Mouthwashes and the Effect on the Viral Load of SARS-CoV-2 in Saliva: A Literature Review

ABSTRACT

BACKGROUND: At present, several active ingredients have been investigated in mouthwashes having certain virucidal properties, which could reduce the viral load of SARS-CoV-2 to avoid contamination in medical or dental practice. AIM: The objective of this review is to analyze the available evidence regarding mouthwashes and their effect on the salivary viral load of SARS-CoV-2. METHOD(S) Records were retrieved from databases such as PubMed, Scopus, Web of Science, and Virtual Health Library up to June 21, 2022. Randomized or non-randomized clinical trials were included where saliva samples and laboratory or in vitro studies were used in the presence of saliva. RESULT(S) After a systematic selection process, 11 clinical studies that evaluated at least one mouthwash within clinical protocols and three laboratory studies that evaluated the virucidal efficacy against SARS-CoV-2 in the presence of saliva were finally included. CONCLUSION(S) There are oral disinfectants with virucidal action in saliva samples, under clinical and laboratory conditions, capable of reducing the viral load of SARS-CoV-2. Cetylpyridinium chloride, chlorhexidine, and povidone-iodine present the best results so far. However, it was also possible to find active principles of recent appearance that, based on favorable exploratory results, needs further investigation on their efficacy and possible adverse events. Copyright © 2022 Mariano Ortiz Pizarro, Christian R. Mejia, David R. Rodriguez-Diaz, Ygnacio Moreno Herrera, Alexander Bustamante Cabrejo, Victor Serna-Alarcon.