The toothbrush is an oral hygiene instrument used to clean the teeth and gums that consists of a head of tightly clustered bristles mounted on a handle, which facilitates the cleansing of hard-to-reach areas of the mouth. Toothpaste, which often contains fluoride, is commonly used in conjunction with a toothbrush to increase the effectiveness of tooth brushing. Toothbrushes are available with different bristle textures, sizes and forms. Most dentists recommend using a toothbrush labelled "soft", since hard bristled toothbrushes can damage tooth enamel and irritate the gums.[1] Toothbrushes have usually been made from synthetic fibers since they were originally developed, although animal bristles are still sometimes used.


A variety of oral hygiene measures have been used since before recorded history.[2] This has been verified by various excavations done all over the world, in which chew sticks, tree twigs, bird feathers, animal bones and porcupine quills were recovered.

A recent archaeological dig has found that the earliest use of toothbrushes may have occurred in India and Africa. It was discovered that a bristle toothbrush had been used there as early as 1600 BC.

The first bristle toothbrush found was in China during the Tang Dynasty (619–907) and used hog bristle.[3][4] In 1223, Japanese Zen master Dōgen Kigen recorded on Shōbōgenzō that he saw monks in China clean their teeth with brushes made of horse-tail hairs attached to an ox-bone handle. The bristle toothbrush spread to Europe, brought back from China to Europe by travellers.[5] It was adopted in Europe during the 17th century.[6] Many mass-produced toothbrushes, made with horse or boar bristle, were imported to England from China until the mid-20th century.[2]

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.[7]

In Europe, William Addis of England is believed to have produced the first mass-produced toothbrush in 1780.[5][8] In 1770, he had been jailed for causing a riot; while in prison he decided that the method used to clean teeth – at the time rubbing a rag with soot and salt on the teeth – was ineffective and could be improved. To that end, he saved a small animal bone left over from the meal he had eaten the previous night, into which he drilled small holes. He then obtained some bristles from one of his guards, which he tied in tufts that he then passed through the holes in the bone, and which he finally sealed with glue. After his release, he started a business that would manufacture the toothbrushes he had built, and he soon became very rich. He died in 1808, and left the business to his eldest son, also called William; the company was continuing, as of the middle of October 2013, to do business under the name of Wisdom Toothbrushes.[9] By 1840 toothbrushes were being mass-produced in England, France, Germany, and Japan.[9] Pig bristle was used for cheaper toothbrushes, and badger hair for the more expensive ones.[9]

The first patent for a toothbrush was by H. N. Wadsworth in 1857 (US Patent No. 18,653) in the United States, but mass production in the United States only started in 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 retains bacteria and does not dry well, and the bristles often fell out. In addition to bone, sometimes handles were made of wood or ivory.[10] In the United States, brushing teeth did not become routine until after World War II, when American soldiers had to clean their teeth daily.[8]

During the 1900s, celluloid handles gradually replaced bone handles in toothbrushes.[3] Natural animal bristles were also replaced by synthetic fibers, 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.[11] As of 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.[2]

Johnson & Johnson, a leading medical-supplies firm, introduced the "Reach" toothbrush in the middle 1980s. It differed from previous toothbrushes in three ways: First, it had an angled head, similar to dental instruments, to reach back teeth; second, the bristles were concentrated more closely than usual to clean each tooth of potentially carigenic (cavity-causing) materials; and third, the outer bristles were longer and softer than the inner bristles, to clean between teeth. 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, and promoted as being, more effective than the basic toothbrush design that had been employed for years.

In January 2003 the toothbrush was selected as the number one invention Americans could not live without according to the Lemelson-MIT Invention Index.[12]

Types of toothbrush

Electric toothbrush

An Electric toothbrush is a tooth brush that performs oscillations or rotations driven by a motor. Most studies report a medical performance equal to the one of manual brushes,[13] the electric version can be more comfortable, an additional timer and pressure sensors can support a correct cleaning process.[14]

Interdental brush

An interdental brush, also called an interproximal brush or a 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 wire of dental braces and the teeth.

There are evidences that, after tooth brushing with a conventional tooth brush, interdental brushes remove more plaque than dental floss.[15]

Brushes are available in a range of widths from 1 to 7, color-coded as per ISO 16409. Interdental brushes are classified according to ISO standard 16409:2006. The ISO brush size is determined by the PHD or Passage Hole Diameter in mm. This PHD is the minimum diameter of a hole that the interdental brush will pass through without deforming the brush wire stem.

Brush Color (coded as per ISO 16409) Brush Size Wire Size Passage Hole Diameter (PHD)
Pink 0 0.4mm
Orange 1 0.45mm <=0.8mm
Red 2 0.5mm 0.9 mm-1.0 mm
Blue 3 0.6mm 1.1 mm-1.2 mm
Yellow 4 0.7mm 1.3 mm-1.5 mm
Green 5 0.8mm 1.6 mm-1.8 mm
Purple 6 1.1mm >1.9 mm
Grey 7 1.3mm
Black 7 1.5mm

End-tufted brush

An end-tufted brush is a type of toothbrush used specifically for cleaning along the gumline adjacent to the teeth. The bristles are usually shaped in a pointed arrow pattern to allow closer adaptation to the gums. An end-tufted brush 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 braces.

Chewable toothbrush

A chewable toothbrush is a miniature plastic moulded toothbrush. While not commonly used they prove to be quite handy to travelers and are sometimes available from bathroom vending machines. 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, can be used without water.

Ecological toothbrushes

Traditionally, toothbrushes are made of plastic. Such brushes constitute a small source of pollution.[16][17] In order to reduce the environmental impact, some manufacturers have switched to using biodegradable materials and/or use replaceable heads.

Adversity of toothbrushes

Teeth can be damaged by several factors including poor oral hygiene, but also by wrong oral hygiene. Especially for sensitive teeth dentin and gums damages can be prevented by several measures[18] including a correct brushing technique.

It is beneficial not to scrub horizontally over the necks of teeth, pressing the brush not too hard against the teeth, not choosing a tooth paste that is too abrasive,[19] and maintain a waiting time of 30 minutes minimum after consumption of acidic food or drinks before brushing.[18][20]

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.[21]

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, like Hepatitis C.[22]
  • After use it is feasible to rinse the toothbrush with water, shake it off and let the toothbrush dry.
  • Tilt 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).

See also

Dentistry portal


External links

  • Interdental Brushes for Better Oral Care
  • American Dental Association statements on Toothbrushing
  • International Toothbrush Collection, a searchable database
  • BBC h2g2 The History of Toothpaste and Toothbrushes
  • Selecting a Toothbrush

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