With an annual production of 8 billion toothpicks, Minnesota-based Diamond Brands is the only company still making toothpicks in the United States, as of 2007. China and Southeast Asian nations produce large quantities of toothpicks and ship them around the world.
In 1910, the yearly output of wooden toothpicks in the United States was 25 billion, but companies undercut each other on price to the point at which manufacturing costs could not be met by sales, and then production slumped. After the Great Depression and World War II, production and consumption increased again, to a record 75 billion toothpicks per year.
However, by the 1990s, American dentists were emphasizing brushing and flossing over picking, and using a toothpick at the table came to be considered impolite.