Use Of Mouthrinses Research Articles

Early periodontal wound healing after chlorhexidine rinsing: a randomized clinical trial

ObjectivesThis single-center randomized, parallel design, clinical trial with a 2-week follow-up involved patients affected by periodontitis undergoing periodontal surgery. The aim was to evaluate periodontal surgical wound healing with the use of chlorhexidine-based mouth rinses versus an untreated control group.Materials and methodsPeriodontal surgery was performed following a standardized protocol. Patients were randomly prescribed i) chlorhexidine (CHX) + anti-discoloration system (ADS) + hyaluronic acid (HA), ii) CHX + ADS or iii) no treatment (control group). Plaque score, gingival inflammation, and Early Healing Index (EHI), assessing the degree of wound closure and the presence of fibrin and necrosis, were evaluated at 3, 7 and 14 days after surgery.ResultsIn total, 33 patients were enrolled. Patients were comparable at baseline for all measured clinical parameters. At 3-days wound healing was significantly improved in all patients treated with CHX + ADS-based mouth rinses with a lower EHI score at the interdental papillae compared with control group (p < 0.01). CHX + ADS + HA group presented improved healing across all time points in terms of EHI, plaque containment, and gingival inflammation when compared to control group (p < 0.01).ConclusionsThe usage of CHX-ADS following periodontal surgery improved early wound healing, reduced plaque accumulation and gingival inflammation. During the early post-operative period the adjunct of HA further improved soft tissue closure.Clinical relevanceThis study aims at evaluating the response of gingival tissues to mouth rinsing with chlorhexidine and anti-discoloration system (CHX + ADS) or CHX + ADS + hyaluronic acid (CHX + ADS + HA) versus no rinse in terms of healing of the periodontal surgical wound. CHX + ADS mouth rinses enhanced early soft tissue closure after periodontal surgery and contributed to the reduction in plaque accumulation and gingival inflammation. The adjunct of HA may be beneficial especially in the early post-operative period. CHX + ADS administration following periodontal surgery may improve soft tissue healing in the first two post-operative weeks.

Effect of herbal mouthrinsein dental ultrasonic scalers among Indians.

The use of herbal mouthrinse is gaining momentum in recent years. Therefore, it is of interest to evaluate the effect of 2 herbal mouthrinse (curcumin, cinnamon) in comparison with2 conventional mouthrinse (povidone iodine, chlorhexidine) when used as coolant in dental ultrasonic scalers. Hence, 200 participants were included in this study. Analysis of gingival index, periodontal index at baseline and one month follow up was completed. The inhibitory effects of both conventional and herbal mouth rinse in gingival health are similar. However, cinnamon and curcumin owing to its minimal adverse effects and low cost is useful as an alternative to chlorhexidine for reducing bacterial load in dental aerosols produced due to ultrasonic scalers.

Assessment regarding dental practitioners’ knowledge, attitude, and practices towards pre-procedural mouth rinse during COVID-19 pandemic – A cross-sectional study in Tamil Nadu

Objectives: Evolving strains of SARS-CoV-2 causing the COVID-19 disease has challenged the scientific world in limiting the disease and curbing the pandemic. Several factors such as increased salivary viral load in COVID-infected patients, procedures generating aerosols put the dental professionals at high risk of acquiring the disease. The present study aims to assess the knowledge, attitude and practices regarding the use of pre-procedural mouth rinse among the dental practitioners in Coimbatore. Material and Methods: A descriptive, cross-sectional study was conducted among dental practitioners in Coimbatore using a pre-validated questionnaire which comprised of sections interrogating knowledge, awareness, and practice of the use of pre-procedural mouth rinse in dental setup. One hundred and twenty-five dental practitioners in Coimbatore responded to the questionnaire. Results: Assessment of knowledge regarding the effectiveness of pre-procedural mouthwashes in reducing the bacterial and viral load was 97%. About 89% of dental practitioners were aware of the superior antimicrobial properties of Povidone Iodine in comparison with Chlorhexidine. Only 65% of dental practitioners used pre-procedural mouthwashes in practice. Conclusion: There is high inquisitiveness among dental practitioners in acquiring knowledge regarding preventive measures for SARS-CoV-2 alike the use of pre-procedural mouth rinses in reducing the viral load in COVID-19 infected patients. Although there is high awareness, there exists reluctance in implementing the knowledge acquired in real practice.

The relationship between children’s oral health behaviours and oral health-related quality of life: a cross-sectional study

BackgroundUnderstanding oral health behaviour s and their impact on Oral Health-Related Quality of Life (OHRQoL) may serve as an instrument to articulate the conventional oral health policy framework, thereby ameliorating the overall health of young individuals in the long term.ObjectiveThe aim of this study was to investigate the relationship between children’s oral health behaviour s and Oral Health-Related Quality of Life in the capital governorate, Kuwait.MethodsA cross-sectional study involving 607 children aged 12–14 years, randomly selected from schools in Kuwait Capital Region. A validated Oral Health Behaviour s and OHRQoL Child Perception Questionnaires (CPQ12-14) was used to collect the data. Chi-square, t-tests, and ANOVA were used to examine the association between oral behaviour s and children’s OHRQoL.ResultsAbout 52.2% of participants were males and the overall response rate was 93.8%. The mean ± SD for total OHRQoL impact was 3.1 ± 0.58, while the total mean for individual domains- for oral symptoms, functional limitations, emotional well-being and social well-being were 2.89 ± 0.63, 2.89 ± 0.72, 3.1 ± 0.91 and 3.4 ± 0.61, respectively. There was no significant difference in total OHRQoL impact score by frequency of last dental visit, flossing, use of mouth rinse or chewing gum (p > 0.05) but for the overall OHRQoL, frequency of soft drink intake was the only significant predictor associated with 0.2-unit decrease (B = -0.207, 95% CI, p = 0.002) in total OHRQoL scores.ConclusionsHigh frequency of soft drink consumption was related to poorer OHRQoL. Behaviour changing interventions based on OHRQoL inferences coupled with clinical intervention are needed.

Preparation and characterization of NaF/Chitosan supramolecular complex and their effects on prevention of enamel demineralization

Fluoridated mouthrinse is indicated for individuals with high risk of caries. Chitosan (Chit) exhibits antibacterial properties, but little is known about its effects on enamel when combined with sodium fluoride (NaF) to form NaF/Chit supramolecular complexes. In our study, NaF/Chit supramolecular complexes structured as microparticles were synthetized and characterized, and their effects on human enamel were evaluated after cariogenic challenge simulating the daily mouthrinse use. Initially, NaF/Chit complex formation was investigated based on several titrations by measuring the zeta potential, electrical conductivity (κ), hydrodynamic diameter (Dh), viscosity (η) and heat flow (by isothermal titration calorimetry) against the molar ratio [NaF]/[Chitmonomer], which allowed us to identify the interactions between Chit-NaF with a stoichiometry of approximately 0.68. Spontaneous microparticle formation was observed. Samples of enamel blocks were prepared and divided into eight groups (n = 10/group): (i) 0.2% Chit; (ii) 0.2% NaF; (iii) 0.2% NaF/Chit suspension; (iv) 0.2% acetic acid; (v) 0.05% Chit; (vi) 0.05% NaF; (vii) 0.05% NaF/Chit suspension; and (viii) 0.05% acetic acid. Cariogenic challenge was performed in each sample by cycling in demineralization and remineralization solutions for 7 days. Before each demineralization cycle, the corresponding substances were passively applied daily for 90 s, even in groups with 0.02% concentration. After 7 days, samples were examined for Knoop hardness (KHN) measurements. The data were analyzed by repeated-measures ANOVA and Tukey tests (α = 0.05). The 0.2% NaF and 0.2% NaF/Chit groups showed higher KHNpost-challenge values than the other groups. The 0.2% NaF/Chit microparticle suspension reduced the enamel hardness loss after cariogenic challenge as effectively as the 0.2% NaF solution and demonstrated potential for use in a formulation with anti-caries effects.

Association between mouth rinse use and changes in blood pressure: A systematic review and meta-analysis with trial sequential analysis.

Previous randomized controlled trials have shown that the use of antiseptic mouth rinses not only eradicates oral bacteria but also disrupts their ability to convert nitrate to nitrite, which is the key molecule in regulating blood pressure (BP). This study aimed to evaluate the association between the use of mouth rinses and changes in BP. The PubMed, Web of Science, EMBASE, Scopus, and Cochrane Library databases were systematically searched from their respective inception dates to 18th December 2022 to identify potential interventional studies with information on the association between the use of mouth rinse and changes in BP. Five trials using a controlled, crossover design were identified for data analysis. The weighted mean difference was pooled using a random-effects model. The pooled results of five trials together showed that the use of mouth rinses did not result in a statistically or clinically significant increase in the systolic BP (SBP) (1.59 mmHg; 95% confidence interval [CI], -0.15 to 3.33) or diastolic BP (DBP) (0.46 mmHg; 95% CI, -0.72 to 1.64). The trial sequential analysis did not present conclusive evidence supporting the association between mouth rinse use and BP elevation. Within the limits of the available evidence, our review and meta-analysis showed that mouth rinse use did not result in a statistically significant increase in the SBP, DBP, or mean arterial pressure (MAP). Nevertheless, the results should be interpreted cautiously due to the high degree of inconsistency across the studies.

Combined use of stannous fluoride-containing mouth rinse and toothpaste prevents enamel erosion in vitro

ObjectiveTo compare the protective effect of commercial stannous-containing mouth rinses on enamel erosion in a simulated 5-day in vitro cycling model.Materials and methods81 human enamel specimens were embedded in resin blocks and divided into nine groups as follows; group 1: stannous fluoride (1000SnF2) toothpaste; groups 2,3, and 4 were the same as group 1 plus Elmex®, PerioMed™, and Meridol®, respectively, group 5: stannous fluoride (1450SnF2) toothpaste, groups 6, 7, and 8 were the same as group 5 plus Elmex®, PerioMed™, and Meridol®, respectively, group 9: negative control. An erosive challenge was induced with a 1 min hydrochloric acid (0.01 M, pH 2.2) treatment 3 times per day. Each cycle included immersing in the toothpaste slurry twice for two minutes and a one-minute rinse. The enamel slabs were immersed in artificial saliva between each erosive cycle and incubated overnight at 37 °C. Surface hardness loss and enamel loss were determined by Knoop surface hardness and non-contact profilometry, respectively. Finally, enamel surfaces were analyzed by scanning electron microscopy and X-ray energy dispersive spectroscopy (SEM/EDS).ResultsAll three mouth rinses had similar protective effects against erosion when using adjunct with 1000 SnF2 toothpaste (p > 0.05). With 1450 SnF2 toothpaste, Elmex® presented significantly lower surface hardness loss than Meridol® (p < 0.05). The combined use of Elmex® or PerioMed™ with toothpaste provided significantly better erosion protection than toothpaste alone, either 1000 or 1450 SnF2. In addition, 1000SnF2 toothpaste adjunct with mouth rinse is comparable to 1450 SnF2 toothpaste alone in preventing enamel erosion.ConclusionAll three mouth rinses reduced enamel erosion. The additional use of a high concentration stannous containing mouth rinse with 1450 SnF2 toothpaste increases the protective effect against enamel erosion in vitro.Clinical significanceTo date, no standard protocol for preventing dental erosion is available. There are three stannous-containing mouth rinses on the market; however, no study compared their efficacy or indicated whether using adjuncts with anti-erosion toothpaste provides additional benefits. This study found that adding stannous mouth rinse to twice-daily toothpaste increases erosion protection.

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 &lt; 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.

Best Practices in Oral Care.

Best Practices in Oral Care.

Association of exogenous factors with molecular epidemiology of Staphylococcus aureus in human oral cavity

The frequency ofStaphylococcus aureusstrains associated with oral cavity microbiota has prodigious consideration. AlthoughS. aureushas been reflected as an ephemeral member of the human oral cavity microbiota, the isolation, identification, and characterization of S. aureus is important. The present study aimed to characterizeS. aureusstrains from the oral cavity microflora, isolation of S. aureus from the human oral cavity microbiota, and demographic information of the participants to evaluate exogenous factors associated with the presence of S. aureus and their genetic analysis linkage with different factors. The method used in this study is the isolation of oral cavity microbiomes using sheep blood agar and Mannitol salt agar. We performed antibiotic profiling with various antibiotics and genetic analysis utilizing gene-specific primers for specific genes, including nuc, mecA, pvl, agr, and coa. A significant number of S. aureus isolates were found in the oral cavity of humans 18/84 (21.42%), and all 18 strains tested positive for the confirmatory nuc gene. Antibiotic resistance-conferring gene mecA was positive in 10 (55.6%) isolates. It was found that the occurrence of pvl, agr, and coagulase (coa) genes was 9 (50%), 6 (33.33%), and 10 (55.6%), respectively. The genetic analysis reported that significant associations were present between male and mecA gene (P = 0.03) and coa (P = 0.03), smokers with the occurrence of mecA (P = 0.02), agr (P = 0.048) and coa (P = 0.02) genes. Likewise, the association of antibiotic usage was significantly found with mecA (P = 0.02), coa (P = 0.02); however, the individuals who have taken orthodontic treatment recently have a significant association with agr (P = 0.017). The use of mouth rinse was significantly associated with the prevalence of the pvl gene (P = 0.01), and tooth brushing frequency and inflammation of the buccal cavity were also statistically significant in relation to pvl gene prevalence (P = 0.02, 0.00, respectively). Moreover, calories and weight-controlled diet were significantly associated with mecA, agr, and highly significant with coa (P = 0.02, 0.048, 0.000), so all P < 0.05, and no significant association was found between the socioeconomic status of individuals with aforementioned analyzed genes.

Efficacy of chlorhexidine/herbal formulation for microbial reduction in aerosol generated following ultrasonic scaling - A double-blinded randomized controlled trial.

Ultrasonic scaling is a potential source of aerosol contamination in dental clinics. The two primary sources of microbial load in aerosols are from the oral cavity and dental unit water line. Literature evidence suggest that the use of preprocedural mouth rinse reduce the bacterial load in aerosol generated during ultrasonic scaling. The aim of the study is to assess the comparative efficacy of reduction in viable bacteria in the aerosol at patient's chest area, doctor's mask area and two feet beside the patient following use of chlorhexidine/herbal formulation diluted in the water source by a randomized controlled clinical trial. Forty-five subjects (with chronic gingivitis) were matched for age, gender, and gingival index score. The subjects were randomized and received ultrasonic scaling with distilled water (control)/chlorhexidine (tTest)/herbal formulation (test). Aerosol produced during scaling was collected at patient's chest area, doctor's mask area, two feet beside the patient on blood agar plates, which were incubated at 37°C for 48 h and total colony forming units (CFUs) were counted. A significant reduction in the total CFUs' counts was observed at all the three sites sampled in test groups (chlorhexidine group and herbal formulation group) as compared to control (P < 0.01). The addition of antiseptic agents to the water source contributed to a significant reduction of the cultivable microbial counts in the aerosol and hence can be used to reduce the risk of cross-infection during ultrasonic scaling.

Dental Aerosol Hazard Prevention with Pre-procedural Antiseptic Mouthwashes (Comparative Study)

Background: One of the recommended methods for reducing aerosol contamination during the daily regular usage of high-speed turbine and ultrasonic scaling is the use of preprocedural mouth rinse. Several agents have been investigated as a preprocedural mouth rinse. Chlorhexidine significantly reduce the viable microbial content of aerosol when used as a preprocedural rinse. Studies have shown that cetylpridinum chloride (CPC) mouthwash is equally effective as chlorhexidine in reducing plaque and gingivitis. This study compared the effect of 0.07% CPC to 0.2% chlorhexidine gluconate (CHX) as preprocedural mouth rinses in reducing the aerosol contamination by high-speed turbine. Materials and Methods: 36 patients were divided into three groups based on the preprocedural rinse used (0.2% CHX, 0.07% CPC and distilled water). Conservative treatment was done for 20 min. (10 min before rinsing and 10 min after rinsing) in the same closed operatory for all the patients after keeping blood agar plates opened at three standardized locations (patient chest, dentist chest and at 12-inch from patient mouth). Colony forming units (CFUs) on blood agar plates were counted, after incubation at 37°C for 48 hr. Statistical analysis was done with (SPSS version 21(. Results: This study showed that the two antiseptic mouthwashes significantly reduced the bacterial colony forming units (CFUs) in aerosol samples at three plates locations. Chlorhexidine rinses were found to be superior to cetylpridinum chloride when used pre-procedurally in reducing aerolized bacteria. The number of CFUs were higher at the patient’s chest location as compared to other locations. Conclusion: 0.07% CPC and 0.2% CHX were effective as a pre-procedural rinse in reducing CFU count during dental treatment using high-speed turbine.

Effects of preprocedural mouth rinse on microbial load in aerosols produced during the ultrasonic scaling: A randomized controlled trial.

During ultrasonic scaling, the harbored microorganisms in the oral cavity get aerosolized, which have important impacts on air quality and can cause a serious health threat to the clinician, patients, and the surroundings. Therefore, this study was conducted to evaluate whether preprocedural mouth rinse has any effect on bacterial load in aerosols generated during ultrasonic scaling. A total of 80 subjects with chronic periodontitis were selected and randomly grouped into four comprising twenty in each. The groups were based on the use of preprocedural mouth rinse: no rinse group (control) (A), and test groups with preprocedural mouth rinse with water (B), 0.2% Chlorhexidine gluconate (C), and herbal mouthwash (D). The aerosol produced during ultrasonic scaling was collected on blood agar plates positioned at the chest area of patients, operators, and assistants. Aerosol collected in the operatory before the procedure was considered as baseline. Colonies on the blood agar plates were counted after incubating at 37°C for 24 h. Pairwise comparisons involving positions and mouth rinses on microbial colonies were conducted using independent sample t-test and Tukey's test for post hoc analysis considering 0.05 as the significance level. Microbial colonies were significantly reduced with chlorhexidine gluconate compared to that of others (P < 0.001), followed by herbal mouthwash and water. Again, microbial colonies were highest at the chest area of the operator and lowest at the chest area of the assistant. 0.2% Chlorhexidine gluconate is superior in reducing the microbial load in aerosols produced during ultrasonic scaling.

Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental healthcare providers.

Aerosols and spatter are generated in a dental clinic during aerosol-generating procedures (AGPs) that use high-speed hand pieces. Dental healthcare providers can be at increased risk of transmission of diseases such as tuberculosis, measles and severe acute respiratory syndrome (SARS) through droplets on mucosae, inhalation of aerosols or through fomites on mucosae, which harbour micro-organisms. There are ways to mitigate and contain spatter and aerosols that may, in turn, reduce any risk of disease transmission. In addition to personal protective equipment (PPE) and aerosol-reducing devices such as high-volume suction, it has been hypothesised that the use of mouth rinse by patients before dental procedures could reduce the microbial load of aerosols that are generated during dental AGPs. To assess the effects of preprocedural mouth rinses used in dental clinics to minimise incidence of infection in dental healthcare providers and reduce or neutralise contamination in aerosols. We used standard, extensive Cochrane search methods. The latest search date was 4 February 2022. We included randomised controlled trials and excluded laboratory-based studies. Study participants were dental patients undergoing AGPs. Studies compared any preprocedural mouth rinse used to reduce contaminated aerosols versus placebo, no mouth rinse or another mouth rinse. Our primary outcome was incidence of infection of dental healthcare providers and secondary outcomes were reduction in the level of contamination of the dental operatory environment, cost, change in mouth microbiota, adverse events, and acceptability and feasibility of the intervention. Two review authors screened search results, extracted data from included studies, assessed the risk of bias in the studies and judged the certainty of the available evidence. We used mean differences (MDs) and 95% confidence intervals (CIs) as the effect estimate for continuous outcomes, and random-effects meta-analysis to combine data MAIN RESULTS: We included 17 studies with 830 participants aged 18 to 70 years. We judged three trials at high risk of bias, two at low risk and 12 at unclear risk of bias. None of the studies measured our primary outcome of the incidence of infection in dental healthcare providers. The primary outcome in the studies was reduction in the level of bacterial contamination measured in colony-forming units (CFUs) at distances of less than 2 m (intended to capture larger droplets) and 2 m or more (to capture droplet nuclei from aerosols arising from the participant's oral cavity). It is unclear what size of CFU reduction represents a clinically significant amount. There is low- to very low-certainty evidence that chlorhexidine (CHX) may reduce bacterial contamination, as measured by CFUs, compared with no rinsing or rinsing with water. There were similar results when comparing cetylpyridinium chloride (CPC) with no rinsing and when comparing CPC, essential oils/herbal mouthwashes or boric acid with water. There is very low-certainty evidence that tempered mouth rinses may provide a greater reduction in CFUs than cold mouth rinses. There is low-certainty evidence that CHX may reduce CFUs more than essential oils/herbal mouthwashes. The evidence for other head-to-head comparisons was limited and inconsistent. The studies did not provide any information on costs, change in micro-organisms in the patient's mouth or adverse events such as temporary discolouration, altered taste, allergic reaction or hypersensitivity. The studies did not assess acceptability of the intervention to patients or feasibility of implementation for dentists. AUTHORS' CONCLUSIONS: None of the included studies measured the incidence of infection among dental healthcare providers. The studies measured only reduction in level of bacterial contamination in aerosols. None of the studies evaluated viral or fungalcontamination. We have only low to very low certainty for all findings. We are unable to draw conclusions regarding whether there is a role for preprocedural mouth rinses in reducing infection risk or the possible superiority of one preprocedural rinse over another. Studies are needed that measure the effect of rinses on infectious disease risk among dental healthcare providers and on contaminated aerosols at larger distances with standardised outcome measurement.

Comparison of antimicrobial efficacy of chemical mouthwash and herbal mouthwash

Background: The use of mouth rinse for oral hygiene maintenance has been advocated as an adjuvant to mechanical aids of plaque removal. The aim of this study was to compare the antimicrobial effect of herbal and chemical mouth rinse on bacterial accumulation on orthodontic arch wires. Materials and Methods: The study sample consisted of 15 numbers of 0.016 Nickel Titanium (NiTi) arch wires removed from patients' mouths, which were split into three segments of 1 cm each. Wires were dipped in solutions of Chlorhexidine (Group A), Befresh Herbal (Group B) and Distilled water (Group C) individually for 30 seconds and then in normal saline for one minute. 0.5microlitre of this saline solution was inoculated in a Brain heart infusion medium (BHI) for 24 hours and then examined for bacterial count. The obtained results were subjected to One-way ANOVA, Bonferroni and post hoc tests for statistical analysis. Results: Group A showed the maximum reduction in the bacterial colony forming units (CFU) after 24 hours with a mean value of 65.67cfu. Group B showed a mean value of 336.87cfu. There was a statistically significant difference between the Chlorhexidine group and the Control group.

A scoping review on the effectiveness of mouth rinse against SARS-CoV-2

Although studies reporting the efficacy of mouth rinse against SARS-CoV-2 have been continuously published, it is chal-lenging to select literature through qualitative meta-synthesis or quality assessment of the study. Therefore, this study aims to systematically review the efficacy of mouth rinse against SARS-CoV-2 using the scoping review method and to provide the latest information. Literature search on electronic databases (PubMed, Scopus, and Cochrane Trials) was conducted. After establishing liter-ature inclusion and exclusion criteria, two independent researchers were selected literatures. Of the 15 articles were included in this scoping review, 11 were in vitro studies, and four were in vivo studies. The ingredients tested in these studies were povidone-iodine, chlorhexidine, hydrogen peroxide, essential oils, and qua-ternary ammonium compounds, and they showed various efficacy against SARS-CoV-2. Despite the relatively limited evidence from the included studies, the use of mouth rinse has the potential to reduce the viral load of SARS-CoV-2. In particular, povidone-iodine is expected to be the most effective against SARS-CoV-2, given the evidence so far.

Practitioner’s Perspective of Personal Protection Against COVID-19 During Prosthodontics Rehabilitation

The corona virus pandemic has impacted almost all kinds of public health care professions, including dentistry. Objectives: In the present study, we aimed to evaluate the practitioner’s perspective of personal protection against COVID-19 and evaluating the practicing protective protocols adopted by local practitioners. Methods: This cross-sectional study included 150 practitioners from two different private dental hospitals. Data was collected by pre-structured questionnaire, which composed of 20 questions. These questions assessed infection control measures and their perspective and knowledge regarding spread of Corona virus. Data were analysed using (SPSS version 20.0) Results: A total of 150 practitioners participated in the study (70 house officers and 80 post graduate residents and above). The most commonly practiced procedure was wearing mask (81.3%) and washing hands (76%) after gloves removal. A small number of practitioners preferred rinsing mouth with mouth wash (2.7%), use of water-resistant gowns (4.7%), wearing goggles (8%), use of N95 mask and rubber dam application (9.3%) each during procedure. Conclusion: Prosthodontists are at highest risk of contracting the virus owing to aerosol generating procedures. Current study observed an inadequate use of PPEs as depicted from various responses from practitioners such as limited use of mouth rinses before start of procedures, goggles, water resistant gowns and N95 masks

Who to Be Treated: Nomogram Using Self-Reported Periodontal Screening Instrument among English-Speaking Adults in Multi-Ethnic Singapore.

Periodontal disease is a major public health problem. This study aimed to develop a nomogram using a self-reported periodontitis screening instrument in predicting severe periodontitis (SP), defined by the World Workshop on Classification of Periodontal and Peri-Implant Diseases and Conditions, and evaluate its utility in clinical setting. An Akaike information criterion selected multivariable model was developed to predict SP using a self-reported questionnaire, with a nomogram developed based on its regression coefficients. Discriminatory capability was evaluated by Receiver-operating characteristic curve. Ability to predict SP of individual patients was evaluated with bootstrapping. Decision curve analysis (DCA) was performed to evaluate its potential clinical utility by evaluating clinical net benefit at different thresholds. 58.1% of 155 participants were classified with SP. Older males without tertiary education, with ‘loose teeth’, ‘bone loss’ and ‘mouth rinse use’ had higher SP risk. The nomogram showed excellent discriminatory capability with Area under Curve of 0.83 (95% CI = (0.76, 0.89)), good calibration (intercept = 0.026) and slight overestimation of high risk and underestimation of low risk (slope = 0.834). DCA showed consistent clinical net benefit across the range of thresholds relative to assumption of ‘no patient’ or ‘all patient’ with SP. Our nomogram using a self-reported periodontitis instrument is useful in SP screening in English-speaking Singaporean adults.

Mouthrinses and SARS-CoV-2 viral load in saliva: a living systematic review.

Objective To conduct a living systematic review of the clinical evidence about the effect of different mouthrinses on the viral load of SARS-CoV-2 in the saliva of infected patients.Methods This study was reported using the PRISMA guidelines. An electronic search was conducted in seven databases and preprint repositories. We included human clinical trials that evaluated the effect of mouthrinses with antiseptic substances on the viral load of SARS-CoV-2 in the saliva of children or adults, who tested positive for SARS-CoV-2 by reverse transcriptase-polymerase chain reaction (RT-PCR). The risk of bias was assessed using the ROBINS-I tool. PROSPERO registration number: CRD42021240561.Results Five studies were included (n = 66 participants). Study participants underwent oral rinses with hydrogen peroxide (H2O2) at 1%, povidone-iodine (PI) at 0.5% or 1%, chlorhexidine gluconate (CHX) at 0.2% or 0.12%, cetylpyridinium chloride (CPC) at 0.075%, and Linolasept. Only one study included a control group with sterile water. Three of the studies identified a reduction in viral load in saliva after the use of mouthrinses with PI (up to three hours), CHX (up to four hours), or Linolasept mouthwash (up to six hours). One study reported a statistically significant reduction after the use of mouthrinses with CPC or PI vs water (up to six hours) and one study reported a non-significant reduction in viral load after the use of H2O2 rinses.Conclusions According to the present systematic review, the effect of mouthrinses on SARS-CoV-2 viral load in the saliva of COVID-19 patients remains uncertain. Evidence from well-designed randomised clinical trials is required for further and more objective evaluation of this effect.Supplementary InformationZusatzmaterial online: Zu diesem Beitrag sind unter 10.1038/s41432-022-0253-z für autorisierte Leser zusätzliche Dateien abrufbar.

Effect of a mouth rinse and a high-fluoride toothpaste on caries incidence in orthodontic patients: A randomized controlled trial

The objective was to evaluate the effect of a fluoride mouth rinse and a high-fluoride toothpaste on caries incidence in patients undergoing orthodontic treatment with fixed appliances. In this 3-armed, parallel-group, randomized controlled trial, patients referred to the Specialist Clinic of Orthodontics, Mölndal, Sweden, were randomly allocated to 1 of the 3 groups. (1) Fluoride mouth rinse (FMR) group: 0.2 % sodium fluoride (NaF) mouth rinse plus 1450 ppm fluoride (F) toothpaste; (2) High-fluoride tootpaste (HFT) group: 5000 ppm F toothpaste; and (3) Control (CTR) group: 1450 ppm F toothpaste. The generation of a randomization sequence was performed in blocks of 30. Inclusion criteria included patients scheduled for treatment with fixed appliances in the maxillary and mandibular arch aged 12-20 years. The primary outcome variable was the change in Decayed Initial Filled Surfaces (ΔDiFS) based on radiographs taken before and after the treatment. For statistical comparisons between groups, the Kruskal-Wallis test were used for continuous variables, whereas the Mann-Whitney U-test was used for pairwisegroup comparisons. Furthermore, the risk ratio (RR) and 95% confidence interval (CI) based on clinically relevant cutoffs (DiFS ≥2) were calculated to compare the increase of caries during orthodontic treatment between 2 groups. The Cochran-Mantel-Haenszel method was used to adjust RR for baseline values. Blinding was employed during the caries registration and the data analysis. In total, 270 participants were randomized, with 15 patients dropping out, such that 255 patients were included in the statistical analyses. Recruitment was from October 2010 to December 2012. An increase in DiFS (≥1 DiFS) during treatment was observed in 48.3% of the FMR group, 42.0% of the HFT group, and 35.6% of the CTR group. There was no significant difference between the groups regarding increased DiFS (P= 0.17). The risk of increase in DiFS ≥2 during orthodontic treatment was 31.0% in the FMR group, 25.9% in the HFT group, and 18.4% in the CTR group. The RR for an increase of ≥2 DiFS during orthodontic treatment was 1.38 (95% CI, 0.81-2.34; P= 0.23) for FMR vs CTR, 1.21 (95% CI, 0.70-2.10; P= 0.51) for HFT vs CTR, and 0.93 (95% CI, 0.57-1.49; P= 0.76) for HFT vs FMR. In patients who demonstrate a low prevalence of caries and are undergoing orthodontic treatment, daily use of high-fluoride toothpaste or fluoride mouth rinse in combination with regular toothpaste does not appear to significantly alter the caries incidence compared with the use of regular toothpaste. The trial was registered in the FoU i Sverige research database (http://www.fou.nu/is/sverige), with registration no.236251. The protocol was not published before trial commencement. Local Research and Development Board for Gothenburg and South Bohuslän (grant no. 768531); and The Swedish Patent Revenue Fund (grant number EKF-780/19).