The lowly toothbrush, primarily an instrument of health promotion, has now been found to be an instrument of potentially life-threatening injury in children.
A review of the more than 1.6 million reports to the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) between 1990 and 2005 showed that toothbrush injuries are rare, accounting for fewer than one per cent of reports during that time, but the injuries they did cause included potentially serious penetrating trauma.
Health Canada had asked the Public Health Agency of Canada (PHAC) to review reports to the CHIRPP database after it learned of one particular type of toothbrush whose bristles easily broke free and caused choking in some children. CHIRPP is an emergency room-based injury surveillance system operating in 10 pediatric and four general hospitals across Canada.
Steven McFaull, a PHAC research analyst, found 198 toothbrush-related injuries in the database. Nearly 80 per cent occurred in children under the age of five, and most happened when children were fooling around. In only 10 per cent of cases, the children were brushing their teeth (or having them brushed) at the time of the injury.
More than two-thirds of the injuries occurred when the children fell or bumped into something while the toothbrush was in their mouth, but there were a few cases in which the entire toothbrush was swallowed.
"In some cases, older teenage girls are trying to induce vomiting, but there are some kids who just actually swallowed the toothbrush and it's not clear what they were doing," McFaull says.
McFaull says PHAC researchers will continue to monitor toothbrush injuries in the CHIRPP database "due to the current market influx of different toothbrush types, including those with batteries."
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