Abstract

Introduction:The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in saliva and nasopharyngeal secretions has challenged the routine practice of dentistry. Use of preprocedural mouth rinses has been recommended by several organizations to potentially reduce the transmission of SARS-CoV-2. This scoping review aimed at evaluating the available evidence on the efficacy of mouth rinses against SARS-CoV-2.Methods:A thorough literature search on electronic databases (PubMed, Scopus, and Google Scholar) was performed by two independent reviewers and data from articles addressing the aim of this article were extracted.Results:After exclusion of articles not addressing the end point in question, 12 articles were included in this scoping review. Of the 12 articles, seven werein vitrostudies and five werein vivohuman clinical studies. Thein vitrostudies used a standardized methodology (endpoint dilution assay) to evaluate the efficacy of antimicrobial mouth rinses against SARS-CoV-2. Thein vivostudies were done utilizing polymerase chain reaction assay of samples obtained from saliva or nasopharyngeal swab or a combination of both nasopharyngeal and oropharyngeal swab. The reagents tested in these studies included povidone-iodine, chlorhexidine, hydrogen peroxide (H2O2), essential oils, and quaternary ammonium compounds and demonstrated varied efficacy against SARS-CoV-2.Conclusion:Based on the available evidence fromin vitrostudies, it can be concluded that mouth rinses have a potential to reduce SARS-CoV-2 viral load; however, effectiveness inin vivoconditions is still inconclusive. Owing to the substantial heterogeneity in reporting of the anti–SARS-CoV-2 efficacy of mouth rinses, this review highlights the need to conduct future research with robust and standardized methodologies to confirm effectiveness of mouth rinses.

Highlights

  • The presence of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) in saliva and nasopharyngeal secretions has challenged the routine practice of dentistry

  • There has been a shift toward reopening of practices and provision of routine dental care, which has led to an increase in aerosol-generating procedures

  • This scoping review was conducted according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and MetaAnalyses extension for scoping reviews) statement [23], and the review focused on the following evidence-based question: “What is the efficacy of mouth rinses against SARS-CoV-2?”

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Summary

Introduction

The presence of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) in saliva and nasopharyngeal secretions has challenged the routine practice of dentistry. Coronavirus disease 2019 (COVID-19) and its rapid spread have drastically affected the dental community worldwide This has led to a diverse set of recommendations in which some regions had a complete lockdown of dental practices, in contrast to certain areas where dentists continued to provide care for emergency patients. Aerosols are air-borne suspended particles with a potential to contain salivary components and Efficacy of Mouth Rinses Against SARS-CoV-2 microorganisms [1]. This is a cause for concern as saliva and nasopharyngeal secretions can carry high viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in COVID-19 affected individuals [2]. Various dental organizations responded by specifying guidelines for provision of dental care during the pandemic [6,7,8]

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