Antiviral mouthwashes: possible benefit for COVID-19 with evidence-based approach

Abstract

Background The outbreak, and pandemic of COVID-19 causing widespread concerns in all health systems of countries. Virus-carrying aerosols can penetrate the healthy human body and lungs, resulting in rapid transmission. For the first time, in this evidence-based article, the effects of different types of mouthwashes to reduce the viral load were investigated. Also, another aim of this essay is a reduction in viral load in patients with COVID-19 and prevention developing ventilator-associated pneumonia in critically ill patients. Methods Related databases were comprehensively searched for relevant studies. The present study was performed according to the preferred cases for standard systematic reviews (PRISMA). Results Five original studies in which the subject matter was directly evaluated were included. Different types of mouthwashes and viruses were investigated in this study. Conclusions The antiviral mouthwashes play a certainly important role in reducing the viral load of the salivary virus. In the present study, this importance could be proved in two different aspects, that is, the use of mouthwash before dental procedures to reduce the risk of transmission of the virus to the dental team and the use of this mouthwash in COVID-19 patients to help improve systemic problems associated with oral microbial flora.

Efficacy of Mouth Rinses Against SARS-CoV-2: A Scoping Review

“…Full texts of 29 articles were reviewed for eligibility assessment, and eventually 12 records (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) were included in the review based on the inclusion/exclusion criteria. The reasons for excluding 17 articles (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) are presented in Figure 1.…”

Use of mouthwashes in the management of COVID-19 patients in intensive care units: recommendations and current evidence

“…Dear Editor, According to recent studies, approximately 33% of patients hospitalized with coronavirus disease 2019 (COVID-19) should require intensive care, and up to 20% of those admitted to hospital may need invasive mechanical ventilation. (1) Considering the performance of multidisciplinary teams composed of physicians, nurses, dentists, physical therapists, and other health professionals at intensive care units (ICU) for treatment of COVID-19 patients, (2)(3)(4) and evidence pointing to a decrease in viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in saliva through the use of mouthwashes, (5,6) some questions on this subject deserve to be discussed in more detail, focusing on safe approaches for the professional teams working in this context, as well as in relation to appropriate care for these patients.…”

“…First, based on the existing evidence, the use of mouthwashes in COVID-19 patients admitted to ICU is currently suggested before performing daily routine procedures with a potential risk of generating aerosols, and/or droplet emission during the care of intubated patients, and droplet release from those without intubation, which should undoubtedly contribute to reduce the risks of virus transmission to the team of health professionals at ICU (5) (Table 1).…”

“…Accepted on: Jan 19, 2021 (5) Vergara-Buenaventura A, Castro-Ruiz C. Use of mouthwashes against COVID-19 in dentistry. Br J Oral Maxillofac Surg.…”

“…Another important point concerning the use of mouthwashes in this group of patients is the contribution to improve of systemic problems associated with oral microbial flora, as well as to prevent the occurrence of nosocomial pneumonia associated with mechanical ventilation, leading to a probable reduction in the length of hospital stay (5) (Figure 1). Also, the possibility of reducing the risk of cross-infection among hospitalized patients during the pandemic is expected as a secondary benefit.…”