Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: randomized control trial in Singapore.

PURPOSE: One of the key approaches to minimize the risk of COVID-19 transmission would be to reduce the titres of SARS-CoV-2 in the saliva of infected COVID-19 patients. This is particularly important in high-risk procedures like dental treatment. The present randomized control trial evaluated the efficacy of three commercial mouth-rinse viz. povidone-iodine (PI), chlorhexidine gluconate (CHX) and cetylpyridinium chloride (CPC), in reducing the salivary SARS-CoV-2 viral load in COVID-19 patients compared with water. METHODS: A total of 36 SARS-CoV-2-positive patients were recruited, of which 16 patients were randomly assigned to four groups-PI group (n = 4), CHX group (n = 6), CPC group (n = 4) and water as control group (n = 2). Saliva samples were collected from all patients at baseline and at 5 min, 3 h and 6 h post-application of mouth-rinses/water. The samples were subjected to SARS-CoV-2 RT-PCR analysis. RESULTS: Comparison of salivary Ct values of patients within each group of PI, CHX, CPC and water at 5 min, 3 h and 6 h time points did not show any significant differences. However, when the Ct value fold change of each of the mouth-rinse group patients were compared with the fold change of water group patients at the respective time points, a significant increase was observed in the CPC group patients at 5 min and 6 h and in the PI group patients at 6 h. CONCLUSION: The effect of decreasing salivary load with CPC and PI mouth-rinsing was observed to be sustained at 6 h time point. Within the limitation of the current study, as number of the samples analyzed, the use of CPC and PI formulated that commercial mouth-rinses may be useful as a pre-procedural rinse to help reduce the transmission of COVID-19. ISRCTN (ISRCTN95933274), 09/09/20, retrospectively registered.

The Role of Dentists in COVID-19 Is Beyond Dentistry: Voluntary Medical Engagements and Future Preparedness.

The emergence of the highly infectious novel coronavirus SARS-CoV-2 has led to a global COVID-19 pandemic. Since the outbreak of COVID-19, worldwide healthcare systems have been severely challenged. The rapid and explosive surge of positive cases has significantly increased the demand for medical care. Herein we provide a perspective on the role dentists can play in voluntary medical assistance and future preparedness for a similar pandemic. Though dentists and physicians have different scopes of practice, their trainings share many similarities. Hence, dental professionals, with their knowledge of basic human science and sterile surgical techniques, are an invaluable resource in the COVID-19 pandemic response. Overall, it is commendable that many dentists have risen to the challenge in the fight against COVID-19. For example, in Singapore, National Dental Centre Singapore (NDCS) deployed dental clinicians as well as volunteers from research laboratories to screen for suspected cases, provide consultations as well as conduct swabbing operations. Dental practice will be considerably changed in the post-COVID-19 era. There is a greater need to have refresher courses for practicing dentists on new infection control strategies. Moreover, the curriculum in dental schools should be expanded to include competencies in pandemic and disaster relief. In addition, voluntary medical work should be made a part of the community dentistry curriculum. This volunteerism will leave a positive impact on developing the careers of young dentists. Hence, the contribution of dentists beyond dental practice in this pandemic situation will be appreciated by future generations.