The Indispensable Toothbrush

The first US patent on a toothbrush was awarded in 1857,7 (Figure 1) but humans have been attempting to clean their teeth since at least 3500 B.C., when “chew sticks” were fashioned from twigs in Mesopotamia. The prototype for our modern toothbrushes probably originated in China in 1498 in the form of a bone or bamboo-handled brush with hog bristles, but it would be another 400 years before the first nylon-bristled brushes were introduced.8

Figure 1. Wadworth’s Patent for the First United States Toothbrush.7
Illustration showing Wadworth’s patent for the first United States toothbrush

Prior to mass-produced affordable toothbrushes, men and women in the past seeking better breath and cleaner teeth had to get creative with dental plaque and food debris removal implements (e.g., sponges, metal toothpicks, stiff quills,)9,10 Today’s better access to easy-to-use cleaning tools means toothbrushing is now normative in developed regions globally. The 2003 Lemelson-MIT Invention Index survey of Americans revealed that the toothbrush beat out even cars and phones as the top invention they couldn’t live without.11 A rapid evolution in toothbrush design for cleaning effectiveness and safety over the last several decades has brought a wide, diverse selection of manual and electric toothbrushes that offer basic or more advanced handle and bristle configurations and functionality.

The utility of a toothbrush for better dental and gum health and a more cosmetically appealing smile is predicated on mechanical debridement: the sweeping action that can lift and remove discoloring and odor-causing debris, as well as disease-inducing bacteria imbedded within dental plaque biofilms and on the tongue. Beginning with Van Leeuwenhoek’s 1680 discovery of microbes in plaque,12 ongoing scientific inquiry has illuminated the dynamics of the oral microbial flora and shed light on the contributions of undisturbed, pathogenic plaque in the etiology of the most common and pressing oral public health concerns. The toothbrush – from its crude beginnings centuries ago to the advanced models available today – remains a primary weapon in the fight against gingivitis/periodontitis, and against tooth decay when it acts as a delivery vehicle for anti-caries agents (see Toothpaste as a Vehicle).