Electrolyzed water for the microbiologic control in the pandemic dental setting: a systematic review

Abstract

Background Electrolyzed water has brought recent attention due to its antimicrobial properties. Indeed, electrolyzed water has been proposed to sterilize dental materials and instruments without compromising their structural integrity. In addition, electrolyzed water has been proposed as a mouthwash to control bacterial and viral oral infections without detrimental effects on the oral mucosa. However, no current consensus or evidence synthesis could indicate its potentially favorable use in the dental setting, particularly during the COVID-19 context. Therefore, this systematic review aimed to elucidate whether electrolyzed water could improve microbiologic control in the COVID-19 pandemic dental setting. Methods MEDLINE via Pubmed, EMBASE, Cochrane’s CENTRAL, Scopus, LILACS, and Web of Science databases were searched up to September 2021 to identify experimental studies utilizing electrolyzed water for eliminating microorganisms in a dental setting. Besides, a manual and a grey literature search were performed. The data selection and extraction were performed individually and in duplicate. The Risk of Bias (RoB) was assessed with the Nature Publication Quality Improvement Project (NPQIP) score sheet. The study protocol was registered at PROSPERO CRD42020206986. Results From a total of 299 articles, 63 studies met the inclusion criteria. The included studies assessed several types of electrolyzed waters, which showed a high disinfection potential when used to deal with different oral conditions. Electrolyzed water demonstrated a broad antimicrobial spectrum and was highly efficient in the dental office disinfection against viruses, fungi, and bacteria, being compatible with most dental materials. In addition, electrolyzed water could protect against SARS-CoV-2 infection and contamination in the dental office. Regarding the RoB, only 35.18% of entries were answered as ‘Yes’, thus achieving less than half of the reporting sheet. Conclusion Electrolyzed water effectively disinfects contaminated surfaces, dental materials, and equipment. Therefore, their use is recommendable in the SARS-CoV-2 pandemic dental setting.

Electrolysed oxidising water as a multi‐purpose biocide in dental healthcare—A scoping review

“…Additionally, we identified one systematic review exploring the antimicrobial action of EOW from the perspective of COVID‐19 in the pandemic dental setting (Table 2). 56 The most studied application of EOW is as an antiseptic endodontic irrigant (n = 45; 39%). Fewer articles studied EOW as either an oral rinse/surgical irrigant (n = 24; 21%) or as a disinfectant for DUWLs/dental operatory cross‐infection control (n = 22; 19%) and dental biomaterials (n = 19; 17%).…”

“…The one systematic review 56 retrieved included studies up to September 2021 and explored EOW as a microbiological control measure in the COVID‐19 pandemic dental setting and, as such, was limited to this objective (Table 2). The authors included literature pertaining to antimicrobial effectiveness in general and in dental healthcare specifically, including effectiveness against oral microorganisms in vitro, inoculated in an animal model or sampled from the oral cavity.…”

“…Antimicrobial outcomes are influenced by the type of EOW, 70,80 its shelf‐life and storage conditions, 57,58,61 concentration, 70,72,79,80 contact time, 61 temperature, 68 organic contaminants in test substrates, 67 test strain 50,57,68,84 and inoculum density 72 . Between‐study comparisons are difficult due to the substantial heterogenicity of designs, a limitation that was highlighted previously 56 . Suspension and biofilm assays report efficacy as a reduction in colony forming units (cfu), non‐detectable counts, percentage killing and growth inhibition.…”

“…72 Betweenstudy comparisons are difficult due to the substantial heterogenicity of designs, a limitation that was highlighted previously. 56 Suspension and biofilm assays report efficacy as a reduction in colony forming units (cfu), non-detectable counts, percentage killing and growth inhibition. Antibiofilm assays also report efficacy as changes to the biofilm cover (structural observations), 61,70,75,77,78,89,91,101,102,[109][110][111] gene expression (RT-qPCR) 79 and biofilm composition (16S rRNA gene sequencing).…”

Oral mouthwashes for asymptomatic to mildly symptomatic adults with COVID-19 and salivary viral load: a randomized, placebo-controlled, open-label clinical trial

“…Antiviral drugs and vaccines may be insufficient to prevent the spread of COVID-19 infection, and public health services may need to prepare for COVID-19 infection through the implementation of a range of non-pharmaceutical preventive interventions. Mouthwashes are cheap, simple to use, and commonly employed as a daily antiseptic complement to brushing the teeth for oral hygiene maintenance [ 45 ]. Populations at high risk for contracting COVID-19 experience limited access to oral healthcare, and oral healthcare problems particularly affect poor and minority populations [ 46 ].…”