Do Mouthwashes Reduce Covid-19 Viral Load during Dental Procedures and Oropharyngeal Examinations? A Systematic Review

Abstract

There is a relatively high risk of virus transmission in dental procedures and oropharyngeal examinations. We investigated the effects of mouthwashes on covid-19 viral load reduction during dental practices and oro-pharyngeal assessments. We performed a systematic search in PubMed, EMBASE, Scopus, Web of Science, Cochrane library for relevant studies up to February 2021. Papers evaluating patients with covid-19 infection (patients) who rinse mouthwashes (intervention) compared to patients who don’t rinse them (comparison) for reducing covid-19 viral load or reducing cross-infection of covid-19 (outcome) in the randomized and non-randomized clinical trial and quasi-experimental studies (study) were included due to PICOS question. Three independent authors conducted literature screening and data extraction. We extracted the most relevant data and we evaluated the risk of bias from the included studies. Out of 344 potentially eligible articles, six studies were included in this systematic review. Regarding viral load and negative cycle threshold (ct) values, 1% PVP_I and Listerine mouthwash were effective. 0.12% CHX mouthwash was effective 0-2 hours post rinsing, but it was not effective after 2 hours. A mixture solution of 0.2% Chlorhexidine gluconate and 6% Hydrogen peroxide was effective on day 5 of intervention. Gargling 1% hydrogen peroxide, 0.075% Cetylpiridinum Chloride (CPC), 0.5%PVP-I and 0.2% CHX mouthwashes was not effective on SARS-COV-2. It cannot be guaranteed that rinsing a specific kind of mouthwash prevents cross-infection of covid-19; however, the viral load of SARS-COV-2 in saliva will be decreased after rinsing mouthwashes containing 1%PVP-I and Listerine.

Dental Care and Education Facing Highly Transmissible SARS-CoV-2 Variants: Prospective Biosafety Setting: Prospective, Single-Arm, Single-Center Study

“…At present, molecular iodine rinse is the clear evidence-based winner as a prerinse for SARS-CoV-2. This is particularly important considering that many other oral rinses are neutralized in the presence of saliva [38][39][40][41][42][43]. Oral rinses are a regular part of various dental biosafety protocols.…”

Utilizing the Potential of Antimicrobial Peptide LL-37 for Combating SARS-COV- 2 Viral Load in Saliva: an In Silico Analysis

“…Suggested products containing CPC or delmopinol hydrochloride as antiseptics decrease viral loads. 20 Farook et al recommend preprocedural rinse with chlorhexidine, PI, which is being used in dental clinics to reduce viral load in oral cavity even through it is not established, 21 either with usage of 0.12% of chlorhexidine, 1% of hydrogen peroxide or 0.2% of PI solution. 22 23 LL-37 is proved through in silico work to have capacity to disrupt the viral membrane; various studies have employed the AMP LL-37 in different treatment strategies in various viral conditions with therapeutic effect.…”

Conhecimento e práticas de biossegurança de estudantes de Odontologia frente ao COVID-19

“…The number of clinical trials examining the effect of mouthwash on the reduction of COVID-19 in saliva is very limited, so more standard sample size clinical trial studies are needed to evaluate the impact of mouthwash on SARS-COV-2 virus (Z. Mohebbi et al, 2021) When asked about the application of biosafety before the COVID-19 pandemic, most respondents replied that it was good or excellent (87/70.73%) and only 3 (2.44%) rated it as bad. According to recently published papers in the literature, an appropriate disinfection of the dental office, use of personal protective equipment, preoperative mouthwash, as well as the correct handling of infected waste and hand washing, are all very important measures to help prevent the spread of COVID-19 in a dental environment (Ather et al, 2020;Center for Disease Control, 2020;Peng et al, 2020;Tuñas et al, 2020;Wu et al, 2020).…”