What do Mao Zedong and Howard Hughes have in common?
In maturity, especially later in life, neither one brushed his teeth. Ever.
Hughes—inventor of one of the largest planes in history, owner of Trans-World Airlines, blockbusting director, millionaire (for a while the world’s wealthiest man), and aviation pioneer (a transcontinental airspeed record-holder)—was also a lifelong obsessive-compulsive germaphobe. His fixation on germs began in childhood, after a polio scare prompted his mother to keep him isolated. Later in life, a horrific plane crash exacerbated his paranoia and isolation, and led to a painkiller addiction. His aversion to the toothbrush stemmed from its ability to carry invisible contaminants.
The mastermind of China’s Communist revolution and the author of the “Little Red Book,” on the other hand, simply preferred not to brush. Instead, Chairman Mao rubbed his teeth with green tea leaves, giving them a well-documented jade tinge. “A tiger,” he reasoned, “never brushes his teeth.”
The two men may have exposed themselves to health and hygiene problems, but they also—no doubt unintentionally—avoided injury. The US Consumer Product Safety Commission estimates that 2,953 Americans were treated in 2007 for toothbrush-related injuries. The odds a person will visit an emergency department due to an accident involving a toothbrush in a year are 1 in 99,340, making a toothbrush slightly more dangerous on average than a garage door. (The odds a person will visit an emergency department due to an accident involving an automatic garage door in a year are 1 in 106,300). The increased risk comes, as one might expect, from increased exposure. A fair percentage of Americans encounter their toothbrush at least twice a day: the odds an adult brushes his or her teeth twice a day or after every meal are 1 in 1.28 (78%).
So, what injuries might a toothbrush cause? It is an object designed for safety, after all. Today’s designs have reinforced handles to prevent snaps or breaks at stress points, and the long-traditional boar-hair bristles have largely been replaced by nylon filament, which breeds significantly less bacteria.
Still, toothbrushes—typically by dint of slips and falls—can cut gums or cheeks (from pokes), puncture palates or pharynges (from falling or passing out with a toothbrush in one’s mouth), and break teeth. Instances of toothbrush-related injuries recorded by the National Electronic Injury Surveillance System (NEISS) may be found here (product code for non-electric toothbrush: 1629). While a few injuries stand out, like the poor 4-year-old who “brushed [her] teeth with acne medication” (2002), and the all-too-predictable wrong-orifice injuries, most involve oral lacerations and contusions. The frequency with which Americans push these plastic sticks around in their mouths, combined with environmental factors (slippery tiles, say, or tiredness), increases the chances that a toothbrush will, for a moment, be less-than-benign.
Of course, avoiding your toothbrush is also dangerous, just in other ways. The American Academy of Periodontology has published many articles and press statements suggesting a link between periodontal disease (a.k.a. gum disease caused by not brushing) and heart disease. Medical researchers have found a correlation between the two, the leading theories being that the bacteria that cause periodontal disease either increase arterial plaque buildup, or cause arterial inflammation. Given the possible connection between gum- and heart disease, Mao and Hughes were taking their chances.
But, as with vending machines or soda straws it is not the toothbrush’s inherent danger, but human klutziness—and occasionally comedy—along with frequent exposure to the object, that creates this mild risk.