Is it time to ditch your germy, old toothbrush?

Toothbrushes do a lot of work if you use them right. That means they wear down. Bristles get bent, soft or fuzzy.

But you probably should be tossing them before you can see the signs because of germs.

Your toothbrush harbors a lot of bacteria. You can’t see it, but it might cause tooth decay or illness.

According to the American Dental Association, you should:

• Get a new toothbrush every 3-4 months.
• Mark the date with a waterproof marker so you know how old it is.
• Toss the toothbrush sooner if it looks worn. Bent bristles don’t clean well.
• Replace kids’ toothbrushes more often if it appears the child chews on it. Or they might just brush too hard!
• Toss the brush sooner if you’re susceptible to infections.

Other toothbrush tips:

• Use a soft-bristled brush — always! Soft bristles clean plaque just as well as harder ones. But they don’t scratch the enamel or harm your gums.
• Rinse well under running water to clean after each use. You don’t need to use special cleansers.
• Store upright to dry. If you store it with other people’s brushes, make sure the bristles don’t touch.
• Wash and dry the toothbrush storage container often: It’s probably one of the germiest places in your house.
• Don’t share your toothbrush. It’s full of body fluids that can raise the risk of infection.
• Don’t keep the brush in a closed container or cap it for long. Moisture gets trapped and germs breed.

Special cleaning routines?

Rinse, dry and replace is the best approach for most people. You don’t need to bother with special routines.

• There’s no evidence that soaking your brush in antibacterial mouthwash or other solutions makes a difference in your health. It might kill some bacteria, though.
• Using boiling water, the dishwasher or a microwave oven to clean the brush will probably only damage the brush.
• Toothbrush sanitizers don’t really have any evidence for their value. But if you want to use one, the American Dental Association suggests you choose an FDA-approved product.

If someone in your household is immune-suppressed, disposable toothbrushes might be a good idea.

Are electric toothbrushes better?

For some people, electric is better. You probably brush better and remove more plaque with an electric brush. And if you have arthritis or stiff hands, they can be easier to hold. But you still need to replace the head every 3-4 months.

Dr. Natalya Puckett is a family medicine physician at Lakeshore Medical Clinic in St. Francis, WI.