Abstract
BackgroundHealthcare professionals, especially dentists and dental hygienists, are at increased risk for contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through air-borne particles and splatter. This study assessed the in vitro virucidal activity of 0.5% (w/v) povidone-iodine (PVP-I) oral rinse against SARS-CoV-2 to demonstrate its utility as a professional oral rinse.MethodsA 0.5% (w/v) PVP-I oral rinse formulation, placebo oral rinse, and positive (70% [v/v] ethanol and water) and negative (water) controls were assessed using the time-kill method. SARS-CoV-2 was propagated in Vero 76 host cells. Following neutralization validation, triplicate tests were performed for each test formulation and virucidal activity measured at 15, 30, and 60 s and 5 min.ResultsThe 0.5% (w/v) PVP-I oral rinse demonstrated effective in vitro virucidal activity against SARS-CoV-2 as early as 15 s after exposure; viral titer was reduced to < 0.67 log10 50% cell culture infectious dose (CCID50)/0.1 mL (log10 reduction of > 4.0) at 30 s, whereas the placebo oral rinse reduced the SARS-CoV-2 viral titer to 4.67 and 4.5 log10 CCID50/0.1 mL at the 15- and 30-s time points, with a log10 reduction of 0.63 and 0.17, respectively. No toxicity or cytotoxic effects against Vero 76 host cells were observed with the 0.5% (w/v) PVP-I oral rinse; positive and negative controls performed as expected.ConclusionsIn vitro virucidal activity of 0.5% (w/v) PVP-I oral rinse against SARS-CoV-2 was demonstrated. Rapid inactivation of SARS-CoV-2 was observed with 0.5% (w/v) formulation with a contact duration of 15 s. Clinical investigations are needed to assess the effectiveness of PVP-I oral rinse against SARS-CoV-2 in dental practice.
Highlights
Healthcare professionals, especially dentists and dental hygienists, are at increased risk for contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through air-borne particles and splatter
There is currently no published evidence regarding the clinical effectiveness of preprocedural mouth rinses (PPMRs) to prevent SARS-CoV-2 transmission, PPMRs with an antimicrobial product such as chlorhexidine gluconate, essential oils, povidone-iodine (PVP-I), or cetylpyridinium chloride may reduce the level of oral microorganisms in aerosols and spatter generated during dental procedures [7]
A smallscale randomized study in SARS-CoV-2–positive patients assessing the efficacy of PVP-I, chlorhexidine gluconate, and cetylpyridinium chloride in reducing salivary SARSCoV-2 viral load found that viral load was reduced for up to 6 h with cetylpyridinium chloride or PVP-I, whereas another in vivo test demonstrated a significant reduction in viral load for at least 3 h after PVP-I oral rinse in 50% of patients [9, 10]
Summary
Healthcare professionals, especially dentists and dental hygienists, are at increased risk for contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through air-borne particles and splatter. Since the emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) toward the end of 2019, global daily cases peaked at almost 1.5 million in December 2020, and almost 18,000 daily deaths were reported globally in January 2021 [1] This new and highly transmissible SARS-CoV-2 has impacted all levels of society; healthcare professionals are at a higher risk of contracting the virus as a result of their. There is currently no published evidence regarding the clinical effectiveness of preprocedural mouth rinses (PPMRs) to prevent SARS-CoV-2 transmission, PPMRs with an antimicrobial product such as chlorhexidine gluconate, essential oils, povidone-iodine (PVP-I), or cetylpyridinium chloride may reduce the level of oral microorganisms in aerosols and spatter generated during dental procedures [7]. The use of PVP-I formulations has been evaluated for high-risk clinical procedures involving the oropharynx and nasopharynx and in surgical practice [11,12,13]
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