How many toothbrushes do you own? Well, many a people will say I have one. But for how long have you used it? This is a question most people have never bothered to think about. While most people own a toothbrush and brush at least two to three times a day, many take months using the same toothbrush.

Well if you are one of those people who use the same toothbrush for months without discarding it, then you need to think twice because you are seated on a health time bomb.

Health experts warn that using an old toothbrush is as bad as not brushing teeth at all since both compromise oral hygiene.

According to Dr Isaac Kalisa, a dentist at Kigali Health Institute, using the same toothbrush for ages wears out its tough bristles due to friction leaving a surface incapable of applying the necessary force to scrub the enamel clean.

"Some bristles fall out and clearly, a toothbrush without bristles has a scrubbing force similar to that of a sponge. Imagine filling a sponge with water to scrub a hard surface free of solid dirt,” he explains.

Dr Kalisa adds that with such worn out brushes; individuals only create room for bacteria within the mouth that eventually yields an unpleasant odour due to rotting of food debris which remain under the teeth.

The dentist therefore advises that since toothbrushes are affordable, it should be routine to replace them after a fortnight if sufficient oral hygiene is to be maintained.

"I always tell my patients to change their tooth brush after fourteen days. Besides you should not have one toothbrush in a home,” he adds.

Burden of cavities

Ordinarily, when food is eaten, it is broken down into smaller particles within your mouth. To clear these residues, brushing followed by thorough rinsing is expected to clear the food residues.

Unfortunately due to poor dental practices such as using old brushes, a film of old food forms on the surface of teeth. Bacteria ferment this and eventually cavities are formed.

Globally, 60–90 percent of school children and nearly 100 per cent of adults have dental cavities while severe periodontal (gum) disease, which may result in tooth loss, is found in 15–20 per cent of middle-aged (35-44 years) adults.

About 30 per cent of people aged 65–74 have no natural teeth.

The 2015 Tokyo Declaration on Dental Care and Oral Health for Healthy Longevity compels government to establish systems that ensure sufficient dental hygiene and health care as part of efforts to eradicate non-communicable diseases by 2030.

However, Rwanda still faces a challenge of shortage of dentists, according to the Rwanda Dental Association. With a population of 11.8 million people, 1 dentist serves one million people.

There are 11 dentists working in the countryside, among which only 1 has a master’s degree level; and 17 dentists are foreigners.

To avert some of these problems, individuals are required to maintain, the minimum standards of oral hygiene.

Replace old toothbrushes

The average price of a toothbrush on the local market is about Rwf800 while other materials for dental hygiene such as mouthwash and dental floss go for 3000 and 1,200 respectively.

Dr Achile Manirakiza, a trainee in Clinical Oncology at Mubimbili in Tanzania reiterates that every one can afford a new toothbrush and old ones should be discarded from washrooms.

"With such brushes, dirt only remains clogged within the teeth and nothing big in terms of hygiene is achieved. A new toothbrush can provide the maximum health requirements,” he explains.

Manirakiza also suggests that individuals should regularly, examine the conditions of bristles and determine whether they pose any health threat.

"It is important to examine the condition of the bristles regularly. I believe dental brushes should be replaced more than four times in a year,” he adds.

Use the right toothpaste

The other important thing that dental experts suggest is that people need to consider selecting appropriate types of toothpaste.

Most tooth pastes on the market contain ingredients such as abrasives to remove stains and plaque and polish the teeth; detergents to create the foaming action that dislodges food debris and bacterial plaque; humectants that give toothpaste its texture and retain moisture while thickeners improve texture.

According to the World Health Organization, maintaining a constant low level of fluoride in the oral cavity can prevent dental cavities.

Dr Kalisa also explains that it is important for individuals to look at the ingredients on the toothpaste and select that which has a reasonable concentration of fluoride.

"The fluoride is needed to keep teeth in proper shape. When buying tooth paste, it is important to read the labels carefully then choose one which has a reasonable concentration of fluoride,” he explains.

To supplement such views, a study published in the Journal of Dental Research showed that adults who spent more than 75 percent of their lifetime living in environments exposed to fluoride experienced 30 percent less tooth decay compared to those who had lived less than 25 percent of their lifetime in similar environments.

Dr Jean Marie Vianney Kayinamura, a dentist at Kabutare hospital warns that when poor choice of toothpaste is combined with old dental brushes, there are several other risks on teeth and the body that in the end prove costly.

"With an old toothbrush, chances are high the bristles would break off and some fall in the gut. Besides the more you use a brush, the more layers of debris remain in between the gaps,” he explains.

While some brushes are durable, Dr Kayinamura advises that the maximum, period of use should not exceed a month.

"Well some could be long lasting for up to three months but for maximum cleaning effect, they should be discarded after a month,” he adds.

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HOW OFTEN DO YOU REPLACE YOUR TOOTHBRUSH

Emily Murajimana, a university studentI have never been keen about replacing my toothbrush. I normally find it in a good shape even after using it for several months.I am only concerned about how often teeth should be brushed. There is no doubt that old toothbrushes should be replaced but sometimes it is impossible to tell when one needs to be discarded.

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Claudine Mbabazi, a Kigali residentI always buy a new brush after six or seven months since I buy those that are strong. Clearly with such kind of durability, it would be wastage throwing it away after a month. As long as you can maintain good oral hygiene and avoid bad breath, there is no big deal about buying a new brush.

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James Tuyishimiye, a taxi driverMy trick is simple, buy toothpaste that comes along with a toothbrush. By all means you will be compelled to use the new one. I take dental hygiene seriously and every one should because waiting for that time when you get dental cavities is extremely costly.

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Manuel Maniriho, a parentI can tolerate, anything but bad breath no. Well some people need more time to be educated about oral dental hygiene although that should not be an excuse to do the bare minimum. A smile with sparkling white teeth can land you a job during an interview, and dirty mouth will block all your hopes. All in all, we need to teach our people, what it means not to neglect the little things.

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Eddy Mucumbisti, a studentThe last thing I want to experience is a tooth extraction. Because of such fears, I try as much as possible to ensure that I replace my brushes on time and also use the best toothpaste possible. For young children, ensuring that proper dental hygiene is maintained should be the role of parents.