issue = Suppl 1| pages = 5–13 | doi = 10.1007/s00784-007-0179-z |PMC=2238777 | pmid=18228059}} {{open access}}</ref> and to wait at least 30 minutes after consumption of acidic food or drinks before brushing.<ref name="PreventiveMeasures" /><ref>{{cite journal | last1 = Cheng | first1 = R | last2 = Yang | first2 = H | last3 = Shao | first3 = M | last4 = Hu | first4 = T | last5 = Zhou | first5 = X | last6 = Zhejiang | first6 = J | year = 2009 | title = Dental erosion and severe tooth decay related to soft drinks: a case report and literature review; | url = | journal = Univ Sci B. | volume = 10 | issue = 5| pages = 395–399 | doi = 10.1631/jzus.B0820245 | PMC=2676420 | pmid=19434767}} {{open access}} "It is concluded that keeping tooth unbrushed for at least 30 min after an erosive attack is necessary for protecting dentin"</ref>
Harder tooth brushes reduce plaque more efficiently but are more stressful to teeth and gum, using a medium to soft tooth brush for a longer cleaning time was rated to be the best compromise between cleaning result and gum and tooth health.<ref>{{cite journal | last1 = Zimmer | first1 = S | last2 = Öztürk | first2 = M | last3 = Barthel | first3 = CR | last4 = Bizhang | first4 = M | last5 = Jordan | first5 = RA | date = Feb 2011 | title = Cleaning efficacy and soft tissue trauma after use of manual toothbrushes with different bristle stiffness | url = | journal = J Periodontol | volume = 82 | issue = 2| pages = 267–71 | doi = 10.1902/jop.2010.100328 }} {{open access}}</ref>

A study by [[University College London]] found that advice on brushing technique and frequency given by 10 national dental associations, toothpaste and toothbrush companies, and in dental textbooks was inconsistent.<ref>{{cite news |url=http://medicalxpress.com/news/2014-08-teeth-dentists-dental-associations-dont.html |title=What's the best way to brush teeth? Even dentists and dental associations don't agree |newspaper=Medical Xpress |date=7 August 2014 |accessdate=8 August 2014}}</ref>

==Hygiene and care==
* It is not recommended to share toothbrushes with others since besides general hygienic concerns there is a risk of transmitting diseases that are typically transmittable by blood, such as [[Hepatitis C]].<ref>Lock, G., Dirscherl, M., Obermeier, F., Gelbmann, C. M., Hellerbrand, C., Knöll, A., Schölmerich, J. and Jilg, W. (2006), Hepatitis C – contamination of toothbrushes: myth or reality?. Journal of Viral Hepatitis, 13: 571–573. {{doi|10.1111/j.1365-2893.2006.00735.x}}</ref>
* After use it is advisable to rinse the toothbrush with water, shake it off and let the toothbrush dry.
* Bent and worn out bristles of a toothbrush lead to decreased cleaning efficiency. It is therefore recommended to change it for a new one when it appears to be worn out (roughly after 6–16 weeks).{{citation needed|date=June 2016}}

==References==
{{Reflist|32em}}

==External links==
{{Commons+cat|Toothbrush|Toothbrushes}}

*[https://web.archive.org/web/20070404144834/http://www.ada.org/prof/resources/positions/statements/toothbrush.asp American Dental Association statements on Toothbrushing]
*[http://www.bbc.co.uk/dna/h2g2/A2818686 BBC h2g2 The History of Toothpaste and Toothbrushes]

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[[Category:Chinese inventions]]
[[Category:Dental equipment]]
[[Category:Domestic implements]]
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[[Category:Oral hygiene]]

Revision as of 18:22, 4 April 2017

Brush ya teeth yo