Efficacy in reducing oral viral load (SARS-CoV-2) of three types of mouthwashes. Literature review

Authors

  • Henry G Fajardo-Sotamba

Keywords:

SARS-CoV-2, antiseptics buckles, chlorhexidine, hydrogen peroxide, povidone iodine, inactivation, virus.

Abstract

In Wuhan-China, an outbreak of pneumonia of idiopathic origin was identified in December 2019; the causative agent was isolated in January 2020; a new variant of coronavirus (SARS-CoV-2) was declared by the World Health Organization (OMS) as coronavirus disease 2019 (COVID-19). Due to the ways of transmission this virus has shown a high ease of contagion, spreading rapidly, it is known that approximately 148 million infected and 3.012 million died from SARS-CoV-2, affecting more than 190 countries in 5 continents.  It is important for health personnel due to the working conditions to which they are exposed, being this in order to the optimal conditions for the acquisition of this pathology. Objective: To compare the efficacy and efficiency of the use of mouthwashes: hydrogen peroxide, povidone iodine and chlorhexidine against SARS-CoV-2 viral load. Materials and methods: A search were carried out in the databases of PubMed, SAGE JOURNAL, ACP, Medigraphic, PMC, which were selected according to the inclusion criteria, obtaining 30 studies Results: Chlorhexidine (CHX) at concentrations of 0. 12% and 2% did not show a statistically significant index capable of inactivating SARS-CoV-2 viral load, Hydrogen peroxide (H2O2) showed minimal inactivation to SARS-CoV-2 virus at concentrations of 0. 5%, 1.25% or 1.5%, Povidone iodine (PVP-I) is able to inactivate SARS-CoV-2, at concentrations of 0.5%, 1.25% and 1.5%, in contact periods of 60 seconds, which reduces the transmission of SARS-CoV-2. Conclusion: It can be evidenced that the different mouthwashes with bactericidal or bacteriostatic effects are an important reference with the aim of protecting the professional as well as the community. The rinse that showed the greatest effectiveness against SARS-CoV-2 virus was iodopovidone with the ability to inactivate the virus and thus prevent its spread.

References

1. Pedraza-Maquera KI, Lévano-Villanueva CJ. Efectividad de enjuagues bucales en el tratamiento dental durante la pandemia COVID-19. Rev. Odont Basadrina. 2020;(1): 48-53

2. Sabino-Silva R, Jardim ACG, Siqueira WL. Coronavirus COVID-19 impacts to dentistry and potential salivary diagnosis. Clin Oral Investig. 2020 Apr;24(4):1619-1621. doi: 10.1007/s00784-020-03248-x. Epub 2020 Feb 20. PMID: 32078048; PMCID: PMC7088419.

3. Wölfel, R., Corman, V.M., Guggemos, W. et al. Virological assessment of hospitalized patients with COVID-2019. Nature 581, 465–469 (2020). https://doi.org/10.1038/s41586-020-2196-x

4. Bueno L. Recomendaciones generales en Periodoncia en momento de pandemia. Rev. Odontoestomatología. 2020;22(1):60-66.

5. Falcón-Guerrero BE. La cavidad bucal como fuente de transmisión del SARSCoV-2. Arch Méd Camagüey.2020; 24(6):8-12.

6. Villegas Rojas IM. La Estomatología actual siguiendo la ruta de la covid-19. AD. 2 de enero de 2021;4(1):17-8.

7. Vergara-Buenaventura A, Castro-Ruiz C. Use of mouthwashes against COVID-19 in dentistry. The British journal of oral & maxillofacial surgery.2020; 58(8):924–927.

8. Carrouel F, Gonçalves LS, Conte MP, Campus G, Fisher J, Fraticelli L, Gadea-Deschamps E, Ottolenghi L, Bourgeois D. Antiviral Activity of Reagents in Mouth Rinses against SARS-CoV-2. J Dent Res. 2020;100(2):124-132.

9. Gottsauner MJ, Michaelides I, Schmidt B, Scholz KJ, Buchalla W, Widbiller M, et al. A prospective clinical pilot study on the effects of a hydrogen peroxide mouthrinse on the intraoral viral load of SARS-CoV-2. Clin Oral Investig. 2020 Oct;24(10):3707-3713.

10. Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect. 2020 Mar;104(3):246-251.

11. Carrouel F, Gonçalves LS, Conte MP, Campus G, Fisher J, Fraticelli L, Gadea-Deschamps E, Ottolenghi L, Bourgeois D. Antiviral Activity of Reagents in Mouth Rinses against SARS-CoV-2. J Dent Res. 2021 Feb;100(2):124-132.

12. Valerie B O’Donnell, David Thomas, Richard Stanton, Jean-Yves Maillard, Robert C Murphy, Simon A Jones, Ian Humphreys, Michael J O Wakelam, Christopher Fegan, Matt P Wise, Albert Bosch, Syed A Sattar, Potential Role of Oral Rinses Targeting the Viral Lipid Envelope in SARS-CoV-2 Infection, Function, Volume 1, Issue 1, 2020.

13. YuC,LiL,TuersunY,ZhaoX,FengQ,ZhangT,TayFR,MaJ (2020) Oropharyngeal secretion as alternative for SARS-CoV-2 detection. J Dent Res 99:1199–1205.

14. Bidra AS, Pelletier JS, Westover JB, Frank S, Brown SM, Tessema B. Rapid In-Vitro Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Using Povidone-Iodine Oral Antiseptic Rinse. J Prosthodont. 2020 Jul;29(6):529-533.

15. Meister TL., Brüggemann Y., Todt D., Conzelmann C., Müller JA., et al. Virucidal Efficacy of Different Oral Rinses Against Severe Acute Respiratory Syndrome Coronavirus 2. The Journal of infectious diseases.2020;222(8):1289–1292.

16. Khan FR, Kazmi SMR, Iqbal NT, Iqbal J, Ali ST, Abbas SA. A quadruple blind, randomised controlled trial of gargling agents in reducing intraoral viral load among hospitalised COVID-19 patients: A structured summary of a study protocol for a randomised controlled trial. Trials. 2020 Sep 14;21(1):785.

17. Pattanshetty S, Narayana A, Radhakrishnan R Povidone-iodine gargle as a prophylactic intervention to interrupt the transmission of SARS-CoV-2.2020;27(1):752-753.

18. Frank S, Capriotti J, Brown SM, Tessema B. Povidone-Iodine Use in Sinonasal and Oral Cavities: A Review of Safety in the COVID-19 Era. Ear Nose Throat J. 2020 Nov;99(9):586-593.

19. Yoon, J. G., Yoon, J., Song, J. Y., Yoon, S. Y., Lim, C. S., Seong, H., Noh, J. Y., Cheong, H. J., & Kim, W. J. (2020). Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva. Journal of Korean medical science, 35(20), e195.

20. Herrera-Plasencia PM., Enoki-Miñano E., Ruiz-Barrueto A. Risks, contamination and prevention against COVID-19 in dental work: a review.Rev. Salud Pública.2020;22(5):1-6.

21. Peng, X., Xu, X., Li, Y. et al. Rutas de transmisión de 2019-nCoV y controles en la práctica odontológica. Int J Oral Sci 12, 9 (2020). https://doi.org/10.1038/s41368-020-0075-9

22. Yoon JG, Yoon J, Song JY, et al. Importancia clínica de una carga viral alta de SARS-CoV-2 en la saliva. J Korean Med Sci . 2020; 35 (20): e195.

23. Imran E, Khurshid Z, M Al Qadhi AA, A Al-Quraini AA, Tariq K. Preprocedural Use of Povidone-Iodine Mouthwash during Dental Procedures in the COVID-19 Pandemic. Eur J Dent. 2020; 12(1):182-184.

24. Kelly, N., Nic Íomhair, A., & McKenna, G. (2020). Can oral rinses play a role in preventing transmission of Covid 19 infection?. Evidence-based dentistry.2020; 21(2), 42–43.

25. Guiñez-Coelho Marcial. Impacto del COVID-19 (SARS-CoV-2) a Nivel Mundial, Implicancias y Medidas Preventivas en la Práctica Dental y sus Consecuencias Psicológicas en los Pacientes. Int. J. Odontostomat. [Internet]. 2020 Sep [citado 2020 Dic 13] ; 14( 3 ): 271-278.

26. Academia Nacional de Odontología. El COVID-19, la saliva y la mucosa lingual. Población y profesionales en riesgo. 2020.

27. Ortega García MV. COVID-19: la nueva enfermedad X. Sanid. Mil. 2020; 76 ( 1 ): 5-7.

28. Yoon JG, Yoon J, Song JY, Yoon SY, Lim CS, Seong H, et al. Clinical significance of a high SARS-CoV-2 viral load in the Saliva. J Korean Med Sci. 2020;35(20): e195.

29. Méndez J.,Villansanti, U. Uso de peróxido de hidrógeno como enjuague bucal previo a la consulta dental para disminuir la carga viral de Covid-19. Revisión de la Literatura. Int. J. Odontostomat.2020; 14(4):544-547.

30. Eggers M, Koburger-Janssen T, Eickmann M, Zorn J. In Vitro Bactericidal and Virucidal Efficacy of Povidone-Iodine Gargle/Mouthwash Against Respiratory and Oral Tract Pathogens. Infect Dis Ther. 2018 Jun;7(2):249-259.

31. Hassandarvish P, Tiong V, Mohamed NA, Arumugam H, Ananthanarayanan A, Qasuri M, Hadjiat Y, Abubakar S. In vitro virucidal activity of povidone iodine gargle and mouthwash against SARS-CoV-2: implications for dental practice. Br Dent J. 2020.

32. Castro-Ruiz C, Vergara-Buenaventura A. Povidone-Iodine Solution: A Potential Antiseptic to Minimize the Risk of COVID-19? A Narrative Review. J Int Soc Prev Community Dent. 2020 Oct 19;10(6):681-685.

Published

2022-03-04