Use Of Mouthwash Research Articles

To Evaluate the Efficacy of Adjuncts Mouthwash along with Oral Hygiene Habits in Reduction of Peri-implant Mucositis - A Randomized Controlled Trial

Peri-implantitis is a site-specific condition that causes an inflammatory procedure in delicate tissues, and bone loss around an osseo-integrated implants in work. The etiology of the implant infection is caused by the status of the tissue encompassing the implants, implant design, degree of roughness, outer morphology, and excessive mechanical burden. Peri-implantitis can cause the loss of implant without multilateral expectation and treatment thoughts, Aim: the main aim of this study is to evaluate the efficacy of additional adjuncts (mouthwash) apart from the self administered oral health care in prevalence of peri-implantitis. Material and Methodology: a randomized controlled trial was done in Srinagar district of Jammu and Kashmir. Specific clinics which undergo additional implant placement with the help of a professional were selected. A total of 45 subjects were selected who had undergone implant placements and were divided into three groups on the basis of type of adjunct/ mouthwash given. Results: 45 periodontally healthy subjects were assessed for the presence of peri-implant mucositis. 100% of subjects were disease free within 12 weeks period. The prevalence of peri-implantitis was found to be much reduced in group 1, followed by group 2and group 3. Average plaque index and bleeding on probing index was also decreased in first two groups. Conclusion: within the limits of the said study, additional use of mouthwash along with other oral hygiene practices can reduce the prevalence and severity of peri-implantitis within a week’s period of time. Keywords: Bone-Loss, Chlorohexidine, Periimplantitis, Mouthwash

Key opinion leaders reach an evidence-based consensus on mouthwash use

Key opinion leaders reach an evidence-based consensus on mouthwash use

Effect of Dextranase and Dextranase-and-Nisin-Containing Mouthwashes on Oral Microbial Community of Healthy Adults—A Pilot Study

This study analyzed the alteration of oral microbial composition in healthy subjects after using dextranase-containing mouthwash (DMW; Mouthwash formulation I) and dextranase-and-nisin-containing mouthwash (DNMW; Mouthwash formulation II). Eighteen participants were recruited and were randomly allocated to two groups: G1 (DMW user; n = 8) and G2 (DNMW user; n = 10). The subjects were instructed to use the provided mouthwash regularly twice a day for 30 days. The bleeding on probing (BOP), plaque index (PI), probing depth (PBD), and gingival index (GI) were analyzed, and saliva samples were collected before (day 0) and after (day 30) the use of mouthwashes. The saliva metagenomic DNA was extracted and sequenced (next-generation sequencing, Miseq paired-end Illumina 2 × 250 bp platform). The oral microbial community in the pre-and post-treated samples were annotated using QIIME 2™. The results showed the PI and PBD values were significantly reduced in G2 samples. The BOP and GI values of both groups were not significantly altered. The post-treated samples of both groups yielded a reduced amount of microbial DNA. The computed phylogenetic diversity, species richness, and evenness were reduced significantly in the post-treated samples of G2 compared to the post-treated G1 samples. The mouthwash formulations also supported some pathogens’ growth, which indicated that formulations required further improvement. The study needs further experiments to conclude the results. The study suggested that the improved DNMW could be an adjuvant product to improve oral hygiene.

Could polyhexanide and chlorine dioxide be used as an alternative to chlorhexidine? A systematic review.

Maintenance of oral microbiota balance is the simplest way to prevent infectious oral diseases, through controlling dental biofilm. Combined use of mouthwash and mechanical removal has been shown to be a very effective way for this. To identify clinical studies comparing the antimicrobial effect and possible adverse effects and/or side effects of chlorhexidine-based mouthwashes with those of mouthwashes containing chlorine dioxide and/or polyhexanide, for controlling oral microbiota. Systematic review designed by the stomatology sector of postgraduation in applied dental sciences of Bauru Dentistry School, University of São Paulo, Brazil. A systematic review was conducted using online databases (PubMed, Embase, Web of Science and Science Direct) up to April 8, 2020. The search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The studies included comprised eight articles published between 2001 and 2017. A total of 295 young adults, adults and elderly people were evaluated (males 44.75% and females 55.25%). Three articles compared polyhexanide with chlorhexidine and five articles compared chlorine dioxide with chlorhexidine. No studies comparing all three mouthwashes were found. The concentrations of the study solutions were quite varied, and all rinses had an antimicrobial effect. In four studies, it was stated that no side effects or adverse effects had been found. Three studies did not address these results and only one study addressed side effects and/or adverse effects. Mouthwashes containing chlorine dioxide and polyhexanide are viable alternatives to chlorhexidine, since they reduce oral biofilm and have little or no reported side or adverse effects.

Effect of Limonene, Camphor and Menthol on Cariogenic Oral Pathogens

Streptococci, Lactobacillus, and fungi take a significant role in caries development. It confirms the importance of controlling these microorganisms to prevent dental caries. Chemical methods are used to prevent plaque accumulation in addition to physical methods, which include the use of chemical mouthwashes like chlorhexidine. Chemicals, while beneficial, have many side effects. This study aimed to find the herbal compounds having fewer side effects. Three monoterpenes, menthol, limonene, and camphor in plants that have been shown to have an antibacterial effect have been prepared and by sensitization drug in 96-well plates exposed to Streptococcus mutans, Streptococcus salivarius, Streptococcus sobrinus, Lactobacillus casei, and several Candida spp.. The minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and minimum fungicidal concentration (MFC) were identified. The menthol had the best inhibitory effect on yeast growth (MIC = 0.5-1 µg/ml), and the limonene composition had the lowest fungicidal concentration against Candida spp. (MFC = 1.9 µg/ml). Menthol at a concentration of 128 μg/mL had no bactericidal effect while it killed Lactobacillus. Strep.salivarius were killed at a concentration of 128 μg/ml of limonene. At the same concentration of camphor, Strep.mutans were killed. Monoterpenes exhibited great antimicrobial activity, which can use in mouthwashes formulation. Keywords: Monoterpenes, Streptococcus mutans, Candida albicans, Anti-Bacterial Compounds, Limonene, Menthol

Efficacy of herbal- versus chlorhexidine-based mouthwashes towards oral hygiene maintenance in patients undergoing fixed orthodontic therapy: A systematic review and meta-analysis.

The review aims to fill the gap in literature by comparing the efficacy of herbal and chlorhexidine-based mouthwashes towards oral hygiene maintenance (OHM) in patients undergoing fixed orthodontic treatment (OT). Indexed databases were searched electronically to include randomized controlled trials (RCTs) for data gathering. The protocol was registered in PROSPERO (CRD42020182497). Risk of bias assessment, quality of evidence investigation and meta-analysis were performed to evaluate reported OHM-related parameters at time points before and after the use of chlorhexidine (control group) and herbal mouthwashes (intervention group). With 95% confidence intervals, mean difference (MD) or standardized mean difference (SMD) was used to estimate effect size. Out of eight RCTs, results from one RCT favoured chlorhexidine and the results from a second RCT favoured herbal mouthwashes. Results from three RCTs showed comparable effects for the respective investigated OHM-related parameters. Chlorhexidine demonstrated higher antimicrobial efficacy against Streptococcusmutans (S.mutans) in two studies, and one RCT found comparable antimicrobial efficacies. Risk of bias was low in two studies, and moderate and high in two studies each. Quality of evidence was very low to moderate for the respective investigated parameters. Sub-group analysis for parameters colony forming units (CFU) {SMD (0.40) [95% CI (-0.22, 1.03)], gingival index (GI) {MD (0.06) [95% CI (-0.08, 0.20)]}, plaque index (PI) {SMD 0.22 [95% CI (-0.23, 0.67)]} before the use of chlorhexidine and herbal mouthwashes remained inconclusive. The comparison between efficacy of herbal and chlorhexidine towards OHM in patients undergoing fixed OT remains debatable.

The Impact of Mouthwash on the Oropharyngeal Microbiota of Men Who Have Sex with Men: a Substudy of the OMEGA Trial.

ABSTRACTMouthwash is a commonly used product and has been proposed as an alternative intervention to prevent gonorrhea transmission. However, the long-term effects of mouthwash on the oral microbiota are largely unknown. We investigated the impact of 12 weeks of daily mouthwash use on the oropharyngeal microbiota in a subset of men who have sex with men who participated in a randomized trial comparing the efficacy of two alcohol-free mouthwashes for the prevention of gonorrhea. We characterized the oropharyngeal microbiota using 16S rRNA gene sequencing of tonsillar fossae samples collected before and after 12 weeks of daily use of Listerine mouthwash or Biotène dry mouth oral rinse. Permutational multivariate analysis of variance (PERMANOVA) was used to assess differences in oropharyngeal microbiota composition following mouthwash use. Differential abundance testing was performed using ALDEx2, with false-discovery rate correction. A total of 306 samples from 153 men were analyzed (Listerine, n = 78 and Biotène, n = 75). There was no difference in the overall structure of the oropharyngeal microbiota following Listerine or Biotène use (PERMANOVA P = 0.413 and P = 0.331, respectively). Although no bacterial taxa were significantly differentially abundant following Listerine use, we observed a small but significant decrease in the abundance of both Streptococcus and Leptotrichia following Biotène use. Overall, our findings suggest that daily use of antiseptic mouthwash has minimal long-term effects on the composition of the oropharyngeal microbiota.IMPORTANCE Given the role of the oral microbiota in human health, it is important to understand if and how external factors influence its composition. Mouthwash use is common in some populations, and the use of antiseptic mouthwash has been proposed as an alternative intervention to prevent gonorrhea transmission. However, the long-term effect of mouthwash use on the oral microbiota composition is largely unknown. We found that daily use of two different commercially available mouthwashes had limited long-term effects on the composition of the oropharyngeal microbiota over a 12-week period. The results from our study and prior studies highlight that different mouthwashes may differentially affect the oral microbiome composition and that further studies are needed to determine if mouthwash use induces short-term changes to the oral microbiota that may have detrimental effects.

Meta-Analysis the Effect of Chlorhexidine and Povidone Iodine Mouthwashes on Viral Load SARS-CoV-2-Saliva

Background: The strategy to reduce the risk of transmission of COVID-19 is to reduce the salivary SARS-CoV-2 viral load. Chlorhexidine and povidone iodine mouthwash are common active ingredients in oral antiseptics that have efficient viral activity against salivary SARS-CoV-2. This study aims to combine the results of several effect sizes regarding the effect of using chlorhexidine and povidone iodine mouthwash on the salivary SARS-CoV-2 viral load from various countries. Subject and Method: This study is a meta-analysis with the following PICO model, P: COVID-19 patients. I: use of chlorhexidine and povidone iodine mouthwash. C: no mouthwash. O: salivary SARS-CoV-2 viral load. A search for the articles used in this study was carried out using the keywords “COVID-19” OR “SARS-CoV-2” OR “viral load” OR “SARS-Cov-2 viral load” OR “Chlorhexidine mouthrinse” OR “Povidone Iodine mouthrinse ” OR “Randomized Controlled Trial” OR “RCT” between 2012-2022 from the PubMed, Springerlink, Elsevier, Google Scholar and Wiley Online Library databases. The inclusion criteria used in this study were full-text articles using a Randomized Controlled Trial (RCT) design. The analysis used was multivariate with Standardized Mean Difference (SMD). The articles collected were then critically reviewed using the PRISMA checklist, then the data were analyzed using the Review Manager 5.4 tool. Results: This meta-analysis examined 10 articles with a Randomized Controlled Trial (RCT) study design originating from Singapore, Saudi Arabia, Iran, Brazil, Italy, South Korea and Malaysia. A meta-analysis of 7 articles showed that the use of chlorhexidine mouthwash could reduce salivary SARS-CoV-2 viral load by 0.12 units lower than without the use of mouthwash (SMD= -0.12; 95% CI= -0.33 to 0.09; p=0.250). Meanwhile, 7 articles showed that the use of povidone iodine mouthwash could reduce the salivary SARS-CoV-2 viral load by 0.64 units lower than without the use of mouthwash (SMD= -0.64; 95% CI= -1.51 to 0.23; p=0.150). Conclusion: The use of chlorhexidine and povidone iodine mouthwashes can reduce the amount of salivary SARS-CoV-2 viral Keywords: mouthwash, chlorhexidine, povidone iodine, COVID-19, salivary SARS-CoV-2 viral load. Correspondence: Danti Narulita. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah. Email: dantinarulita@yahoo.co.id. Mobile: +6282158818400. Indonesian Journal of Medicine (2022), 07(04): 387-400 https://doi.org/10.26911/theijmed.2022.07.04.04

Use of Mouthwash in Preventing Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a virus that enters the respiratory tract through the nose and mouth affects a wide range of cells and systems of the body, causing various types of symptoms. Therefore, the discovery that the use of mouthwash may help prevent COVID-19 from entering the body is a breakthrough and an area of interest for research. In this report, several research papers about the effects of mouthwash in preventing COVID-19 are evaluated and different types of mouthwash are discussed. In particular, one randomized prospective cohort study presented the promising result of chlorhexidine mouthwash and spray in preventing COVID-19. Despite the result, the number of clinical trials is lacking, and more clinical trials need to be performed to obtain more conclusive clinical evidence that the mouthwash indeed has a preventive effect on SARS-CoV-2 transmission.

Evaluation effect of chlorhexidine and green tea mouthwash on saliva pH and plaque index

Aims: Applying mouthwash has an important role in reducing caries when compared to other prevention methods. The purpose of this study is to compare saliva pH and plaque index before and after using chlorhexidine mouthwash and a mouthwash with green tea extract. Materials and Methods: Forty dental students were randomly assigned to two groups (chlorhexidine and green tea mouthwash). A week before research getting started and during that, the students were asked to use normal diet and Bass brushing method. Salivary pH and plaque index of the participants were measured before, 1 week, and also 2 weeks after the use of mouth washes. Then, the data were analyzed based on Friedman, Mann–Whitney, and repeated-measures ANOVA tests. Results: The mean pH was significantly different in the three times of 1 week prior, during, and 2 week after the treatment for the green tea group (P = 0.01). However, there was no significant difference in the chlorhexidine group (P = 0.211). The mean of new plaque in both chlorhexidine green tea groups was significant (P < 0.001). The mean of plaque formation at <48 h in chlorhexidine and in green tea was both significant (P < 0.001). Conclusion: The effect of chlorhexidine mouthwash and green tea on salivary pH and plaque index was the same in a week. However, the effect of green tea was more than that of chlorhexidine in a 3-week application.

Preprocedural Mouth Rinse in COVID-19 Era - Chemical and Phytotherapeutic Approach

COVID-19 has impacted the dental services majorly, and there have been some major changes in the dental treatment protocols. As the dental treatment mostly involves the production of aerosols, dentists and dental patients are at high risk of acquiring and transmitting the virus. To reduce the transmission of SARS CoV-2 through aerosols, preprocedural mouth rinse has been recommended. The use of mouthwashes can help in reducing the viral load. The aim of the present review is to discuss different mouthwashes having virucidal action against COVID-19 virus.

White lesions that can be wiped off: A case report of oral mucosal peeling

Background: Oral mucosal peeling (OMP) refers to an asymptomatic white lesion commonly encountered in daily practice but rarely discussed in the literature. OMP can be induced by various daily oral care products. Although common, some clinicians may not be familiar with OMP. In this case report, we describe a case of widespread OMP associated with toothpaste and mouthwash use. Case Report: A 40-year-old man presented with asymptomatic white lesions, with thin sloughing appearance in the whole oral mucosa. The patient was healthy, with no routine use of medications. The lesions were easily removed using a sterile gauze, with no subsequent erosion or ulceration occurring. The lesions were attributed to the use of sodium lauryl sulfate (SLS)-containing toothpaste and a mouthwash containing chlorhexidine (CHX) and essential oils. The patient was advised about the benign nature of the lesions. Discontinuation of SLS-containing toothpaste was suggested. Conclusion: OMP is commonly associated with the use of SLS-containing toothpastes and dentifrices and mouthwashes containing essential oils or CHX with the use of SLS-containing toothpastes and dentifrices and mouthwashes containing essential oils or CHX. Dentists must be able to identify OMP and provide appropriate patient education.

Evaluation of the Topical Effect of Probiotic Mouthwash in the Treatment of Patients with Peri-Implant Mucositis.

Peri-implant mucositis is a reversible inflammatory process of the soft tissue surrounding a dental implant. If left untreated, peri-implant mucositis can evolve into peri-implantitis, which leads to the loss of the supporting bone around the implant. The treatment of peri-implantitis is of special importance, since peri-implantitis can be very expensive and troublesome for both the patient and the dentist and a lack of complete resolution can lead to a low probability of implant success. This study aims to evaluate the effects of probiotic tablets on the condition of patients with peri-implant mucositis after scaling. In this double-blind randomized intervention trial, packages containing 14 probiotic capsules or a single-dose placebo were provided to 25 volunteer patients after scaling among those called to a private clinic in Mashhad. During the research process, we used the probing depth (PD) index and the bleeding on probing (BOP) index to diagnose peri-implant mucositis before and after the 28-day period. According to the study findings, on the day of scaling and 4 weeks after scaling and mouthwash use, there was a statistically significant difference in BOP index values between the probiotic group and the placebo group (P < 0.001). There was no difference in PD index values between these two groups. In conclusion, probiotic treatment can be used in interventions, prevention, and dentists' recommendations to alleviate or eradicate peri-implant mucositis.

Effect of pediatric mouthwashes on the color stability of dental restorations with composite resins. In vitro comparative study.

To evaluate in vitro the effect of three pediatric mouth rinses on the color stability of three different composite resins. One hundred thirty-two disc-shaped samples (n = 132) were prepared, with 44 for each type of composite resin (n = 44), and the initial color values were measured with a spectrophotometer. Eleven (n= 11) samples were placed in each immersion substance, and 3 types of pediatric mouthwashes were used with distilled water as a control. The samples were placed in an incubator at 37°C for one hour (equivalent to 1 month of mouthwash use). and color measurement was performed. Color change values (ΔE*) were obtained and the results were statistically analyzed. Kruskal Wallis and Mann-Whitney U tests were used to compare the values between groups (P<0.05). All composite resin samples showed color changes after immersion in the different solutions studied. The ΔE* showed that pediatric mouth rinses produced significant changes in color of the composites tested. The group of nanohybrid resins presented lower levels of change in color stability (ΔE * = 4.63), followed by bulk resins (ΔE * = 5.70) and, finally, nanoparticle resins presented greater effects in color stability. (ΔE *= 5.84). All the composite resin restorative materials used showed differences in color after immersion in the 3 mouthwashes and the distilled water analyzed, these changes should be taken into by dentists working with pediatric patients - o - by pediatric dentists. Key words:Mouthwashes, color stability composite resins, bulk resins, surface roughness.

The effects of fluoride mouthwash use at school age on oral health and self-management ability after adulthood

The effects of fluoride mouthwash use at school age on oral health and self-management ability after adulthood

Antibacterial activity of garlic extract, tea tree oil, and its mouthwashes against Streptococcus mutans and Lactobacillus: An In vivo study

Background: A wide group of microorganisms is identified from carious lesions, of which Streptococcus mutans and Lactobacillus acidophilus are the main pathogenic species involved in the initiation and propagation of dental caries. Mouthrinses can deliver therapeutic ingredients and benefits to all accessible surfaces in the mouth. With the increasing use of drugs, microorganisms are attaining resistance to commonly used antibiotics, which leads to the downfall of the effectiveness of conventional medicines, and therefore, a search for new antimicrobial agents has become necessary. The objective of the study was to evaluate the effect of mouthwashes containing garlic extract (GE), tea tree oil (TTO), and chlorhexidine (CHX) on salivary S. mutans and Lactobacillus. Methods: An in vivo parallel study was conducted among 90 18–25-year-old subjects. GE (2.5%) and TTO (0.2%) mouthwashes were prepared for use in the study. Commercially available CHX mouthwash (0.12%) was used as a positive control. The study duration was 5 weeks. The participants were randomly assigned into three groups with 30 participants in each group. To assess the residual effects following discontinuation of mouthwashes, saliva samples were collected on the 18th and 24th days. One-way ANOVA was used to assess the mean colony difference. Results: No significant difference in the counts of S. mutans and Lactobacillus was observed at baseline and 6th day between all the three groups. On the 12th day, the highest reduction in S. mutans and Lactobacillus counts was observed following the use of TTO mouthwash, followed by CHX mouthwash. The reduction in the count of S. mutans was significantly higher in the TTO group on the 24th day comparable to the garlic mouthwash group, followed by the CHX mouthwash group. Conclusion: Both GE and TTO mouthwashes demonstrated a significant antibacterial activity against S. mutans and Lactobacillus in vivo, with TTO demonstrating the greatest effect.

Comparative Evaluation of the Influence of Single Preoperative Antibiotic Dose of Amoxicillin (1gm) and Postoperative Antibiotic Dose of Amoxicillin Drug (500mg) Regimen on Postoperative Outcome and Implant Stability in Single Tooth Dental Implant Surgery: Randomized Controlled Trial

Aims: A single blinded randomized controlled trial was conducted to test the efficiency of two antibiotic regimens on post operative outcome and implant stability in single tooth dental implant to overcome the increasing drug resistance due to over prescription of medicines and side effects of the same.&#x0D; Methodology: 20 participants needing single tooth dental implant were enrolled based on inclusion and exclusion criteria. The participants were randomly assigned into groups. 10 participants in group 1 received only a single preoperative dosage of amoxicillin 1gm which was followed by paracetamol. In group 2, 500mg amoxicillin was given postoperatively followed by a three times a day for 3 days regimen. The postoperative outcome was evaluated based on swelling, post-operative bruising, suppuration and wound dehiscence noticed on 2nd and 7th day postoperatively. ISQ (implant stability quotient) was checked 3 months post implant placement as osseointergration is the main goal of implant placement.&#x0D; Results: Post-operative bruising, suppuration and wound dehiscence were not noticed in the entire study due to sterile environment during implant placement. When swelling was compared between group 1 and 2 it was statistically insignificant on day 2 (Mann Whitney u=40.00, p=0.383) and day 7 (Mann Whitney u=50.00, p=01.00). ISQ (IMPLANT STABILITY QUOTIENT) score in group 1&amp;2 also showed statistically insignificant results (t=0.00, p=1.00) Which states that there was no significant difference in the stability of implants when single preoperative antibiotic dose of amoxicillin(1gm) and postoperative antibiotic dose of amoxicillin drug(500mg) regimen 3 times a day for 3 days was given.&#x0D; Conclusion: this study shows that in healthy individual, when single implant is placed in proper sterile environment with routine dental hygiene such as brushing and chlorhexidine mouthwash use by patient, single preoperative dose of amoxicillin 1gm is sufficient for the success of implant. However, considering the limitations of the study, further work is necessary to validate reliability.&#x0D; No adverse effects were observed in the study&#x0D; Funding: NIL&#x0D; Reg no:DYPDCH/EC/648/12/2021

THE EFFECT OF 0.12% CHLORHEXIDINE DIGLUCONATE AND 0.1% CHLORINE DIOXIDE ON DISCOLORATION OF NANOFILLED COMPOSITE RESIN

ABSTRAK Background: Composite resins are able to generate the color of dental restorative materials based on the original teeth's color. Nanofilled composite resins have compressive strength, good polishing, and color stability compared to other types of composite resins. Color changes may occur due to intrinsic and extrinsic factor example mouthwash. Mouthwash that is commonly used is chlorhexidine. The use of chlorhexidine mouthwash continuously may stain the composite resins. Mouthwash that has a good anti-plaque other than chlorhexidine is chlorine dioxide which has a clear color and does not cause changes in taste on the tongue.Aim: To determine the effect of 0.12% chlorhexidine digluconate mouthwash and 0.1% chlorine dioxide mouthwash to the discoloration of nanofilled composite resins. Methods: This study is an experimental study with a pre-test and post-test control group design. Samples are nanofilledcomposite resins made into discs in total of 27 and divided into three groups with different treatments, soaked with 0.12% chlorhexidine digluconate mouthwash, 0.1% chlorine dioxide mouthwash, and sterile distilled water. Each group was soaked for 24 hours and tested for staining using chromameter.Result: ANOVA test showed the significant difference between group, that the greatest color change is the one soaked with 0.12% chlorhexidine digluconate mouthwash compared to 0.1% chlorine dioxide mouthwashConclusions: The use of 0.1% chlorine dioxide mouthwash does not cause discoloration as much as 0.12% chlorhexidine digluconate mouthwash.Keywords: Chlorhexidine digluconate, Chlorine dioxide, nanofilled composite resin, discoloration

Evidence for the use of mouthwash as a preprocedural preventive measure against COVID-19: Should we rinse and repeat?

To the Editor: Despite the effectiveness of vaccines in limiting severe illness, hospitalization, and death due to COVID-19, the prevention of viral transmission has proven to be a much more elusive target. The coronavirus, enriched in the upper airway, appears to spread via droplet and aerosol even in the absence of symptomatic disease. Research and guidance from otolaryngology and dentistry, specialties at a particularly high risk of exposure, have recommended that in addition to the use of standard infection control measures, patients be given a preprocedural mouth rinse in the outpatient setting.

Clinical evaluation of antiseptic mouth rinses to reduce salivary load of SARS-CoV-2

Most public health measures to contain the COVID-19 pandemic are based on preventing the pathogen spread, and the use of oral antiseptics has been proposed as a strategy to reduce transmission risk. The aim of this manuscript is to test the efficacy of mouthwashes to reduce salivary viral load in vivo. This is a multi-centre, blinded, parallel-group, placebo-controlled randomised clinical trial that tests the effect of four mouthwashes (cetylpyridinium chloride, chlorhexidine, povidone-iodine and hydrogen peroxide) in SARS-CoV-2 salivary load measured by qPCR at baseline and 30, 60 and 120 min after the mouthrinse. A fifth group of patients used distilled water mouthrinse as a control. Eighty-four participants were recruited and divided into 12–15 per group. There were no statistically significant changes in salivary viral load after the use of the different mouthwashes. Although oral antiseptics have shown virucidal effects in vitro, our data show that salivary viral load in COVID-19 patients was not affected by the tested treatments. This could reflect that those mouthwashes are not effective in vivo, or that viral particles are not infective but viral RNA is still detected by PCR. Viral infectivity studies after the use of mouthwashes are therefore required. (https://clinicaltrials.gov/ct2/show/NCT04707742; Identifier: NCT04707742)