11 Gross Things That Could Be On Your Toothbrush

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Before you brush today, consider this: Poop is just the beginning of what could possibly be hanging out on your toothbrush.

1. E. COLI

Guess what? If your bathroom has the sink and toilet in one room, and you flush with the lid open, there is fecal matter on everything within a 5 to 6 foot radius. Flushing aerosolizes your poop, depositing bacteria like Escherichia coli, or E. coli, directly onto your toothbrush—and brushing with an E. coli-loaded instrument could make you sick. “This bacteria is associated with gastrointestinal disease,” says Dr. Maria Geisinger, DDS, an assistant professor and periodontist at the University of Alabama at Birmingham.

Gastroenteritis, or infectious diarrhea, is one such illness. “In bathrooms with a toilet attached, [researchers] looked at toothbrushes in normal use between one and three months,” Geisinger says. “At the three-month mark, they found E. coli colonies. That’s a good reminder to replace your toothbrush every three months.”

Once E. coli and the other bacteria on this list form colonies, they’re a lot harder to kill because “they start to make an extracellular matrix, which protects them from antimicrobial medicines that you might use in the toothpaste, mouthwash, and even antibiotics,” Geisinger says. “One of the reasons you can’t just take an antibiotic and say ‘oh good, my dental disease is cured’ is because they’re actually in a biofilm.”

The colonies on your toothbrush are similar to the algae that grows at the bottom of the pool, according to Geisinger. “Your pool is full of water—you can’t just swish it around and get that algae off,” Geisinger says. “It’s got to be scrubbed off because it’s protected by this extracellular matrix. In fact, complex biofilms have a circulatory system. So they’re almost like a living organism, composed of all this different bacteria.”

So make sure to flush with the lid down, which will greatly decrease aerosolization, and, therefore, the literal crap on your toothbrush. Also, be sure to wash your hands after you use the restroom and before you brush to avoid transferring fecal matter to your toothbrush that way, Geisinger says, and change your toothbrush every three months.

2. STAPHYLOCOCCUS AUREUS

This bacteria typically lives in your respiratory tract and on your skin, and, under the right conditions, can be responsible for some pretty nasty stuff. “It’s often associated with [antibiotic resistant] MRSA infections or necrotizing fasciitis, which is flesh-eating bacteria,” Geisinger says. Necrotizing fasciitis occurs when bacteria enters the skin through an open wound, and, according to the CDC, most often affects people who have other health problems that might hinder their bodies’ efforts to fight infection. Thankfully, this condition very rare, but you still don’t want the stuff that could cause it on your toothbrush.

3. STREPTOCOCCUS MUTANS

It makes sense that this bacteria would be on your toothbrush—it’s responsible for tooth decay. “But again, we’d like it not to be there,” Geisinger says. “You don’t want to take tooth decaying material from one area of your mouth and put it in another while you’re trying to do your due-diligence about removing deposits.”

Keeping bacteria and other nasty stuff to a minimum on your toothbrush could be as simple as what you buy. According to one study, “Toothbrushes with lighter or clear bristles retain up to 50 percent less bacteria than colored toothbrush bristles,” Geisinger says, potentially because clear toothbrush bristles have less porosity than colored ones. And instead of brushes with fancy perforated or rubber handles, opt for solid plastic handles which studies have shown “had less microbio load than larger or perforated or multi-surface handles [because there are] fewer nooks and crannies for the bacteria to hide in,” Geisinger says.

4. FOOD DEBRIS

That thing you had for dinner last night? Yeah, it’s probably still on your toothbrush the next morning … and now it’s food for the bacteria on there, too! (As are your poop particles. Yuck.) Avoid having unintentional leftovers and clear out bacteria by washing your brush before it goes in your mouth in potable tap water or antibacterial mouth rinse, Geisinger says.

5. AND 6. LACTOBACILLUS and PSEUDOMONAS

“These are two bacteria that have been associated with pneumonia type infections, particularly in hospital settings” where a patient is on a ventilator, Geisinger says. Though Lactobacillus is typically considered a “friendly” bacteria—it’s sometimes used to treat diarrhea and is present in foods and our own guts—it can also be linked to cavities and tooth decay. Pseudomonas can cause eye infections if you use contacts and don't clean them adequately.

Bacteria thrives on brushes that have frayed bristles, by the way, so Geisginer (and the American Dental Association) recommend replacing your toothbrush if the bristles are looking like they’ve seen better days—even if you haven’t hit the three-month mark yet.

7. HERPES SIMPLEX TYPE ONE

And now, a virus! “Herpes simplex type one used to be called oral herpes, but now almost 50 percent of genital lesions are also herpes simplex type one,” Geisinger says. “The viruses are different than bacteria because they come in little capsules, and they’re not technically alive—they need your cells to replicate. In a patient who has an active herpes outbreak, an oral cold sore, that virus can be retained on the toothbrush up to a week.”

Geisinger says she's not aware of any research into "the viability of the viruses on the toothbrushes," but says that transfer of a virus from one person to another by sharing toothbrushes is a possibility under the right circumstances. "HSV can be transmitted in saliva, so sharing toothbrushes during an oral herpes outbreak could lead to a higher risk transfer of viral particles and therefore disease," she says.

8. HPV

Another virus that can make a home on your toothbrush is Human papillomavirus, or HPV. “It’s linked to both cervical cancer and esophageal and oral cancers,” Geisinger says. “The interesting thing about HPV is that the presence of HPV in your mouth seems to decrease if you do a good job with toothbrushing.” And once again, if you share toothbrushes with someone who has HPV, you could be at risk for contracting it yourself. "Both viruses are transmissible in saliva," Geisinger says, "so viral transmission through shared toothbrushes is a possibility."

9. CANDIDA

This fungus is responsible for yeast infections and diaper rash. The most common species in the mouth is called Candida albicans, which causes oral thrush—basically, a yeast infection in your mouth. “[C. albincans] is linked to higher decay rates in kids,” Geisinger says. “In kids that have candida infections, about 15 percent have candida reservoirs on their toothbrush, and it can certainly be passed among siblings or other toothbrushes stored in the same area.” To keep candida from infecting multiple toothbrushes, make sure that the instruments are stored upright and away from each other.

10. MOISTURE

According to Geisinger, one of the worst things you have on your toothbrush is moisture because it encourages bacteria to grow. “There’s a precipitous drop in bacteria [on toothbrushes] after about 24 hours, and that’s really because the toothbrush dries out," she says. "So, if you can, having two toothbrushes is probably advantageous.” If you’re using a toothbrush just once every 24 hours, it will stay nice and dry, and bacterial loads will be low.

Another thing you shouldn’t do: Cover your toothbrush. “Even though it’s tempting because of the fecal matter from the toilet, covering toothbrushes or putting them in your medicine cabinet does not allow them to dry out,” Geisinger says. “Bacterial counts on those toothbrushes are considerably higher than on toothbrushes that are stored upright, separate, and allowed to dry completely.”

11. BLOOD

Up to 70 percent of adults in the United States have gingivitis, and about 47 percent of people over the age of 30 have destructive gum disease. "That means they have ulcerations or microscopic breaks in the tissue underneath the gum lines where they can’t see, which allows blood to get on the toothbrush,” Geisinger says. “It also allows a pathway for bacteria to get into the bloodstream. In patients with inflammation, bacteria in your bloodstream spike after things that would irritate those inflammations—including mastication, eating, toothbrushing, even a visit to your dentist to have a cleaning.” That’s how dental and oral bacteria end up in plaques that are associated with heart disease.

“The amount of bacteria in the bloodstream is actually proportional to how much inflammation and dental disease is present in the mouth,” Geisinger says. “Patients who are receiving regular dental care—that includes dental cleaning and exams—have improved levels of gingival inflammation, less blood in their saliva, and less blood on their toothbrush. So go see your dentist!”

This piece originally ran in 2016.

Nike Is Releasing a Durable Slip-On Sneaker Designed for Medical Professionals

monkeybusinessimages/iStock via Getty Images
monkeybusinessimages/iStock via Getty Images

Nike is known for releasing footwear that covers just about every activity under the moon—impact-absorbing running shoes, sleek soccer cleats, snazzy fashion statements, and so much more. Now, they’ve developed a sneaker for nurses, doctors, and other medical professionals who spend long shifts on their feet.

According to a press release, Nike sent designers to the OHSU Doernbecher Children’s Hospital in Portland, Oregon, where they learned from healthcare providers exactly what their jobs entail. Then, they used their findings to create the Nike Air Zoom Pulse, a “traditional clog made athletic.”

nike air zoom pulse
Nike

If you’ve ever gone sightseeing in a new city or even just taken a longer-than-expected afternoon stroll, you might have experienced firsthand that even your most comfortable walking shoes stop being so comfortable after a few miles of non-stop action—and nurses experience that type of exercise every time they go to work. During a regular 12-hour shift, a nurse might walk between four and five miles and sit for less than an hour. To account for that, the Nike Air Zoom Pulse features a full-rubber outsole, a flexible drop-in midsole, arch support, and a “heel fit so secure [that] it feels like a soft, snug hug.”

nike air zoom pulse
Nike

Since healthcare professionals also need a shoe durable enough to withstand spills of any kind, Nike coated the top of the Air Zoom Pulse with a polyurethane layer that’s easy to wipe down. It’s also a laceless slip-on, so people won’t have to worry about tripping on untied laces—and they’ll also be able to slip their shoes off for a quick nap in the staff room.

nike air zoom pulse
Nike

Six patients at the OHSU Doernbecher Children’s Hospital have contributed vibrant, colorful designs for the Air Zoom Pulse, which Nike will release for online orders (in versions that include its own colorways) starting December 7.

9 Facts About Narcolepsy

Korrawin/iStock via Getty Images
Korrawin/iStock via Getty Images

Everyone experiences occasional daytime sleepiness, but just a small fraction of the population knows what it’s like to have narcolepsy. The disorder is defined by persistent drowsiness throughout the day, and in some cases, sleep paralysis, hallucinations, and the sudden loss of muscle control known as cataplexy. Having narcolepsy can make doing everyday activities difficult or dangerous for patients, but unlike some chronic conditions, it’s also easy to diagnose and treat. Here are some facts you should know about the condition.

1. There are two types of narcolepsy.

If everything you know about narcolepsy comes from movies and TV, you may think of it as the disease that causes people to go limp without warning. Sudden loss of muscle control is called cataplexy, and it’s the defining symptom of type 1 narcolepsy. Type 2 narcolepsy, on the other hand, is mainly characterized by fatigue. Losing motor function while awake isn’t a problem for those with type 2.

2. Type 1 narcolepsy stems from a chemical deficiency.

Almost every patient with type 1 narcolepsy has low levels of hypocretin. Hypocretin is a neurochemical that regulates the wake-sleep cycle. When there isn’t enough of this chemical in the brain, people have trouble staying conscious and alert throughout the day. Most people with the second, less severe type of narcolepsy have normal hypocretin levels, with about a third of them producing low or undetectable amounts. Type 2 narcoplepsy has been studied far less than type 1 of the disorder, and scientists are still figuring out what causes it.

3. The exact causes of narcolepsy aren’t always clear.

So why do some people’s brains produce less hypocretin than others? That part has been hard for scientists to figure out. One possible explanation is that certain autoimmune disorders cause the body to attack the healthy brain cells that make this chemical. This disorder can be the result of genetic and environmental factors. Although people with narcolepsy rarely pass it down to their offspring (this happens less than 1 percent of the time), the sleep condition does occasionally crop up in family clusters, suggesting there is sometimes a genetic component at play. Head trauma that impacts the area of the brain responsible for governing sleep can also lead to narcolepsy in rare cases.

4. There are tests to diagnose narcolepsy.

If patients believe they might have narcolepsy, their doctors might ask them to detail their sleep history and keep a record of their sleep habits. There are also a few tests potential narcoleptics can take to determine if they have the condition. During a polysomnography test, patients spend the night at a medical facility with electrodes attached to their heads to monitor their breathing, eye movement, and brain activity. A multiple sleep latency test is similar, except it gauges how long it takes patients to fall asleep during the day.

5. Strong emotions can trigger cataplexy.

Cataplectic spells can sometimes be predicted by triggers. In some patients, feeling strong emotions—whether they’re crying, laughing, angry, or stressed—is all it takes for them to lose muscle control. These triggers vary from patient to patient, and they can even affect the same person randomly. Some people deal with them by avoiding certain situations and closing themselves off emotionally, which can disrupt their social lives.

6. Narcolepsy can make sleep terrifying.

Narcoleptics don’t just worry about their disorder during their waking hours. When they’re trying to fall asleep at night or wake up in the morning, narcolepsy can complicate things. One symptom is experiencing vivid, dream-like hallucinations while transitioning in or out of consciousness. These visions are often scary and may involve an intruder in the room with the sleeper. If they happen as the patient falls asleep, the hallucinations are called hypnagogic, and if they occur as they wake up, they’re hypnopompic.

A related symptom is sleep paralysis. This happens when a person’s brain cuts off muscle control of their body before they’re fully asleep or as they’re waking up. This combined with hypnagogic or hypnopompic nightmares can cause frightening experiences that are sometimes confused for real encounters.

7. Narcoleptics sometimes do activities half-asleep.

To outside observers, narcolepsy is sometimes hard to spot. A narcoleptic patient overcome by sleepiness won’t necessarily pass out in the middle of what they’re doing. Some act out “automatic behavior,” which means they continue with their actions—whether that’s walking, driving, or typing—with limited consciousness. This can cause poor performance at work or school, and in worst case scenarios, accidents while driving a car or operating machinery.

8. Harriet Tubman may have had narcolepsy.

One of the most famous likely narcoleptics in history is Harriet Tubman. The African American abolitionist was known to suffer from what were probably sudden narcoleptic episodes. The condition may have stemmed from the severe head trauma she sustained when a slave master threw an iron at another slave and hit her instead. The injury left her with permanent brain damage: In addition to narcolepsy, she also experienced chronic seizures and migraines throughout her life.

9. Medications and lifestyle changes are common narcolepsy treatments.

Though there’s no way to cure narcolepsy completely, there are many treatment options available. Taking medication is one of the most common ways to manage the disorder. Stimulants such as modafinil and armodafinil can be used to combat mild sleepiness, while amphetamines are often prescribed for more severe forms of fatigue. For hallucinations and sleep paralysis, selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors—drugs that suppress REM sleep—can help.

As an alternative or supplementary treatment to medications, doctors may recommend lifestyle changes. Sticking to a sleep schedule, exercising regularly, avoiding nicotine and alcohol, and taking naps during the day can all reduce the symptoms of narcolepsy.

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