Today’s article looks at whether bidets are sanitary, in general, and how they compare to toilet paper hygiene-wise. We’ll be looking at different factors that can make bidet use unsanitary and which populations (e.g., women and older adults) may need to take certain precautions.
Overall, bidets are considered sanitary when properly used and maintained (disinfected). Caution should be used when sharing bidets, as one study found bidets in public restrooms to be widely contaminated with harmful microorganisms. Also, some populations may need to take precautionary measures.
As for whether bidet water is clean, I recently tested a sample of bidet water alongside a sample of bathwater with a water safety kit that checked for levels of E coli. bacteria, heavy metals, and other contaminants.
It was mentioned that one study found bidet nozzles to be contaminated. Strains of bacteria found on unproperly maintained bidet nozzles include (1):
- Gram-negative Staphylococcus aureus (enteric and non-enteric)
- Streptococcus spp.
- Enterococcus spp.
- Escherichia coli.
- Stenotrophomonas maltophilia.
As we’ll get into, sharing bidets is fine if we’re talking friends and family. But the more traffic the toilet gets, the more often it’ll need to be cleaned.
So, bidet sanitation would differ a lot between an unmaintained unit shared by a big household and a regularly cleaned unit used by only one person.
As we’ll touch on, one thing to keep in mind is that modern bidets clean themselves. The best self-cleaning bidets have self-sanitizing cleaning wands/nozzles. Some even have self-cleaning bowls.
What we’ll do here is tackle some specific questions about bidet use and hygiene.
For those who are new to the subject, here’s a quick breakdown of the different types of bidets mentioned in most articles:
Are Bidets Sanitary for Multiple Users?
Bidets are sanitary for multiple if an adequate bidet cleaning schedule is maintained. Contaminated nozzles on electric bidets have been found in hospitals–high-traffic public restrooms. Hence, the more a bidet is used, the more often it will need to be cleaned to maintain good hygiene.
Keeping the bidet clean is the main thing—so, the bottom line is whether it’s sufficiently clean when in use, regardless of how many people use it. It’s just that, the more the bidet is used, the more often the nozzle will need to be sanitized.
Bidets come with a cleaning schedule (found in the owner’s manual), but the guidelines don’t take into account how often the unit is used. Because sharing a bidet implies it’ll be used more, extra cleaning will be needed.
Plus, most of us don’t clean our bathrooms as often as we should, so there’s probably good reason to think that most fall behind on the cleaning schedule. Therefore, it’s easy to see how a bidet could get dirty quickly when used by a lot of people.
Also, more frequent nozzle cleaning may be a good idea if visitors will be using the bidet a lot. We tend to know when our family members and roommates are sick, but you never know with random people coming in and out of the house.
So, the take-home message is that you should clean the bidet (especially the nozzle) more often than suggested by the manual if it’ll be used by a lot of people, especially visitors.
Bidets Can Be Unsanitary
Bidets can be unsanitary when not used correctly and when not properly maintained. Like any other surface, bidet nozzles can become contaminated with use. By following the cleaning schedule that comes with a bidet, sanitation shouldn’t be an issue.
As mentioned, one study found numerous strains of harmful Gram-negative bacteria on the surfaces of bidets. The study needs some explanation because it’s not as bad as it sounds.
The type and quantity of bacteria were similar to what you’d find on regular toilet seats. Sure enough, bacteria were found on the bidet seat, not just the wand. Of the 292 bidet seats that were sampled, 254 (86.9%) had contaminated nozzles (2).
So, the issue of microbial growth isn’t any worse with bidet seats than it is with regular toilet seats. But, since the nozzle is used to clean sensitive parts, it’s extra important that it remains clean.
Also, the study examined bidets in public restrooms in a hospital of all places, so the number of bacteria found is likely much higher than what you’d find on bidets used by a single person or household.
Interestingly, it was warm water nozzles that were found to be contaminated. As far as I know, there’s no reason to believe that warm water bidets are more prone to microbial growth.
It’s just that the study seems to have only included electric bidets. I.e., for now, we don’t have reason to believe that results would be different for non-electric bidet units.
If anything, they’re probably more sanitary. Electric bidets are more likely to come with self-sanitizing nozzles (E.g., the Silvernado and Ewater technology that comes with Brondell and TOTO bidets, respectively).
Also, electric models are more likely to come with nozzles made with antimicrobial materials—wands that are treated with bactericidal additives.
Are Handheld Bidets Sanitary?
Handheld bidets are sanitary when cleaned regularly. For one, most bidet sprayers are made of brass, an inherently antimicrobial material, or plastic treated with antibacterial additives. For another, handheld bidets are located outside the bowl away from the contents of the toilet when not in use.
Are Bidets More Sanitary than Toilet Paper?
Cleaning with a bidet is more sanitary than using toilet paper, assuming clean water is used and the skin is dried properly. Drying is important because moisture is needed for bacterial growth. Bidets clean thoroughly, while TP smears feces on the skin thus leaving more microbes behind.
This is actually the important question: when it comes to personal hygiene, what is the most sanitary option to choose from? The least sanitary option would be not to clean at all, so we can rule that one out.
Then it’s down to cleaning with toilet paper or water.
Bidet Water Cleanliness
Bidet water is typically sanitary, as it comes from the same water supply that feeds other cold-water appliances in the house (e.g., the cold-water faucet in the sink and shower). Additionally, modern bidets often have filters, cleaning only with purified water.
Most people know that water cleanliness can be an issue, especially in certain areas. For example, if you lived in Flint MI during the water crisis, then you’d have been better off cleaning with paper.
But most cities in developed countries have good water treatment practices. Treatment plants both filter and disinfect water (via chemicals like chlorine and chloramine). The chemicals destroy any remaining viruses, bacteria, and parasites.
Finally, both electric and non-electric bidets can be set up with iodine filters. Electric bidets usually come with filters and the right water connections to accommodate them. With non-electric bidets, parts are available but tend to come separately.
Toilet Paper Isn’t so Great
While most know that water cleanliness is a concern, fewer seem to be aware that toilet paper can be harmful.
Common toilet paper additives include:
- Formaldehyde
- Bisphenol A (BPA)
- Phthalates
- Irritating bleaches
- Dioxins formed from the bleaching process
- Various unnamed fragrance additives
Keep in mind that these additives are considered safe in small amounts as they’re classified as GRAS by the health institutions (GRAS is Generally Recognized as Safe). So, I’m sure they’re fine in moderation. But the long-term effects of these chemicals at different levels of exposure is currently unknown.
Toilet paper is made with bisphenol-laden pulp. BPA and BPS are known to have toxic, mutagenic, carcinogenic (cancerous) effects in living organisms. They also disrupt our endocrine systems (our hormones).
Toilet paper often has additives meant to enhance fragrance and sometimes these ingredients are undisclosed.
Fragrance additives are typically musks and phthalates, the latter of which are known to disrupt endocrine systems and are linked to problems ranging from obesity to sperm quality and hyperactivity.
Formaldehyde is often added to give toilet paper strength. Some believe that formaldehyde in TP contributes to vulvar irritation. Using a bidet for #1 is common among female users to better clean and reduce the need for wiping.
One thing worth mentioning is that a lot of bidet users I talk to say they continue to use toilet paper despite having electric seats with built-in dryers. But even those who continue to use TP to dry (and sometimes pre-wipe), still end up using way less in the long run.
Continued use of TP usually isn’t necessary with most electric bidets, but more a matter of preference. The warm air dryers on quality bidets are usually pretty effective, but some folks don’t want to sit long enough and resort to a combination of TP and air drying.
Are Public Bidets Sanitary?
This picture was taken in Southeast Asia in 2021
Bidets in public restrooms are not sanitary. It’s not practical for custodians to clean bidet nozzles often enough to keep the surfaces free of dirt and microbial growth. While public bidets often have self-cleaning nozzles, you can be sure any self-rinse feature won’t sanitize the nozzle surface.
Plus, even at home, nozzle surfaces require manual cleaning periodically. So, it’s not enough to rely solely on the nozzle self-clean function.
Public restrooms and toilet seats are rarely sanitary themselves, so it makes little sense to expect public bidets to be. For this reason, most public restrooms offer toilet seat covers, and when they don’t, folks usually resort to using TP to cover the surface of the seat.
When using a public restroom, I’d recommend using toilet paper, carrying wet wipes (in a backpack or purse), or using a portable bidet.
Are Bidets Sanitary for Females?
Bidets are considered safe for women when used correctly. It’s usually advised to avoid overusing the frontal spray mode because it can dry out the vaginal flora raising UTI risk. Also, most health organizations discourage douching, a practice some employ with handheld bidets (3).
A list of the best bidets for women can be found here. They’re chosen based on female-friendly features and which are best at preventing infections.
Some owner’s manuals mention female hygiene and certain things women should consider when using their bidet.
From the owner’s manual of a popular bidet seat:
“Preliminary studies in females suggest that overuse of continuous spraying can increase the possibility of vaginal mucosa drying and potential reduction in desirable microbial organisms. Although these studies have not been validated, please consult your healthcare provider for concerns regarding whether these circumstances may apply to you.” TOTO WASHLET Manual, Page 7
So, if you follow the directions, you should be fine.
As for real-world data, any associations found thus far between bidet use and infections (for men and women) are weak.
For example, one study failed to find a significant link between bidet use and urogenital issues (cystitis, UTIs, etc.). Another study examined but failed to show a significant association between bacterial vaginitis (BV) and bidet use (4).
Some precautions to take include:
- Avoid using excessive water pressure. Of the times it was found that a bidet may have caused a UTI, it was thought that excessive pressure may have been a factor. When too high, the water stream can cause water to work its way from the anus to the urethra contaminating the latter with intestinal bacteria.
- Don’t overdo the frontal spray mode. Having a frontal spray capability is one of the main things to look for when searching for a bidet, especially if you’re a woman. They are super helpful and convenient. But they shouldn’t be used to the point of drying out the vaginal area. Drying out the area disrupts the vaginal flora which can cause irritation and infection.
- Avoid douching and douche attachments/kits. There are tons of douche kits on the market. They’re usually attachments that fit on handheld bidet sprayer hoses. It’s best to stay away from these because Institutions like the US HHS and American College of Obstetrics and Gynecology all say that douching can lead to STI’s and problems getting pregnant.
How About for Older Adults?
Bidets are sanitary for older adults. According to manufacturers, there is no age limit (upper or lower) for using a bidet. Immune systems do weaken with age, but only those with immune deficiency as a result of a medical condition are advised to consult a healthcare provider before using a bidet.
At least, according to manufacturers. I reached out to several major bidet makers and they all said pretty much the same thing: there is no age limit for using a bidet.
Some manufacturers do caution users with weakened immune systems.
“More importantly, if you are an individual suffering from any immune deficiency as a result of disease, chemotherapy, or other medical condition compromising the immune system you should consult your healthcare provider before use of this product.” TOTO WASHLET Manual, Page 7
Now, there are other things older adults should consider when choosing a bidet as some models are better for senior adults than others. For example, models that don’t aim well rely on fancy body positioning which requires more muscle strength, balance, and coordination.
With handheld sprayers, you have to clean manually which can be a challenge for those with limited mobility.
To cut out the guesswork, the best bidets for seniors are listed here.
How to Keep Your Bidet Germ-Free
Get a Self-Sanitizing Bidet (Not Just Self-Cleaning)
Self-cleaning features are standard on toilet seat bidets. Nowadays, self-cleaning wands are just about as common as on bidet attachments and non-electric seats as they are on fancy electric models.
For the best hygiene, what you want is a self-sanitizing bidet.
They come with either:
- Antimicrobial wands. Most manufacturers offer models that have wands made of special material–usually plastic or stainless steel treated with microbicidal additives and coatings.
- Sanitizing solutions. Brondell and TOTO have bidets with wands that self-rinse with an antimicrobial solution. Brondell uses a silver solution (silver is naturally antimicrobial) and TOTO uses an electrolyzed water that converts chemicals in tap water into the antiseptic, NaOCl.
Get a Retractable Wand (Stay Away from Chrome Attachments)
90% of the battle in keeping a bidet clean is making sure the wand is out of the way during bowel movements and when urinating.
Bidets accomplish this by having the nozzle remain in a protective housing. The wand extends from the nozzle just long enough to finish the cleaning session at which point it retreats back into the seat or attachment.
Image
Electric bidets extend and retract the nozzle electrically while the nozzles on modern non-electric bidets (seats and attachments) operate mechanically via water pressure.
However, there’s a less common type of attachment that works differently. They’re typically solid chrome and look like something Harley Davidson would design.
The nozzle remains in the bowl 24/7. It operates on a hinge allowing it to swivel back and forth. That way the user can push it out of the way when it’s not in use.
Not only is it more likely to get contaminated with human waste, but you also have to touch the wand twice with each use (before and after using the toilet).
One of the most common questions I get is, do bidets get poop on them. They certainly can and do get contaminated with use but tend not to get poop on them except in cases of diarrhea and bowel incontinence.
Anyway, the primitive chrome attachments look great but they don’t give the same protection provided by newer models.
The wand on this kind is durable (and looks great), but chrome doesn’t have any inherently antibacterial properties (5). If you go with this kind, make sure to get one with a nozzle having an antimicrobial coating.
Follow the Cleaning Schedule
Cleaning isn’t fun, but bidet manufacturers make it easy.
I’ll go into it in more detail in future articles, but you’ll want to give the nozzle a good cleaning regularly, about once a month. The rest of the unit will need to be cleaned from time to time.
Nozzles on electric bidets can be extended for cleaning. With non-electric units, you can pull the nozzle out of its housing manually.
Most of the trouble when installing a bidet is in attaching the mounting bracket to the back of the rim. At that point, the seat can easily be slid on and off for periodic maintenance. This makes cleaning a lot easier.
How Sanitary Are Bidets? Conclusion
Hopefully, that sums it up.
For cleaning private areas, using a bidet is as sanitary as bathing the same areas in the shower. By cleaning with water, bidets provide a superior clean compared to toilet paper. As for sanitation of the bidet itself, most have self-cleaning features that keep the nozzles clean.
When it comes to friends and family, multiple people can use the same bidet if the unit is cleaned here and there. When the bidet is cleaned regularly, including the nozzle, then sharing a bidet should be viewed similarly as the common practice of sharing a toilet.
Getting a self-cleaning bidet means you’ll only need to clean the wand once every few weeks.
Of course, the above applies mostly to shared living situations. You probably wouldn’t want to install a bidet in a public restroom (even a small business) because it would see so much traffic over time.
When a ton of random people are using the same bidet every day, it’s nigh impossible to stay on top of cleaning and maintenance.
Aside from wiping the seat down (something you might want to do daily), most bidet cleaning schedules only call for a brief monthly scrub down using a toothbrush and diluted vinegar water.
That should do it for now. Thanks for reading.