Oral Antiseptics Research Articles

Alveolo-dental trauma: Epidemiological, clinical and therapeutic aspects at Centre Hospitalier Universitaire Yalgado Ouédraogo

: TAD constitutes one of the most frequent and urgent reasons in the stomatology and maxillofacial surgery (S/CMF) department. This study aimed to contribute to improving the management of alveolar-dental trauma at CHU-YO. This was a retrospective case series study, based on the clinical files of patients who underwent TAD and admitted to the S/CMF department of the CHU-YO during the period of study from July 1, 2022 to June 30, 2023. Data were collected from collection sheets and patient files during this period. 100 cases of TAD were collected in the S/CMF department of the CHU-YO. These TADs were relatively frequent. The age group of 15 to 30 years was the most affected (51%). Male predominance was clear (64%). ACRs were the greatest providers of alveolar-dental trauma (84%). Dislocations were predominant (51%) and the elective site was the upper jaw (61%). Medical treatment consisted mainly of antibiotics (100%), analgesics (97%), anti-inflammatories (71%) and topical uses of oral antiseptics (100%). The most commonly performed surgical treatment was soft tissue sutures. Restraints using Duclos arch ligatures were the subject of the majority of cases of orthopedic treatment (46%). Evolution was good in 84% of cases. Dental mobility (4%) and alveolitis (4%) dominated the table of complications.: Reducing ACR, which involves significant road prevention, would undoubtedly contribute to reducing the incidence of alveolar-dental trauma. Strengthening the technical platform and interdisciplinary collaboration of the department of odontostomatology and maxillofacial surgery could improve patient care at the CHU-YO.

Evaluation of the dynamics of oral pathogenic microbiota in COVID-19 patients by genomic sequencing after application of foam with antimicrobial action

Relevance. The COVID-19 pandemic caused by the SARS-CoV-2 virus has demonstrated the critical importance of understanding the mechanisms of transmission and finding effective methods of prevention. Particular attention has been paid to the role of oral hygiene, as the oral cavity serves as a major route of transmission. Studies show that the composition of the oral microbiota can influence the course and outcome of COVID-19 disease. Therefore, there is a need to study the effects of oral antiseptics on the microbiome, which may offer new opportunities for the prevention and treatment of this disease.Objective. The aim of this study is to evaluate the effectiveness of the oral cleansing foam «Parodontol PROF» in reducing the pathogenic microflora of the oral cavity in patients with COVID-19 and to assess its effect on the risk of secondary infections.Materials and methods. The study was conducted on the basis of the Clinical Medical Centre «Kuskovo» of Russian University of Medicine. It included 450 patients with a confirmed diagnosis of COVID-19. The participants were divided into two groups: the test group used oral cleansing foam, while the control group used no additional oral hygiene. Comparative analyses of the taxonomic composition of the oropharyngeal microbiota and dental plaque before and after the use of the cleansing foam were performed.Results. The study showed that patients who regularly used the cleansing foam «Parodontol PROF» had a significant decrease in the representation of pathogens, including Mycoplasma, and an increase in the number of beneficial commensals such as Lactococcus and Lactobacillus. These changes indicate the potential efficacy of this product to improve oral hygiene and reduce the risk of secondary infections.Conclusion. The study supports the hypothesis that improving oral hygiene with specialised antiseptic agents, such as a cleansing foam, may help to reduce pathogenic microflora in the oral cavity in patients with COVID-19. This, in turn, may reduce the risk of pathogen migration into the lower respiratory tract and the development of secondary infections. The findings emphasise the importance of further research in this area and the development of comprehensive approaches to oral hygiene management in the context of infectious diseases.

Cuidados de enfermería en la higiene bucal de pacientes intubados. Revisión de la Literatura

Objective: Determine nursing care in oral hygiene of intubated patients through a bibliographic review. Methods: A documentary, non-systematic and descriptive research was carried out on the nursing care received by intubated patients in intensive care units for oral hygiene, using databases such as: PubMed, BVS, Scielo, Google scholar, using descriptors from Health Sciences DESC and Medical Subject Headings MeSH, whose inclusion criteria were: original articles, bibliographic review and case reports directly related to the topic, published in the period 2019-2023, in language Spanish and English and of scientific quality (SJR). The bibliographic review was developed with nine bibliographic sources, predominantly qualitative and in English. Results: Oral hygiene care generally includes the use of oral antiseptics such as chlorhexidine, brushing with small soft bristles, suction and hydration of the oral cavity to reduce plaque formation and consequently infections and mortality in intubated patients. Conclusion: It is established that nursing care in oral hygiene of intubated patients is essential to keep the oral cavity clean, stimulate saliva flow, avoid inflammation, pain and discomfort in the patient, keep the mucosa and lips hydrated and above all reduce dental plaque, microbial and colonization of the oropharynx.

Revisiting Oral Antiseptics, Microorganism Targets and Effectiveness.

A good oral health status is mostly dependent on good oral hygiene habits, which knowingly impacts systemic health. Although controversial, chemical oral antiseptics can be useful in adjunct use to mechanical dental plaque control techniques in the prevention and management of local and overall health and well-being. This review aims to revisit, gather and update evidence-based clinical indications for the use of the most popular oral antiseptics, considering different types, microorganism targets and effectiveness in order to establish updated clinical recommendations.

Do Oral Antiseptics Affect the Force Degradation of Elastomeric Chains?

Objective: This study aimed to compare the force degradation of elastomeric chains submerged in commonly used mouthrinses. Methods: One hundred samples of elastomeric orthodontic chains from five different brands (Ormco, GC, RMO, Forestandent, and 3M Unitek) were initially activated on double length, and the force was measured with a universal mechanical testing machine. Then, elastomeric modules were thermocycled and immersed into four different mouthrinses: Octenident, Vitis Orthodontic, Perio Plus+, and Listerine through a total number of three cycles which simulated 30 days of intraoral exposure. Force decay was measured after each cycle. Results: All specimens showed statistically significant force degradation over the tested period (p < 0.001). After thermocycling and immersion in oral antiseptics, the lowest measured force was found in Forestadent EOC in Listerine with a median of 70 cN (70–75 cN) and Vitis orthodontic with a median of 70 cN (70–80 cN). On the contrary, the least prone to force reduction was the control group of Ormco 280 cN (275–285 cN) and RMO 280 cN (270–280 cN). Conclusions: Elastomeric chains’ force degradation could be exacerbated by the use of mouth rinses. These data could be beneficial in choosing the appropriate combination of elastomeric chain and mouthrinse for optimal results of orthodontic therapy.

Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review.

(1) There are limited clinical trials to support the effectiveness of mouth rinses when used as a preprocedural rinse against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This systematic review aims to evaluate the efficacy of antiseptic mouth rinses as a preprocedural rinse in reducing SARS-CoV-2 oral viral load in-vivo. (2) Methods: A literature search was conducted through November 2022 for the following databases: PubMed, Web of Science, Cochrane Library, and Google Scholar. The evaluated outcomes were quantitative changes in viral load and the statistical significance of that change after using antiseptic mouth rinses. (3) Results: 14 randomized controlled trials (RCT) were selected for risk of bias assessment and data extraction. (4) Conclusion: Within the limits of this systematic review, preprocedural mouth rinses may significantly reduce SARS-CoV-2 in the mouth, thus, reducing the viral particles available for airborne dispersion. Preprocedural mouth rinses may be an effective strategy for reducing airborne SARS-CoV-2 dispersion in the environment. Their use may be a preventive strategy to reduce the spread of COVID-19 in selected medical and healthcare facilities, including dental clinics. Potential preprocedural mouth rinses are identified for use as an integral part of safe practice for healthcare protocols. This systematic review was registered with the National Institute for Health Research, international prospective register of systematic reviews (PROSPERO): CRD42022315177.

Antibiotics in Dentistry: A Narrative Review of the Evidence beyond the Myth.

Antibiotics have undoubtedly revolutionized medicine and the health and survival of patients with life-threatening infections, being nonetheless free from potential adverse effects, and the risk of intestinal dysbiosis, antimicrobial resistance, and the resulting consequences for the patient's health and the public purse. The present study narratively reviewed the epidemiological data on worldwide antibiotic consumption and administration in dental practice, patients' adherence to prescriptions, the antimicrobial resistance phenomenon in dentistry, and the evidence supporting and recommending appropriate antibiotic use in dental care. Eligible systematic reviews and original studies in humans published in the English language from January 2000 to 26 January 2023 were considered. A total of 78 studies, 47 on the epidemiology of antibiotic use and prescription in dentistry, 6 on antibiotic therapy in dentistry, 12 on antibiotic prophylaxis in dentistry, 0 on adherence of dental patients to antibiotic prescription, and 13 on antimicrobial resistance in dentistry, were presently considered. Retrieved evidence revealed that antibiotics are frequently overused and misused in dental practice, dental patients frequently do not adhere to prescriptions, and antimicrobial resistance in dentistry is a still rising phenomenon also secondary to improper oral antiseptics use. The present findings highlighted the need to establish more evidence-based and accurate antibiotic prescriptions to sensitize dentists and dental patients to minimize and rationalize the use of antibiotics only when it is indicated and necessary, improve patients' adherence, and enhance knowledge and awareness of the antimicrobial resistance in dentistry.

Synthesis of Cationic Silver Nanoparticles with Highly Potent Properties against Oral Pathogens and Their Biofilms

AbstractDental caries is a major disease associated with the proliferation of acidogenic bacterial species such as Streptococcus mutans that are part of the commensal microbiota of the mouth. Silver nanoparticles (AgNPs) are attractive antibacterial agents as they target multiple sites in bacteria which reduces antimicrobial resistance. In this study, we synthesised stable, highly positively charged AgNPs capped with branched PEI (BPEI‐AgNPs) and characterized them using UV–vis absorption, transmission electron microscopy (TEM), the size of which were approximately 7.5 nm. The antibacterial activity and anti‐biofilm capacity of BPEI‐AgNPs was investigated against cariogenic bacteria. Our results demonstrated that BPEI‐AgNPs are potent clinical oral antiseptics. The cytotoxicity of the BPEI‐AgNPs was also studied against two mammalian cell lines. The results indicated that BPEI‐AgNPs were non‐cytotoxic and were safer than commercially used dental antiseptics. We conclude that the BPEI‐AgNPs are safe for oral clinical application and are an effective oral antimicrobial agent.

Potentialities of photoactivated disinfection in dentistry

Infection control is an essential part of dental practice. Oral antiseptics should be highly effective against the most common oral pathogens without causing microbial resistance, biocompatible with the human tissues with no interaction with fillings materials. Photoactivated disinfection (PAD) is based on activation of photosensitizers - specific substances releasing active oxygen forms after absorption of the light. The active oxygen forms destroy bacterial cell structures without affecting human cells. The overwhelming majority of Russian and international researchers have reported high effectiveness of PAD in periodontics, implantology and endodontics, whereas the use of PAD in caries treatment and prevention is not so fully understood yet. Earlier studies have demonstrated high sensitivity of cariogenic bacteria to PAD, suggesting it as an additional minimally invasive caries therapy improving treatment effectiveness. PAD spares dental tissues without reduction in the effectiveness of disinfection. It is particularly important in treatment of deep carious lesions and disinfection of thin dentine layer near the pulp. Effectiveness of PAD in caries treatment has been demonstrated for both permanent and deciduous dentition. PAD doesn't affect bond strength to fillings, improves plasticity of dental pulp and dental hard tissues mineralization in children. Effective control of a wide range of bacteria without causing resistance makes PAD a prospective method of treatment and prevention of caries.

Modification of Taxifolin Properties by Spray Drying

Taxifolin is known as an active pharmaceutical ingredient (API) and food supplement due to its high antioxidant activity, multiple pharmacological effects, and good safety profile. Previously, taxifolin spheres (TS) were obtained from industrially produced API taxifolin in Russia (RT). In our work, we perform a pharmaceutical analysis of this new taxifolin material versus RT. TS is an amorphous material; however, it is stable without the polymer carrier, as confirmed by Fourier transform infrared spectroscopy. Both RT and TS demonstrate high safety profiles and are assigned to Class 1 of the Biopharmaceutical Classification System based on the results of experiments with MDCK cells. The water solubility of the new taxifolin form was 2.225 times higher compared with RT. Hausner ratios for RT and TS were 1.421 and 1.219, respectively, while Carr indices were 29.63% and 19.00%, respectively. Additionally, TS demonstrated sustained release from tablets compared with RT: the half-life values of tablets were 14.56 min and 20.63 min for RT and TS, respectively. Thus, TS may be a promising object for developing oral antiseptics in the form of orally dispersed tablets with sustained release patterns because of its anti-inflammatory, -protozoal, and -viral activities.

Microbial resistance to oral antiseptics used in hospitalized patients: A systematic scoping review of randomized clinical trials.

To evaluate the prevalence and proportions of bacteria resistant to oral antiseptics used in hospitalized patients. A review of randomized clinical trials (RCTs) was led by implementing the PRISMA extension for scoping reviews including various databases. MeSH terms and keywords were used to assess only RCTs with antiseptic-resistant outcomes. Fourth RCTs met the selection criteria. These trials studied 399 hospitalized patients for respiratory infections or cardiovascular disease. Methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii were predominant pathogens in the chlorhexidine group. It was found that Veillonella parvula and Campylobacter gracilis (57% of the isolates) had resistance to triclosan, while 67% of Pseudomonas, Acinetobacter, and Enterobacter species presented resistance to chlorhexidine. However, an increase in minimal inhibitory concentrations of triclosan or chlorhexidine during the follow-up period was not observed. Moreover, chlorhexidine reduced the amount of S. aureus in dental plaque and the oropharyngeal colonization by aerobic microorganisms; nonetheless, it was unsatisfactory to decrease the occurrence of respiratory infections. No adverse events were reported. Resistance of V. parvula and C. gracilis to triclosan, and Pseudomonas, Acinetobacter, and Enterobacter species to chlorhexidine were perceived. However, these resistances did not increase during the follow-up period.

The Microbiome in COPD: Emerging Potential for Microbiome-Targeted Interventions.

The aim of interventions over the respiratory microbiome in COPD is to preserve the original microbial flora, focusing in taxa with a demonstrated impact on the prognosis of the disease. Inhaled therapy is the main treatment for COPD, and chronic corticosteroid use is recommended for patients with frequent exacerbations. This therapy, however, increases both the bronchial microbial load and the abundance of potentially pathogenic bacteria in patients with low peripheral eosinophil counts, and to minimize its use in patients without peripheral eosinophilia, when possible, may avoid increases in bacterial loads of microorganisms as Haemophilus influenzae and Streptococcus pneumoniae. In exacerbations antibiotics determine a decrease in the microbial diversity, a change that persists during stability periods in frequent exacerbators. High-diversity bronchial microbiomes are enriched in non-dominant genera and determine low exacerbation frequencies and survival improvement. Limiting the antibiotic use to the treatment of exacerbations which would clearly benefit would favor the diversity of the respiratory microbiome and may have a positive impact on quality of life and survival. Oral antiseptics have shown and effect on the bronchial microbiome that was associated with improvements in quality of life, and the gut microbiome may be also modified through the oral administration of probiotics or prebiotics, that potentially may determine decreases in lung inflammation and bronchial hyperreactivity. High fiber diets also favor the production of anti-inflammatory molecules by the digestive flora, which would reach the respiratory system through the bloodstream. Interventional approaches favoring the preservation of the respiratory microbiome in COPD need first to select accurately the patients who would benefit from long-term inhaled corticosteroids and antibiotic treatments during exacerbations, under the hypothesis that keeping a respiratory microbiome close to the healthy subject would favor the respiratory health. Additionally, high fiber diets may be able to modify the gut microbiome and influence the respiratory system through the gut-lung axis. Therapeutic approaches targeting the microbiome to improve COPD, however, still require clinical validation and the identification of patient subtypes who would benefit the most with their use.

The In Vitro Virucidal Effects of Mouthwashes on SARS-CoV-2

Oral antiseptic mouthwashes have been widely used for their antibacterial activity. As a result of the SARS-CoV-2 pandemic, the antiviral properties of these oral antiseptics have been aggressively studied. To demonstrate the direct antiviral activity of mouthwashes against SARS-CoV-2, this review will focus on the in vitro virucidal effects of these mouthwashes. Knowledge of the type, concentration, and exposure time of available mouthwashes can provide insights into effective protocols for their clinical use. With an understanding of the characteristics of each oral antiseptic mouthwash, proper mouthwash selection against SARS-CoV-2 may become a useful adjunct to personal protective equipment.

Effect of oral antiseptics on the viral load of SARS-CoV-2: A randomized controlled trial.

In the oral cavity, which plays an important role in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is possible to reduce the viral load of SARS-CoV-2 with antiseptics, thereby minimizing the transmission of the virus during dental procedures. The aim of this study was to clinically evaluate the effect of the hypochlorous acid (HClO) and povidone-iodine (PVP-I) solutions on the oral viral load of SARS-CoV-2. This randomized controlled trial was conducted on 75 patients hospitalized in the COVID-19 ward of a local hospital. All the patients included in the study were within the first 24 h of hospitalization and the first 5 days of coronavirus disease 2019 (COVID-19) symptoms. The viral load of mouthwash samples was measured with the cycle threshold (Ct) value of SARS-CoV-2 through a realtime reverse transcription polymerase chain reaction (RT-PCR). The patients were divided into 3 groups. The effect on the patient's SARS-CoV-2 viral load was investigated after gargling the mouths and throats for 30 s with HClO, PVP-I and isotonic saline. First, a sample was taken after gargling with isotonic saline, then another sample was taken after gargling for 30 s with a particular antiseptic to determine the viral load of SARS-CoV-2. Comparing the before and after mouthwash samples from all 3 groups, there were no statistically significant differences in the Ct values before and after gargling (p > 0.05). However, there were statistically significant differences in the number of negative samples after the use of HClO and PVP-I, which were positive before gargling (p < 0.05). In the light of the data obtained in this study, there is insufficient evidence that gargling with HClO or PVP-I reduces viral load. Taken together, these findings imply no role for antiseptics in the transmission of SARS-CoV-2 by the aerosol generated during dental procedures, or more generally, SARS-CoV-2 infection control.

Oral Antiseptics against SARS-CoV-2: A Literature Review.

Dentists are health care workers with the highest risk of exposure to COVID-19, because the oral cavity is considered to be a reservoir for SARS-CoV-2 transmission. The identification of SARS-CoV-2 in saliva, the generation of aerosols, and the proximity to patients during dental procedures are conditions that have led to these health care workers implementing additional disinfection strategies for their protection. Oral antiseptics are widely used chemical substances due to their ability to reduce the number of microorganisms. Although there is still no evidence that they can prevent the transmission of SARS-CoV-2, some preoperative oral antiseptics have been recommended as control measures, by different health institutions worldwide, to reduce the number of microorganisms in aerosols and droplets during dental procedures. Therefore, this review presents the current recommendations for the use of oral antiseptics against SARS-CoV-2 and analyzes the different oral antiseptic options used in dentistry.

Effect of oral antiseptics in reducing SARS-CoV-2 infectivity: evidence from a randomized double-blind clinical trial

ABSTRACT Background: In vitro studies have shown that several oral antiseptics have virucidal activity against SARS-CoV-2. Thus, mouthwashes have been proposed as an easy to implement strategy to reduce viral transmission. However, there are no data measuring SARS-CoV-2 viability after mouthwashes in vivo. Methods: In this randomized double-blind, five-parallel-group, placebo-controlled clinical trial, SARS-CoV-2 salivary viral load (by quantitative PCR) and its infectious capacity (incubating saliva in cell cultures) have been evaluated before and after four different antiseptic mouthwashes and placebo in 54 COVID-19 patients. Results: Contrary to in vitro evidence, salivary viral load was not affected by any of the four tested mouthwashes. Viral culture indicated that cetylpyridinium chloride (CPC) significantly reduced viral infectivity, but only at 1-hour post-mouthwash. Conclusion: These results indicate that some of the mouthwashes currently used to reduce viral infectivity are not efficient in vivo and, furthermore, that this effect is not immediate, generating a false sense of security. Trial registration: ClinicalTrials.gov identifier: NCT04707742..

Efficacy of Hexetidine, Thymol and Hydrogen Peroxide-Containing Oral Antiseptics in Reducing Sars-Cov-2 Virus in the Oral Cavity: A Pilot Study

Background: Studies have demonstrated the role of sputum as a site of severe acute respiratory syndrome-coronavirus-2 (SARSCoV-2) transmission. However, there is limited literature on the virucidal efficacy of oral antiseptics against SARS-CoV-2 virus. This study investigated the virucidal efficacy of three oral-antiseptics compared to a placebo-control in the sputum of SARS-CoV-2 infected individuals.&#x0D; Methodology: A pilot study of adults with SARS-CoV-2 positive results, as determined by reverse transcription-polymerase chain reaction (RT-PCR) of &lt;7 days. The oral antiseptics investigated were: Hexetidine (0.1% w/v); Thymol (0.063% w/v) and H2O2(1.5%) compared to de-mineralized sterile water (Placebo-control). The primary outcome measure was the proportion of negative RT-PCR results at 15-mins, 30-mins, 1-hour, 2-hours and 4-hours After Oral antiseptics Interventions (AOI) compared to the placebo-control. Statistical analysis was done using STATA 15.0 software with p-values of &lt;0.05 considered statistically significant.&#x0D; Results: Data from a total of 66 participants that were RT-PCR SARS-CoV-2 positive at baseline (0-min) was analysed. At 15-mins AOI, the highest proportion of negativation from sputum samples was observed in the Hexedine group, with 69.2% of the baseline PCR positive cases converting to negative compared to 46.7% in the placebo-control group. In addition, H2O2 demonstrated efficacy at 2-hours AOI compared to placebo-control (62.5% vs 37.5% respectively) and other oral-antiseptics. Across all time-points, the oral-antiseptic groups compared to the placebo-control group, there was no statistically significant difference in the proportion of sputum samples which converted to a negative status (p&gt;0.05).&#x0D; Conclusion: The findings in this study suggest there was no significant difference in the proportion of participants who converted to a negative sputum status across the treatment groups at various time points. Future studies could compare the cycle threshold (ct) viral titre values of sputum samples to determine quantitative differences.&#x0D; Authors&#x0D; S A Ogun 1, O Erinoso 2, O O Aina 3, O I Ojo 2, O Adejumo 4, A Adeniran 2, A Bowale 4, C A Olaniyi 2, B M Adedoyin 5, B Mutiu 6, B Saka 6, O Oshinaike 2, W Arabambi 1, F Adejumo 4, O Shuaib 2, A O Salmon 2, H Abdur-Razzaq 7, O F Njokanma 2, O Ojini 8, O Ogboye 7, O Lajide 7, K O Wright 2, A Osibogun 8, A Abayomi 7

The Articulate Canker-Aphthous Ulcer

Aphthous ulcer occurs as a frequent, idiopathic, painful, singular, multiple or reoccurring oral ulceration. Of obscure aetiology, oral trauma, stress, anxiety, diverse systemic diseases as coeliac disease, Crohn’s disease, Behçet’s syndrome, reactive arthritis or infection with human immune deficiency virus (HIV), drugs such NSAIDs, β-blockers, angiotensin converting enzyme (ACE) inhibitors, deficiencies of vitamins and trace elements as zinc, iron, B12, folate or sensitivity to food and chemicals may engender the ulcer. Contingent to magnitude, aphthous ulcer is subcategorized into minor ulcer, major ulcer or herpetiform ulcer. Aphthous ulcer manifests upon non-keratinized oral mucosa as a well circumscribed, centric, necrotic ulcer circumscribed by a grey, fibrinous exudate and an erythematous halo. The ulcer requires a segregation from contact dermatitis, lichen planus, oral carcinoma, infection with herpes simplex virus (HSV), various drug induced lesions or autoimmune diseases. Aphthous ulcer can be evaluated with clinical examination, complete blood count with nutritional deficiencies of iron, folate or vitamin B12, neutropenia, serum anti-endomysial antibodies and transglutaminase (tTg-IgA) for coeliac disease and investigations for HIV. Cogent therapeutic options are local anaesthetics, coating or occlusive agents as bismuth subsalicylate, sucralfate, 2-octyl cyanoacrylate, bio-adherent emollient pastes, oral antiseptics as chlorhexidine gluconate, hydrogen peroxide, antiinflammatory agents as glucocorticoids, metalloprotease inhibitors, antimicrobials as tetracycline, doxycycline, minocycline, honey, immunomodulatory agents as amlexanox, colchicine, cyclosporine, cyclophosphamide, dapsone, methotrexate, montelukast, thalidomide or retinoids.

Evaluation of Current Evidence on the Use of Oral Antiseptics Against SARS-CoV-2: A Narrative Review.

The detection of SARS-COV-2 in the oral cavity has generated endless claims about the efficacy of using oral mouthwashes to reduce viral load. This review aims to assess the current evidence on the use of oral antiseptics against SARS-CoV-2 and to assess the certainty of the evidence according to the GRADE system. The question this study focussed on was what is the efficacy of oral antiseptics against SARS-CoV-2? A bibliographic search was performed in Medline databases through PubMed, Science Direct, and Google Scholar (until February 2022), using search terms related to COVID-19 and oral antiseptics. Two independent researchers extracted the information from the articles included in an excel form. The identification and selection of the studies was carried out from August 2021 to February 2022. It was found that oral antiseptics can have a potential beneficial effect on COVID-19, mainly in reducing viral load. However, these potential benefits are mainly based on in-vitro studies or clinical studies with various methodological limitations. At present, the certainty of the evidence is very low due to inconsistency (heterogeneity), moderate-to-high risk of bias, and imprecision of the results. The certainty of the current evidence on the efficacy of oral antiseptics against SARS-CoV-2 is very low, mainly due to the methodological limitations of the studies. Therefore, for evidence-based decision-making about this intervention, clinical studies with greater methodological rigor are required. Oral antiseptics could present potential benefits in patients with COVID-19 mainly by reducing viral load. However, a careful and conscious evaluation of the evidence is required for decision-making in clinical practice.

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