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Brook and Gober¹ showed that group A -hemolytic streptococci can survive on toothbrushes and suggested that the failure of treating streptococcal pharyngitis may be due to the persistence of the organism on toothbrushes and orthodontic appliances. This is useful information and not surprising since, as they point out, toothbrushes have been shown to become contaminated with other microorganisms. Considering the price of a toothbrush compared with that of another office visit, it makes sense to follow the suggestion of Glass and Lare²: "We recommend that for the general population, toothbrushes be changed at least once a month and after any illness."

Howard Fischer, MD
Detroit, Mich

1. Brook I, Gober AE. Persistence of group A -hemolytic streptococci in toothbrushes and removable orthodontic appliances following treatment of pharyngotonsillitis. Arch Otolaryngol Head Neck Surg. 1998;124:993-995. FREE FULL TEXT 2. Glass RT, Lare MM. Toothbrush contamination: a potential health risk? Quintessence Int. 1986;17:39-42. PUBMED

Arch Otolaryngol Head Neck Surg. 1999;125:479.