“…1 ). Of these, 51 articles were selected for a full-text review and 11 met the inclusion criteria: Two observational and nine experimental studies [ [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…The following mouthwashes were prescribed: CHX in eight studies with the dosage of 0.12, and 0.2% [ [10] , [11] , [12] , [13] , [14] , [15] , 17 , 18 ], PI with the dosage of 0.4, 0.5, 0.6, 1, and 2% in eight studies [ 11 , 12 , [14] , [15] , [16] , [17] , [18] , [19] ], the dose of 0.07 % of CPC in four studies [ 10 , 11 , 14 , 18 ], HP with the dosage of 1, and 1.5 % in four studies [ [10] , [11] , [12] , 18 ], CDCM in one study [ 9 ], and 0.02% HCIO in one study [ 19 ]. Mouth rinses in the intervention groups were compared with distilled water as the control groups for nine of the studies [ [10] , [11] , [12] , [14] , [15] , [16] , [17] , [18] , [19] ]. In the study of Carrouel et al, the control group used a placebo as mouthwash [ 9 ].…”
Section: Resultsmentioning
confidence: 99%
“…The outcome was measured through RT-PCR: % reduction in viral load was the target. Studies evaluated salivary viral load clearance with CT value changes [ 9 , 10 , 12 , 14 , 15 , [17] , [18] , [19] ] and/or RT-PCR [ 14 ], quantitative RT-PCR [ [9] , [10] , [11] , [12] , 18 ], qualitative RT-PCR [ 16 ], and real-time RT-PCR [ 13 , 15 , 17 , 19 ].…”
Section: Resultsmentioning
confidence: 99%
“…Eight studies evaluated the efficacy of CHX [ [10] , [11] , [12] , [13] , [14] , [15] , 17 , 18 ]. Four examined 0.12% CHX mouth rinses and measured viral load reduction at 5 and 60 minutes.…”
Section: Resultsmentioning
confidence: 99%
“…Also, in the study conducted by Natto et al, both CHX mouthrinse and lozenges were administrated and significantly reduced the viral load [ 17 ]. However, three studies indicated no significant difference using the CHX mouth rinses [ 11 , 14 , 18 ]. ( Table 1 ).…”
“…1 ). Of these, 51 articles were selected for a full-text review and 11 met the inclusion criteria: Two observational and nine experimental studies [ [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…The following mouthwashes were prescribed: CHX in eight studies with the dosage of 0.12, and 0.2% [ [10] , [11] , [12] , [13] , [14] , [15] , 17 , 18 ], PI with the dosage of 0.4, 0.5, 0.6, 1, and 2% in eight studies [ 11 , 12 , [14] , [15] , [16] , [17] , [18] , [19] ], the dose of 0.07 % of CPC in four studies [ 10 , 11 , 14 , 18 ], HP with the dosage of 1, and 1.5 % in four studies [ [10] , [11] , [12] , 18 ], CDCM in one study [ 9 ], and 0.02% HCIO in one study [ 19 ]. Mouth rinses in the intervention groups were compared with distilled water as the control groups for nine of the studies [ [10] , [11] , [12] , [14] , [15] , [16] , [17] , [18] , [19] ]. In the study of Carrouel et al, the control group used a placebo as mouthwash [ 9 ].…”
Section: Resultsmentioning
confidence: 99%
“…The outcome was measured through RT-PCR: % reduction in viral load was the target. Studies evaluated salivary viral load clearance with CT value changes [ 9 , 10 , 12 , 14 , 15 , [17] , [18] , [19] ] and/or RT-PCR [ 14 ], quantitative RT-PCR [ [9] , [10] , [11] , [12] , 18 ], qualitative RT-PCR [ 16 ], and real-time RT-PCR [ 13 , 15 , 17 , 19 ].…”
Section: Resultsmentioning
confidence: 99%
“…Eight studies evaluated the efficacy of CHX [ [10] , [11] , [12] , [13] , [14] , [15] , 17 , 18 ]. Four examined 0.12% CHX mouth rinses and measured viral load reduction at 5 and 60 minutes.…”
Section: Resultsmentioning
confidence: 99%
“…Also, in the study conducted by Natto et al, both CHX mouthrinse and lozenges were administrated and significantly reduced the viral load [ 17 ]. However, three studies indicated no significant difference using the CHX mouth rinses [ 11 , 14 , 18 ]. ( Table 1 ).…”
Background
Viral epidemics or pandemics of acute respiratory infections (ARIs) pose a global threat. Examples are influenza (H1N1) caused by the H1N1pdm09 virus in 2009, severe acute respiratory syndrome (SARS) in 2003, and coronavirus disease 2019 (COVID‐19) caused by SARS‐CoV‐2 in 2019. Antiviral drugs and vaccines may be insufficient to prevent their spread. This is an update of a Cochrane Review last published in 2020. We include results from studies from the current COVID‐19 pandemic.
Objectives
To assess the effectiveness of physical interventions to interrupt or reduce the spread of acute respiratory viruses.
Search methods
We searched CENTRAL, PubMed, Embase, CINAHL, and two trials registers in October 2022, with backwards and forwards citation analysis on the new studies.
Selection criteria
We included randomised controlled trials (RCTs) and cluster‐RCTs investigating physical interventions (screening at entry ports, isolation, quarantine, physical distancing, personal protection, hand hygiene, face masks, glasses, and gargling) to prevent respiratory virus transmission.
Data collection and analysis
We used standard Cochrane methodological procedures.
Main results
We included 11 new RCTs and cluster‐RCTs (610,872 participants) in this update, bringing the total number of RCTs to 78. Six of the new trials were conducted during the COVID‐19 pandemic; two from Mexico, and one each from Denmark, Bangladesh, England, and Norway. We identified four ongoing studies, of which one is completed, but unreported, evaluating masks concurrent with the COVID‐19 pandemic.
Many studies were conducted during non‐epidemic influenza periods. Several were conducted during the 2009 H1N1 influenza pandemic, and others in epidemic influenza seasons up to 2016. Therefore, many studies were conducted in the context of lower respiratory viral circulation and transmission compared to COVID‐19. The included studies were conducted in heterogeneous settings, ranging from suburban schools to hospital wards in high‐income countries; crowded inner city settings in low‐income countries; and an immigrant neighbourhood in a high‐income country. Adherence with interventions was low in many studies.
The risk of bias for the RCTs and cluster‐RCTs was mostly high or unclear.
Medical/surgical masks compared to no masks
We included 12 trials (10 cluster‐RCTs) comparing medical/surgical masks versus no masks to prevent the spread of viral respiratory illness (two trials with healthcare workers and 10 in the community). Wearing masks in the community probably makes little or no difference to the outcome of influenza‐like illness (ILI)/COVID‐19 like illness compared to not wearing masks (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84 to 1.09; 9 trials, 276,917 participants; moderate‐certainty evidence. Weari...
Objectives
Aerosols and splatter are routinely generated in dental practice and can be contaminated by potentially harmful bacteria or viruses such as SARS-CoV-2. Therefore, preprocedural mouthwashes containing antiseptic agents have been proposed as a potential measure for infection control in dental practice. This review article aims to summarize the clinical (and, if insufficient, preclinical) evidence on preprocedural mouthwashes containing antiseptic agents and to draw conclusions for dental practitioners.
Methods
Literature on preprocedural mouthwashes for reduction of bacterial or viral load in dental aerosols was searched and summarized.
Results
Preprocedural mouthwashes, particularly those containing chlorhexidine digluconate (CHX), cetylpyridinium chloride (CPC), or essential oils (EO), can significantly reduce the bacterial load in dental aerosols. With respect to viruses such as HSV-1, there are too little clinical data to draw any clear recommendations. On the other hand, clinical data is consolidating that CPC-containing mouthwashes can temporarily reduce the intraoral viral load and infectivity in SARS-CoV-2 positive individuals. Nevertheless, potential risks and side effects due to regular antiseptic use such as ecological effects or adaptation of bacteria need to be considered.
Conclusions
The use of preprocedural mouthwashes containing antiseptics can be recommended according to currently available data, but further studies are needed, particularly on the effects on other viruses besides SARS-CoV-2. When selecting a specific antiseptic, the biggest data basis currently exists for CHX, CPC, EO, or combinations thereof.
Clinical relevance
Preprocedural mouthwashes containing antiseptics can serve as part of a bundle of measures for protection of dental personnel despite some remaining ambiguities and in view of potential risks and side effects.
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