It isn't but some people want things 100% germ free so they'll jump through hoops to sanitize. I wash my hands, rinse the head of the brush, and use a peas size

It isn't but some people want things 100% germ free so they'll jump through hoops to sanitize. I wash my hands, rinse the head of the brush, and use a peas sized bit of toothpaste, brush a couple minutes. Twice a day. Electric toothbrushes are too complicated and annoying. Toss after three months. You can also use a stannous fluoride based tooth paste as well as it has germ fighting capabilities over and above regular fluoride based toothpaste if that's your jam. I use boka which is a nano-hydroxyapatite based toothpaste like is commonly used in japan. No cavities in the past decade and hygenist always complements me on making her job easy. I use stannous fluoride in the mornings and n-hdap at night before I go to bed.