Comparative Evaluation of Chlorhexidine, Citric Acid, and Sodium Chloride Solutions for Toothbrush Decontamination: A Pilot Exploratory Interventional Study

OBJECTIVE: To compare the effectiveness of three commonly used solutions for toothbrush decontamination, namely, 0.12% chlorhexidine gluconate (CHX), 20% citric acid (CA), and 3.5% sodium chloride (NaCl) solutions. MATERIALS AND METHODS: Fifty-one study participants were given toothbrushes and instructed to brush twice daily. The participants were randomly divided into three experimental groups based on the solution used for decontamination-0.12% CHX (Group A), 20% CA (Group B), and 3.5% NaCl (Group C). After 3 months, the toothbrush heads were collected from the participants and the pretest colony-forming units (CFU) counts were determined. They were then immersed in the respective solutions for 7 h, after which the CFU counts were again determined. A Wilcoxon signed-rank test was used to compare the differences in the pretest and posttest CFU counts. A Kruskal-Wallis test was used to compare the mean percentage reduction in CFU counts for samples in the three groups, followed by Dunn-Bonferroni's post hoc test for intergroup comparisons. RESULTS: There was a statistically significant reduction in CFUs in all three groups tested. CA solution (20% concentration) was comparable to the gold standard CHX when it came to CFU reduction (p ≤ 0.05). Both solutions showed a 99.9% reduction in the colony-forming unit count, whereas 3.5% NaCl solution only showed a 12.2% reduction. CONCLUSION: 0.12% CHX and 20% CA solution showed the maximum percentage reduction in CFUs. CA demonstrated potential as an effective toothbrush decontaminant due to its lower cost and safer profile. TRIAL REGISTRATION: Clinical trial registry, India: CTRI/2020/11/028920.