Virucidal activity in vitro of mouthwashes against a feline coronavirus type II.

Transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can occur through saliva and aerosol droplets deriving from the upper aerodigestive tract during coughing, sneezing, talking, and even during oral inspection or dental procedures. The aim of this study was to assess in vitro virucidal activity of commercial and experimental mouthwashes against a feline coronavirus (FCoV) strain. Commercial and experimental (commercial-based products with addition of either sodium dodecyl sulfate (SDS) or thymus vulgaris essential oil (TEO) at different concentrations) mouthwashes were placed in contact with FCoV for different time intervals, that is, 30 s (T30), 60 s (T60), and 180 s (T180); subsequently, the virus was titrated on Crandell Reese Feline Kidney cells. An SDS-based commercial mouthwash reduced the viral load by 5 log10 tissue culture infectious dose (TCID)50 /50 µl at T30 while a cetylpyridinium (CPC)-based commercial mouthwash was able to reduce the viral titer of 4.75 log10 at T60. Furthermore, five experimental mouthwashes supplemented with SDS reduced the viral titer by 4.75-5 log10 according to a dose- (up to 4 mM) and time-dependent fashion.

Comparison of the Effect of Cetylpyridinium Chloride 0.05% and Povidone-Iodine 1%, Two Types of Mouthwash Effective Against COVID-19, on the Shear Bond Strength of Metal Orthodontic Brackets: a Laboratory Study

Introduction: Povidone-iodine 1% and cetylpyridinium chloride 0.05% mouthwashes have been used to remove microbial plaque and reduce gingivitis and the dysfunction of COVID-19. The present research was conducted to determine these two types of mouthwash effects on the shear bond strength of orthodontic brackets in laboratory conditions. Method: In this experimental-laboratory research, healthy human premolar teeth were selected and preserved in 1% thymol. The samples were divided into three groups, including control and 0.05% cetylpyridinium chloride and 1% povidone-iodine mouthwashes. The shear bond strength values of the brackets were measured with a UTM device and with a blade speed of 1 mm/min After keeping each group in mouthwash and applying thermal cycles. The Adhesive Remnant Index (ARI) observed the amount of residual adhesive using a stereomicroscope at ten magnifications. The bond strength of brackets was investigated by one-way Analysis of Variance (ANOVA) in three groups, and pairwise comparisons were performed with Tukey's test. The chi-square test also analyzed the remaining adhesive degrees in the groups. Results: Significant differences were observed in the shear bond strength of brackets in three groups (p=0.02). The bond strength of the brackets in the povidone-iodine mouthwash group was significantly higher than the control group (p=0.01). However, in other pairwise comparisons, no significant differences were observed between the groups. There were no significant differences in the amount of residual adhesive in the different groups. Conclusion: Immersion in mouthwashes, effective against COVID-19, had no adverse effects on metal orthodontic brackets' shear bond strength values. Therefore, these mouthwashes can establish oral and dental hygiene and destroy COVID-19's function in orthodontic patients. [ FROM AUTHOR] Copyright of Journal of Pharmaceutical Negative Results is the property of ResearchTrentz and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Antiviral effect of oral antiseptic solutions commonly used in dentistry practice: A scoping review

Objective: The purpose of this scoping review is to show the evidence available in the literature and provide an overview of the antimicrobial-containing mouthwashes for reducing viral load in order to group the most up-to-date information and make it more accessible to dentists. Design(s): A structured electronic search in PubMed (Medline), LILACS, EMBASE and EBSCO without temporal restriction was performed. The studies were selected based on their title, and full reading following a pre-established order based on the inclusion and exclusion criteria. The included studies were those that analyzed the effect of viral load reduction by mouthwashes, primary studies, no reviews and in Spanish, English or Portuguese. Result(s): The search resulted in 1881 articles, at the end of the exclusion of duplicates and selection, 71 articles were included in this scoping review. The substances most commonly found were chlorhexidine (CHX), povidone-iodine (PVP-I), essential oils (EO), cetylpyridinium chloride (CPC), hydrogen peroxide (H2O2) and other substances (OTHERS). Conclusion(s): Of all the mouthwashes analyzed, the Essential oils, Cetylpyridinium Chloride and Povidone-iodine, showed antiviral potential against common viruses present in the oral cavity, with no significant side effects in short-term use, and are viable options for use as a pre-procedure in clinical routine against SARS-CoV-2 and other types of viruses. The other solutions need further studies to determine their effect and confirm their clinical use.Copyright © 2023

Antiviral effect of oral antiseptic solutions commonly used in dentistry practice: a scoping review

Objective The purpose of this scoping review is to show the evidence available in the literature and provide an overview of the antimicrobial-containing mouthwashes for reducing viral load in order to group the most up-to-date information and make it more accessible to dentists. Design A structured electronic search in PubMed (Medline), LILACS, EMBASE and EBSCO without temporal restriction was performed. The studies were selected based on their title, and full reading following a pre-established order based on the inclusion and exclusion criteria. The included studies were those that analyzed the effect of viral load reduction by mouthwashes, primary studies, no reviews and in Spanish, English or Portuguese. Results The search resulted in 1881 articles, at the end of the exclusion of duplicates and selection, 71 articles were included in this scoping review. The substances most commonly found were chlorhexidine (CHX), povidone-iodine (PVP-I), essential oils (EO), cetylpyridinium chloride (CPC), hydrogen peroxide (H2O2) and other substances (OTHERS). Conclusion Of all the mouthwashes analyzed, the Essential oils, Cetylpyridinium Chloride and Povidone-iodine, showed antiviral potential against common viruses present in the oral cavity, with no significant side effects in short-term use, and are viable options for use as a pre-procedure in clinical routine against SARS-CoV-2 and other types of viruses. The other solutions need further studies to determine their effect and confirm their clinical use.

Efficacy of Pre-Procedural Mouthwashes against SARS-CoV-2: A Systematic Review of Randomized Controlled Trials.

The oral mucosa is one of the first sites to be affected by the SARS-CoV-2. For this reason, healthcare providers performing aerosol-generating procedures (AGPs) in the oral cavity are at high risk of infection with COVID-19. The aim of this systematic review is to verify whether there is evidence in the literature describing a decrease in the salivary viral load of SARS-CoV-2 after using different mouthwashes. An electronic search of the MEDLINE database (via PubMed), Web of Science, SCOPUS, and the Cochrane library database was carried out. The criteria used were those described by the PRISMA® Statement. Randomized controlled trial studies that have used mouthwashes as a form of intervention to reduce the viral load in saliva were included. The risk of bias was analyzed using the Joanna Briggs Institute Critical Appraisal Tool. Ultimately, eight articles were included that met the established criteria. Based on the evidence currently available in the literature, PVP-I, CHX and CPC present significant virucidal activity against SARS-CoV-2 in saliva and could be used as pre-procedural mouthwashes to reduce the risk of cross-infection.

Mouth rinses efficacy on salivary SARS-CoV-2 viral load: A randomized clinical trial.

Considering the global trend to confine the COVID-19 pandemic by applying various preventive health measures, preprocedural mouth rinsing has been proposed to mitigate the transmission risk of SARS-CoV-2 in dental clinics. The study aimed to investigate the effect of different mouth rinses on salivary viral load in COVID-19 patients. This study was a single-center, randomized, double-blind, six-parallel-group, placebo-controlled clinical trial that investigated the effect of four mouth rinses (1% povidone-iodine, 1.5% hydrogen peroxide, 0.075% cetylpyridinium chloride, and 80 ppm hypochlorous acid) on salivary SARS-CoV-2 viral load relative to the distilled water and no-rinse control groups. The viral load was measured by quantitative reverse transcription PCR (RT-qPCR) at baseline and 5, 30, and 60 min post rinsing. The viral load pattern within each mouth rinse group showed a reduction overtime; however, this reduction was only statistically significant in the hydrogen peroxide group. Further, a significant reduction in the viral load was observed between povidone-iodine, hydrogen peroxide, and cetylpyridinium chloride compared to the no-rinse group at 60 min, indicating their late antiviral potential. Interestingly, a similar statistically significant reduction was also observed in the distilled water control group compared to the no-rinse group at 60 min, proposing mechanical washing of the viral particles through the rinsing procedure. Therefore, results suggest using preprocedural mouth rinses, particularly hydrogen peroxide, as a risk-mitigation step before dental procedures, along with strict adherence to other infection control measures.

The efficacy of mouthwashes in reducing SARS-CoV-2 viral loads in human saliva: A systematic review.

This systematic review aimed to evaluate existing randomized controlled trials (RCT) and cohort studies on the efficacy of mouthwashes in reducing SARS-CoV-2 viral loads in human saliva. Searches with pertinent search terms were conducted in PubMed, MEDLINE, Scopus, and Web of Science databases for relevant records published up to Oct 15, 2022. Google Scholar and ProQuest were searched for grey literature. Manual searches were conducted as well for any pertinent articles. The protocol was prospectively registered at PROSPERO (CRD42022324894). Eligible studies were critically appraised for risk of bias and quality of evidence to assess the efficacy of mouthwash in reducing the SARS-CoV-2 viral load in human saliva. Eleven studies were included. The effect on viral load using various types of mouthwash was observed, including chlorhexidine (CHX), povidone-iodine (PI), cetylpyridinium chloride (CPC), hydrogen peroxide (HP), ß-cyclodextrin-citrox mouthwash (CDCM), and Hypochlorous acid (HCIO). Eight articles discussed CHX use. Five were found to be significant and three did not show any significant decrease in viral loads. Eight studies reviewed the use of PI, with five articles identifying a significant decrease in viral load, and three not showing a significant decrease in viral load. HP was reviewed in four studies, two studies identified significant viral load reductions, and two did not. CPC was reviewed in four studies, two of which identified significant viral load reductions, and two did not. CDCM was reviewed in one article which found a significant decrease in viral load reduction. Also, HCIO which was evaluated in one study indicated no significant difference in CT value. The current systematic review indicates that based on these eleven studies, mouthwashes are effective at reducing the SARS-CoV-2 viral load in human saliva. However, further studies should be performed on larger populations with different mouthwashes. The overall quality of evidence was high.

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

Aims and Objectives: 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? Materials and Methods: 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. Results: 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. Conclusion: 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.

Effect of Mouthwashes for COVID-19 Prevention on Surface Changes of Resin Composites.

OBJECTIVE: The aim of this research was to investigate the effect of various mouthwashes for COVID-19 prevention on surface hardness, roughness, and colour changes of bulk-fill and conventional resin composites and determine the pH and titratable acidity of mouthwashes. METHODS: Four hundred eighty specimens were fabricated in cylindrical moulds (10 mm in diameter and 2 mm in thickness). Before immersion, baseline data of surface hardness, roughness, and colour values were recorded. Each product of specimens (Filtek Z350XT, Premise, Filtek One Bulk Fill Restorative, SonicFil 2) were divided into 4 groups for 0.2% povidone iodine, 1% hydrogen peroxide, 0.12% chlorhexidine, and deionised water (serving as a control). The specimens were immersed in mouthwashes for 1 minute and then stored in artificial saliva until 24 hours. This process was repeated for 14 days. After immersion, surface hardness, roughness, and colour values of specimens were measured at 7 and 14 days. The data were statistically analysed by 2-way repeated analysis of variance, Tukey honestly significant difference, and t test (P < .05). RESULTS: After immersion, all mouthwashes caused significantly lower surface hardness and greater roughness and colour values (P < .05) on all resin composites tested. CONCLUSIONS: Mouthwashes had an effect on all resin composites evaluated leading to a significant decreased surface hardness and an increased roughness and colour values (P < .05).

The Multifaceted Influence of COVID-19 on Indian Dentists: A Cross-Sectional Survey.

Introduction: COVID-19 has had a new challenge on dental workers, radically altering clinical and personal management. The cross-sectional survey sought to examine and comprehend the influence of COVID-19 on Indian dentistry practitioners. Methods: A 38-item questionnaire-based survey was communicated to Indian dental practitioners through a web-based form (Google form). The questionnaire was categorized into four sections: (i) Personal protective equipment (PPE), (ii) dental treatments, (iii) auxiliary management, and (iv) personal impact. The findings were examined and studied in order to comprehend the repercussions of COVID-19. The questionnaire was completed by 513 of the 1129 dentists to whom it was delivered. Results: For the current questionnaire, a response rate that we received was 45.44%. When compared to the pre-pandemic era, the use of PPE has increased dramatically (95.7%). The use of PPE alleviated dental practitioners' and patients' doubts about viral transmission. The epidemic prompted the Ministry of Health and Family Welfare (MoHFW) to issue specific recommendations for dental treatments, which were followed by 92.5% of dentists. The majority of dentists reported a considerable impact on both financial and mental health concerns. Teleconsulting and distant learning gained greater prominence. The COVID-19 epidemic affected the lives of dental professionals both within and outside of the dental setting, as well as the auxiliary. Conclusion: COVID-19 has left a trail of devastation in its aftermath. Dentists were affected both emotionally and professionally. Dentists rapidly and uniformly followed the revised recommendations.

Fighting bioaccumulation: creating safer dentistry for all

In this article, author considered how biodegradable and more eco-friendly products have minimal environmental impact, creating safer dentistry for all.

Reduction in SARS-CoV-2 Oral Viral Load with Prophylactic Mouth Rinse

Objectives The medical and health facilities are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study tested the preprocedural prophylactic mouthwash rinses to reduce the oral viral load. The findings from this study will help the practitioners to select the best mouthwash for the patients to mitigate the risk of transmission during aerosolizing. This study aimed to evaluate the effectiveness of four commonly used types of mouthwash in reducing intraoral viral load among hospitalized coronavirus disease 2019 patients. Materials and Methods This prospective cohort study was conducted with 116 patients referred to the Masih Daneshvari Hospital in Tehran, Hamadan University of Medical Sciences of Hamadan City, and Mashhad University of Medical Sciences. Patients were randomized into four groups with each group rinsed their mouth with 20 mL of 2% povidone-iodine, 1% hydrogen peroxide, normal saline as a control study group, or 0.12% chlorhexidine, respectively, for 20 seconds. The standard reverse transcription polymerase chain reaction method evaluated the virus load before and at 1 hour, 2 hours, and 4 hours after using the mentioned mouthwash. Results Our results revealed that chlorhexidine and H 2O 2showed the highest efficiency in reducing SARS-Co-2 load in the oral cavity and nasopharyngeal region of patients;they increased the Ct values by 9 to 10 (before: 25.84 vs. after 32. 4, p < 0.455) (17.333 vs. after 26.497, p <0.097). Conclusion Our findings suggest that chlorhexidine and H 2O 2could be used in dental clinics to reduce the risk of transmitting the SARS-CoV-2 virus from infected individuals to dentists before dental procedures. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

GENERAL DENTISTS' AWARENESS ON CHLORHEXIDINE HYPERSENSITIVITY IN SAUDI ARABIA. A CROSS-SECTIONAL STUDY

[...]daily mouthwashes can be used as a prophylactic measure, since they are effective antiplaque agents. [...]they help prevent dental caries [5]. Besides mouthwash, other variants of CHX used in dentistry are toothpaste containing chlorhexidine and CHX gels, the former being used as a topical antiseptic to treat peri-implant mucositis or for periodontitis prevention after scaling [12], while CHX chips which are used locally, in less severe periodontal cases [13]. According to these retrospective studies, hypersensitivity to CHX mouthwash can occur, therefore, every general dentist should consider this side effect capable to diagnose and treat an allergic reaction when it occurs. Validity and reliability The self-administered questionnaire distributed to participants included questions about independent demographic variables such as gender, years of clinical experience, place of work (governmental or private), and most frequently prescribed mouthwashes. [...]there were questions about dentists' awareness and knowledge on CHX hypersensitivity.

Cetylpyridinium Chloride Mouthwash to Reduce Shedding of Infectious SARS-CoV-2: A Double-Blind Randomized Clinical Trial.

The airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via respiratory fluids and droplets suggests that mouthwashes containing substances with virucidal activity can help reduce viral spread. We conducted a multicenter, double-blind, placebo-controlled, randomized trial to assess the virucidal activity of cetylpyridinium chloride (CPC) mouthwashes. Outpatients who tested positive for SARS-CoV-2 infection with or without symptoms were randomized to perform washes and gargles for 1 min with 15 mL of either colored distilled water or 0.07% CPC (Vitis CPC Protect) mouthwash. The study outcomes were the SARS-CoV-2 log10 viral RNA load and the nucleocapsid protein levels, both in saliva at 1 and 3 h after the intervention. In total, 118 patients were enrolled and randomized (mean [SD], age 46 [14] y). Thirteen of 118 participants (11%) did not complete follow-up or had insufficient sample volume for testing and were excluded from the analysis. The assessment of the viral load showed no significant differences between groups at any of the investigated points. However, the levels of SARS-CoV-2 nucleocapsid protein of lysed viruses were significantly higher in the CPC group compared with the control group at 1 h (adjusted difference 269.3 pg/mL; 95% confidence interval [CI], 97.1-441.5) and at 3 h postintervention (561.1 pg/mL; 95% CI, 380.0-742.2). In nonhospitalized patients with asymptomatic or mild symptomatic SARS-CoV-2 infection, a 0.07% CPC mouthwash, compared to placebo, was associated with a significant increase of nucleocapsid protein levels in saliva, indicating enhanced disruption of viral particles.

Antiviral effect of mouthwashes against SARS-COV-2: A systematic review

Objective: This systematic review aimed to evaluate the antiviral effect of mouthwashes against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Material and methods: An electronic search was performed on PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ProQuest, and Google Scholar, and was complemented by a manual search. Both clinical and in vitro studies that focused on the antiviral effect of mouthwashes against SARS-CoV-2 were included. Risk of bias assessment was performed only on the clinical studies using the RoB-2 and ROBINS-I tools. Results: A total of 907 records were found;after initial selection by title and , 33 full-text articles were selected to be evaluated for eligibility. Finally, a total of 27 studies were included for the qualitative synthesis, including 16 in vitro studies and 11 clinical trials. Antiviral effects were evaluated separately for the in vitro and clinical studies. In vitro studies included mouthwashes containing hydrogen peroxide, chlorhexidine digluconate, povidone-iodine, essential oils, cetylpyridinium chloride, and other compounds;in vivo studies included mouthwashes containing hydrogen peroxide, chlorhexidine digluconate, povidone-iodine, cetylpyridinium chloride, essential oils, chlorine dioxide, 0-cyclodextrin-citrox, and sorbitol with xylitol. Povidone-iodine, cetylpyridinium chloride, and essential oils were effective in vitro, while hydrogen peroxide, chlorhexidine digluconate, povidone-iodine, cetylpyridinium chloride, 0-cyclodextrin-citrox, and sorbitol with xylitol were effective in vivo. Unclear or high risk of bias was found for almost all clinical studies, and only one study presented with a low risk of bias. No further quantitative analysis was performed. Conclusion: Although povidone-iodine, cetylpyridinium chloride, and essential oils may be an alternative to reduce the viral load in vitro and in vivo, more studies are needed to determine the real antiviral effect of these different mouthwashes against SARS-CoV-2. This work was not funded. The protocol was registered in PROSPERO (identification number: CRD42021236134). (c) 2022 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

In vitro virucidal activity of mouthwashes on SARS-CoV-2.

OBJECTIVES: The objective of the study was to evaluate the in vitro virucidal activity of commercial mouthwashes against SARS-CoV-2 and variants of concern. MATERIALS AND METHODS: Antiviral activity was assessed at different time intervals, based on common use of these products by titrating residual viral infectivity on Vero E6 cells. RESULTS: All the mouthwashes were effective to reduce the infectious titers of SARS-CoV-2 and its tested variants. Mouthwashes Listerine® Cool Mint milder taste and Listerine® Cavity Protection milder taste reduced the infectious viral titer by up to 3.9 log10 after 30 s, while mouthwash Cetilsan® Sugar Free was able to reduce the viral titer by 2.2-2.9 log10 at all tested time intervals. Mouthwash Curasept® ADS DNA Intensive treatment was less effective to decrease viral infectivity (0.7-2.2 log10 TCID50/ml at all tested time intervals). Interestingly, the Gamma variant appeared more resistant to treatment in vitro with the different mouthwashes. CONCLUSIONS: In this study, we were able to assess the ability of different mouthwashes to in vitro decrease the infectivity of SARS-CoV-2 and its variants, and we observed that Gamma variant of concern was more resistant to treatment with mouthwashes.

The effect of normal mouthwash and teeth whitening mouthwash on COVID-19 patient viral load in mouth and PCR results

COVID-19 is a life-threatening viral infection that considers airborne viruses and it's very hard to control the separation of such a pathogen and early diagnosis and treatment can play important role in directly affects patients prognosis, so the period of infection and diagnosis of COVID-19 with good treatment according to patient vital singe is very important. The current diagnosis of COVID-19 has yet to be further improved. To investigate the effect of normalMouthwashand Teeth Whiting Mouthwash onSARS COV-2 patient Viral load in the oral cavity(Lu et al, 2019). Mouth wash has been done on SARS COV-2 patients for 1 min by normal mouth wash (ganger) group 1 and then mouth swap for RT-PCR of SARS-Cov-2 before and after 30 min of mouth washing and other mouth wash has been done on SARS COV-2 patients for 1 min by whiting mouth wash (Oxiactive) group 2 and then mouth swap for RT-PCR of SARS-Cov-2 to know the variation in CT PCR level pre and post mouth wash and to compare the effectiveness between them. The effectiveness of normal mouth wash of COVID-19 patients reducing the viral load, which is considered as an impotent way to protect from the separation of viral shedding (the 14 patients were COVID -19 PCR positive and then after washing became PCR negative). The effectiveness of whitening mouth wash of COVID-19 patients strong reducing the viral load and most cases are becoming negative PCR, which is considered as an important way to protect from the separation of viral shedding and maximum lowering 14 CT or (16000 folds). Mouth wash according to the result could be the best way to decrease the contamination and infection between dentist and patient. Reducing the nosocomial infection by applying mouth wash for several minutes. The PCR false-negative result could be caused by mouth wash the effect the truth of laboratory tests.

Virucidal efficacy of chlorhexidine: a systematic review.

This study aimed to systematically review the literature about the virucidal efficacy of CHX in comparison to other substances used in the oral cavity. Electronic searches were performed in four databases (PubMed, Scopus, Embase, and Web of Science). Only studies that presented the following characteristics were included: (1) verified virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1), any Influenza, or any human coronavirus (HcoV); and (2) compared the virucidal efficacy of CHX with essential oils (Listerine®), quaternary ammonium compounds, povidone-iodine, hydrogen peroxide, negative control substance, and absence of therapy. Two researchers independently selected the studies, extracted data and evaluated the risk of bias. A narrative data synthesis was used. Twenty-five studies were included, of which 21 were in vitro and four were randomized clinical trials (RCT). Studies assessed the virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1) (10 studies), Influenza A (InfluA) (4 studies), human coronavirus (HCoV) (4 studies) and Severe Acute Respiratory Syndrome-Related Coronavirus (SARS-CoV-2) (11 studies). Most studies demonstrated that CHX has a positive virucidal efficacy against HSV-1 and InfluA strains. However, lower efficacy was shown to InfluA strain in comparison to povidone-iodine. Lower to none virucidal efficacy of CHX is expected for HCoV and SARS-CoV-2 strains for in vitro studies. Three RCT demonstrated that CHX was able to significantly reduce the viral load of SARS-CoV-2 for a short period. CHX may present an interesting virucidal efficacy against HSV-1 and InfluA viruses. CHX also presents transient efficacy against SARS-CoV-2 when used as a mouthwash.

Virucidal Activity of Different Mouthwashes against the Salivary Load of SARS-CoV-2: A Narrative Review.

The saliva of COVID-19-confirmed patients presents a high viral load of the virus. Aerosols generated during medical and dental procedures can transport the virus and are a possible causative agent of cross-infection. Since the onset of the pandemic, numerous investigations have been attempting to mitigate the risk of transmission by reducing the viral load in saliva using preprocedural mouthwashes. This study aims to review the most up-to-date in vitro and in vivo studies investigating the efficacy of different mouthwashes on reducing the salivary viral load of SARS-CoV-2, giving particular attention to the most recent randomized control trials published.

Effectiveness of hydrogen peroxide as auxiliary treatment for hospitalized COVID-19 patients in Brazil: preliminary results of a randomized double-blind clinical trial.

OBJECTIVES: To evaluate the effectiveness of hydrogen peroxide (H2O2) in the form of mouthwash and nasal spray as an auxiliary treatment for coronavirus disease 2019 (COVID-19). METHODS: Forty hospitalized patients who tested positive for severe acute respiratory syndrome coronavirus 2 using a reverse-transcription polymerase chain reaction test were evaluated. They were randomly divided into an experimental group (n= 20; gargling with 1.0% H2O2 and nasal wash with 0.5% H2O2) or a control group (n= 20). The solutions were used for 7 days and the patients were monitored every 2 days, for a total of 8 days. At check-ups, patients were asked about their symptoms and possible adverse effects of the solutions. The presence and severity (mild, moderate, or severe) of symptoms were recorded. Data were compared using the Student test and the Fisher exact test (α= 0.05). RESULTS: There was no significant difference between the 2 groups in the length of hospital stay (p= 0.65). The most frequent symptom on day 0 was coughing (72.0% in the experimental group and 76.5% in the control group), which abated over time. There was no significant difference between the groups in the evaluated symptoms. Most (75.0%) of the patients in the experimental group presented a reduction in dyspnea between days 0 and 2. Few patients reported adverse effects from the use of the solutions. CONCLUSIONS: H2O2 as a mouthwash and nasal spray is safe to use. There is insufficient evidence to demonstrate that H2O2 is effective as an auxiliary treatment for hospitalized COVID-19 patients.