Comparison of the in-vitro efficacy of different mouthwash solutions targeting SARS-CoV-2 based on the European Standard EN 14476.

The outbreak of the SARS-CoV-2 pandemic is triggering a global health emergency alert. Until vaccination becomes available, a bundle of effective preventive measures is desperately needed. Recent research is indicating the relevance of aerosols in the spread of SARS-CoV-2. Thus, in this study commercially available antiseptic mouthwashes based on the active ingredients chlorhexidine digluconate and octenidine dihydrochloride (OCT) were investigated regarding their efficacy against SARS-CoV-2 using the European Standard 14476. Based on the requirement of EN 14476 in which reduction of at least four decimal logarithms (≥4 log10) of viral titre is requested to state efficacy, the OCT-based formulation was found to be effective within a contact time of only 15 s against SARS-CoV-2. Based on this in-vitro data the OCT mouthwash thus constitutes an interesting candidate for future clinical studies to prove its effectiveness in a potential prevention of SARS-CoV-2 transmission by aerosols.

Effects of Aroma Gargling, Cold Water Gargling, and Wet Gauze Application on Thirst, Halitosis, and Sore Throat of Patients After Spine Surgery.

This study compared and examined the effects of aroma gargling, cold water gargling, and wet gauze application on thirst, halitosis, and sore throat in patients after spine surgery. A quasiexperimental pretest/posttest control group design was employed. Samples were total 70 patients (aroma gargling: 24 samples, cold gargling: 24 samples, and wet gauze: 22 samples) after spine surgery in K Hospital in Seoul, Korea. The aroma gargle solution as an experimental intervention was prepared by blending peppermint, tea tree, and lemon oils at a ratio of 1:2:2. A 60 cc of aroma gargle solution was used 3 times for 15 to 20 seconds. The visual analog scale was used to measure the degrees of thirst and sore throat, and a portable device was used to examine the degree of halitosis. There were significant differences in the degrees of thirst, halitosis, and sore throat according to interaction between group and duration. In the comparison among 3 groups, aroma gargling provided better oral health by decreasing thirst, halitosis, and sore throat for patients with spine surgery. Aroma gargling can be utilized as an effective nursing intervention for decreasing thirst, halitosis, and sore throat for patients with spine surgery in clinical practice. Results suggest, therefore, that health professionals should consider an array of methods including aroma gargling for patients after spine surgery.

Antibacterial activity of selected commercial products for mouth washing and disinfection, assessed in accordance with PN-EN 1040.

BACKGROUND: Currently, there is a wide range of products for mouth washing on the Polish market. They have different qualitative and quantitative compositions, and they differ particularly in the concentration of active substances. In antisepsis and disinfection, the significant reduction in number of cells of microorganisms in a particular environment is very crucial. The chemical agents should provide a significant decrease in number of microorganisms in a relatively short time. The purpose of this study was to examine the bactericidal activity of selected herbal products used for treatment of inflammation, and disinfection and washing of the mouth, having antibacterial activity as declared by the manufacturers. MATERIAL AND METHODS: The study included 28 products for mouth washing and disinfection available in Poland. Bactericidal activity was studied using a quantitative suspension test according to the standard PN-EN 1040. RESULTS: Only 1 of 4 tested herbal products, registered as medicinal products, showed satisfactory antibacterial activity when they were used according to the manufacturer's recommendations. A total of 13 preparations (48%) complied with the standard requirements against all tested strains. Up to 19% of products showed no bactericidal activity against bacterial strains, and up to 33% were only effective against certain microorganisms. CONCLUSIONS: The informational literature accompanying most antiseptics should be corrected by the manufacturers, providing information about antimicrobial activity consistent with the requirements of applicable standards. The information on the packaging or in the leaflets for antiseptic products should be corrected by the manufacturers to include accurate information on antimicrobial activity.

Avaliação in vitro da atividade antimicrobiana de enxaguatórios bucais / In vitro evaluation of antimicrobial activity of mouthrinses

O potencial antimicrobiano dos seguintes enxaguatórios bucais: Periogard®, Plax®, Oral-B®, Flogoral ® e Listerine® foram avaliados in vitro, frente às seguintes cepas: Pseudomonas aeroginosa, Escherichiacoli, Cândida albicans, Staphilococcus áureos, Staphilococcus epidermidi e Enterococcus faecallis, por meio do método de difusão em Agar Muller Hinton, o qual foi distribuído em alíquotas de 25 ml, em placas de Pétri estéreis. Cinco discos de papel filtro foram colocados em pontos equidistantes e foram embebidos com 20 μl dos enxaguatórios testados. As leituras dos halos foram realizadas após 48 horas. Os melhores resultados médios foram obtidos pelo Periogard® e pelo Plax®.

Reality bites.

When milk teeth are replaced by adult teeth, it is crucial that a good oral health regime is maintained in order to prevent caries. Parents of infant school children should ideally supervise the twice daily cleaning regime to ensure nothing is missed. Older children and teenagers may be adversely influenced by their peers to eat sugary and other junk foods, but appealing to their vanity may work better rather than a lecture on disease prevention.

Efecto comparativo de nuevo colutorio-gel de clorhexidina en colutorios comerciales en el crecimiento de placa en 24 horas / Comparative effect again mouthrinses-gel of chlorhexidine with commercial mouthrinses in the growth of plaque in 24 hours

Introducción. Las soluciones de clorhexidina (CHX), estándares en prevención de formación de placa presentan algunos efectos indeseados como el dolor por alcohol. Objetivos. El propósito de este estudio fue determinar la eficacia clínica de colutorio-gel acuoso de clorhexidina al 0,1% y compararla con colutorios al 0,12% y 0,1% con alcohol, evaluando el crecimiento de placa bacteriana. Materiales y métodos. En un estudio cruzado, doble ciego y randomizado, 25 alumnos de buena salud oral, participaron de cuatro estudios con abstención de limpieza oral por 24 horas, separados entre sí por 4 semanas. Los alumnos se enjuagaron por una vez con uno de los siguientes colutorios: CHX 0,12% + alcohol (Oralgene®), CHX 0,12% + alcohol (Perio.Aid®), CHX 0,1%+ alcohol (Dentilim®) y CHX 0,1% + HMC 2,5% (Colutoriogel®, acuoso nueva fórmula). Después de un día se midió formación de placa, se completó y registro el cuestionario de parámetros clínicos. Resultados. Las formulaciones de CHX 0,12% + alcohol y CHX 0,1% + HMC 2,5% se mostraron eficientes en retardar el crecimiento de placa dental de novo, esto obtenido de las mediciones clínicas, y siempre superior (p<0,05) a la formulación del colutorio de CHX 0,1%+ alcohol (Dentilim®). Conclusiones. Los resultados de este estudio demuestran el potencial clínico de este nuevo colutorio-gel sin alcohol de CHX 0,1% + HMC 2,5% (Colutoriogel®) como un efectivo agente antiplaca y con reducidas efectos secundarios registrados (AU)

The chlorhexidine solutions (CHX) standars in prevention of plaque formation present some undesired effects like the pain by alcohol. The aim of this study was to determine the clinical effectiveness of Colutoriogel® (new formulation) of chlorhexidine to the 0,1% and to compare with mouthrinses to the 0,12% and 0,1% with alcohol being evaluated growth of bacterial plaque. In double-blind, randomised, cross-over study, 25 young dental students with a healthy periodontium, abolished all means of mechanical plaque control during 4 experimental periods of 1 day (separated from each other by a washout period of 4 weeks). During each experimental period, they rinsed 1 daily with one of the following mouthrinses in a randomised order: CHX 0,12% + alcohol (Oralgene ®), CHX 0,12% + alcohol (Perio.Aid®), CHX 0,1%+ alcohol (Dentilim®) and CHX 0,1% + HMC 2,5% (Colutoriogel®). After 1 days of undisturbed plaque formation, clinical parameters were recorded and questionnaires completed. The CHX 0,12% + alcohol and the and CHX 0,1% + HMC 2,5% formulations were efficient in retarding de novo plaque formation (proven by clinical observations data), and always superior (p<0,05) to the CHX 0,1%+ alcohol (Dentilim®) solution. Conclusions. The results of this study demonstrated the potential of a new mouthrinses-gel Colutoriogel®) nonalcoholic formulation as an effective anti-plaque agent with reduced unpleasant subjective side-effects (AU)

[Antimicrobial activity "in vitro" of calcium hydroxide and tergentol on different concentrations in oral bactéria]. / Atividade antimicrobiana "in vitro" de compostos a base de hidróxido de cálcio e tergentol em diferentes concentrações sobre bactérias orais.

PURPOSES: This research desenvolved in Rio Grande do Norte Federal University, Department of Dentistry purpose evaluation "in vitro" Ca(OH) and tergentol solutions action in oral cavity that first reside in and cariogenic microorganisms for dental biofilm chemical control increasing. METHODS: "In vitro" tests with antibiogram discs and biofilm formers bacteria antibiothic action from Ca(OH) and tergentol solutions and the 0.12% clorhexydine digluconate as "gold-standard". RESULTS: The results were analyzed using the Kruskal-Wallis test and Dunn's multiple comparison post-test with p-value always lower than 0,05. The clorhexydine showed a better antimibrobian action in correlation with Ca(OH) and tergentol solutions. The statistical differences among clorhexydine and this study other solutions was not significant in a greater part of comparisons. CONCLUSIONS: The 0.12% clorhexydine digluconate was the most effective antibiotic agent in this research. Ca(OH) and tergentol solutions does not demonstrate satisfactory effectiveness in correlation the clorhexydine, mainly, for the Streptococcus mutans. More complete studies are necessary for CHD 20 evaluation as an oral antiseptic.

Evaluación de normas técnicas: subprograma de enjuagatorios fluorados en 16 escuelas de Temuco, IX Región, Chile, 2003 / Evaluation of technical standards assessment: fluoride mouthwash subprogram in 16 primary schools in Temuco, IX Región, Chile, 2003

La aplicación masiva de medidas preventivas en base a vehículos fluorados, lleva más de 50 años de discusión en los escenarios científicos. Dentro de las estrategias preventivas el Ministerio de Salud de Chile desde el año 1992 formuló, el Subprograma de Enjuagatorios Fluorados (S.E.F.). La finalidad del estudio es evaluar el cumplimiento de la aplicación de las normas técnicas de Ministerio de Salud para la realización del S.E.F. Se realizó un estudio transversal retrospectivo, tipo descriptivo a través de revisión de informes de práctica profesional controlada de los alumnos de sexto año de la carrera de Odontología durante el año 2003. La muestra fue determinada por conveniencia, la unidad de análisis correspondió a 16 escuelas urbanas de Temuco. Los datos fueron registrados en una ficha y analizados bajo el Programa Estadístico de Stata 8.0. El 100 por ciento presentó a lo menos una falta en el cumplimiento de las normas técnicas; el enjuagatorio no se realiza en todos los cursos, siendo esta la norma que más informalidad mostró (68.75 por ciento). El 50 por ciento de las escuelas presentaba tres o más contravención de los parámetros, siendo imposible analizar a largo plazo los resultados de la efectividad del programa. En conclusión, la planificación de medidas preventivas deben considerar tanto su efectividad, su relación costo-beneficio y su correcta ejecución sostenida en el tiempo, los métodos deben ser correctamente señalados por profesionales del área de Promoción de la Salud y cautelando la motivación e interés todos los actores del programa.

Atividade antimicrobiana in vitro de compostos a base de hidróxido de cálcio e tergentol em diferentes concentrações sobre bactérias orais / Antimicrobial activity of calcium hydroxide and tergentol on different concentrations in oral bactéria

OBJETIVOS: Este estudo realizado no departamento de Odontologia da Universidade Federal do Rio Grande do Norte foi idealizado com propósito de pesquisar a ação "in vitro" de soluções a base de Ca(OH)2 e tergentol frente a bactérias colonizadoras da cavidade bucal e cariogênicas visando contribuir para o estudo sobre os agentes químicos para controle do biofilme dental. MÉTODOS: Testou-se através de discos de antibiograma e ação em bactérias formadoras de biofilme a ação antimicrobiana de algumas soluções de Ca(OH)2 e tergentol usando-se como padrão-ouro o digluconato de clorexidina a 0,12 por cento. RESULTADOS: Os resultados foram analisados através do teste de Kruskal-Wallis e do pós-teste de comparação múltipla de Dunn com valores de p sempre menores que 0,05. A clorexidina obteve melhores resultados em nível de ação antimicrobiana em relação às soluções a base de Ca(OH)2 e tergentol. A diferença estatísta da ação da clorexidina frente às demais soluções e aos tipos bacterianos testados não foi significativa para a maiorias dos cruzamentos. CONCLUSÕES: O digluconato de clorexidina a 0,12 por cento foi o egente antimicrobiano mais efetivo neste estudo. As soluções a base de hidróxido de cálcio não apresentaram efetividade satisfatória em relação a clorexidina, principalmente em relação ao Streptococcus mutans. São necessários estudos mais aprofundados para se determinar o real potencial do HCT 20 como anti-séptico bucal.

[The importance of microbiological control over oral hygiene agents in the certification system]. / Znachenie mikrobiologicheskogo kontrolia za sredstvami gigieny polosti rta v sisteme ikh sertifikatsii.

The authors validate the necessity of microbiological control when certifying oral hygiene means. Results of microbiological expert evaluations of tooth pastes, gels, rinsing solutions, and other means are analyzed.

Concentración de flúor en fluoruros de empleo tópico en odontología / Fluor concentration in topic used fluorides in odontology

En muestras de fluoruros tópicos de uso odontológico empleados en el país de diversos tipo, origen y formas farmacéuticas se analizó su condición de expendio de acuerdo a las normas entregadas por el Instituto de Salud Pública, se determinó la concentración de flúor total soluble que ellas presentan mediante un método potenciométrico, y se cuantificó el pH de los productos. Los resultados nos indican que la mayoría de los fluoruros tópicos de procedencia extranjera no presentan registro sanitario. El relación a la determinación de pH casi todos los productos presentan carácter ácido y las determinaciones de fluoruro indican coincidencia entre lo declarado y lo encontrado para los productos tópicos de baja concentración de fluoruro, pero no para los de alta concentración. Se recomienda una mayor fiscalización de la comunidad odontológica sobre los fluoruros de uso tópico sobre todo en los de origen foráneo, porque se podrían estar usando productos que no cumplen los requisitos necesarios de concentración de flúor

Regulation of oral chemotherapeutic products in the United States.

Although many countries have well-established mechanisms for regulation of drugs dispensed by prescription order, far less attention has been directed to control of drugs sold "over-the-counter" (OTC). Since most oral chemotherapeutic agents are OTC preparations, these drugs frequently escape critical review of their safety and efficacy by regulatory agencies. Although widespread use of these OTC preparations indicates that they are generally safe, their effectiveness is not established. In some cases (e.g., detergent pre-brush rinses), there is good evidence for lack of efficacy. In the US, two recent developments suggest that more rigorous scientific review and oversight of oral chemotherapeutic agents will occur. First, the US Food & Drug Administration has initiated a process to evaluate several OTC products which claim to be effective against plaque and gingivitis. A panel of experts has been convened to establish criteria by which these products will be judged and regulated. The agency has also publicly indicated its intention to interact more closely with the dental community in discharging its responsibility for ensuring drug safety and efficacy. Second, the American Dental Association, through its Council on Dental Therapeutics, is refining criteria for evaluating various types of chemotherapeutic agents. These criteria will be used to judge the efficacy and safety of agents voluntarily submitted for review to the Council by manufacturers. Both of these developments should improve the clinical utility of such agents and may provide models for regulatory agencies in other countries.

Breath ammonia depletion and its relevance to acidic aerosol exposure studies.

It is thought that gaseous ammonia in breath neutralizes acidic air pollution and thereby potentially mitigates the pulmonary effects of pollution. The efficacy of breath ammonia depletion methods reported in recent acid aerosol exposure-health response studies was investigated. Fourteen subjects (21 to 54 y of age) performed one or more of the following hygiene maneuvers: (a) acidic oral rinse (pH 2.5); (b) tooth brushing, followed by acidic oral rinse; (c) tooth brushing, followed by distilled water rinse; and (d) distilled water rinse. Initial ammonia levels ranged from 120 to 1,280 ppb (147-1,570 micrograms/m3). Acidic rinsing resulted in an immediate 90% reduction in exhaled ammonia in all subjects, and a return to 50% of baseline levels occurred within 1 h. Depletion that resulted from tooth brushing or distilled water alone was not significant. It was concluded that acidic oral rinsing is an effective method of reducing airway ammonia, but repeated oral rinsing may be required to maintain consistent, low-breath-ammonia conditions during acid aerosol exposure studies.

[The effect of mouthwashes containing amino-fluoride and stannous fluoride on plaque formation and gingivitis in adults]. / Aminfluorid (AmF) és ónfluorid (SnF2) tartalmú fogpaszta és szájöblítö hatása felnötteken a plakk-képzödésre és az ínygyulladásra.

UNLABELLED: The aim of the study was to assess the effect of amine fluoride (AmF)--stannous fluoride (SnF2) containing toothpaste and mouthrinsing on dental plaque accumulation and gingivitis. The examinations were performed on two groups of 20 (using AmF/SnF2)-, resp. 24 (using NaF) participants. The mean age was 45.6-, resp. 48.8 years. The duration of the study was five months. Toothbrushing was performed with standardized (multi-effect) toothbrushes, and after it mouthrinsing twice a day. Dental plaque was scored with the Plaque Index of Silness and Löe (1964) and gingivitis was assessed by the modified Sulcus Bleeding Index (Mühlemann and Son 1971) Plaque Index mean values showed a significant decreased in both groups (p less than 0.01). The reduction in the AmF/SnF2 group was more pronounced (63.7%) than in the NaF group (39.3%). The Sulcus-Bleeding Index mean values decreased also significantly in both groups (p less than 0.01). The decrease in the AmF/SnF2 group was 56.5% and in the NaF group 39.0%. CONCLUSION: in the course of a five-month's period AmF/SnF2 containing toothpaste and mouthrinsing had better clinical effect on plaque accumulation and gingivitis than NaF containing toothpaste and mouthrinsing.

[The significance of the contamination of dental care articles. The results of a field study]. / Die Bedeutung der Kontamination von Zahnpflegeartikeln. Ergebnisse einer Feldstudie.

Permissible conclusions both from recent available literature and our own field-study results concerning the problematic nature of microbial contamination of dental hygiene articles and the resulting possible health hazard for the consumer can be summarized as follows: Manufacturing practices as are given in the basic instructions for production sites of the cosmetic industry, render a possible degree of microbial contamination. This largely rules out the danger of infection of the consumer upon acquisition of the dental hygiene product. Secondary contamination of these products, as inevitably is the case during use of dental hygiene articles, leads to microbial colonization especially of toothbrush bristles. The extent of this colonization depends at least partially upon the utilization age of the toothbrush. Also for this reason a toothbrush should be replaced by a new one after period of three months, six months at the latest and in all cases of inflammatory changes of the mouth and throat region. The contamination of both the glass or plastic container used for rinsing the teeth after brushing or for gargling can be held within certain limits by dry storage. Only in exceptional cases do mouthwashes show a small degree of contamination. Provided they contain antimicrobial substances, no therapeutically serviceable possibilities worth mentioning follow for the reduction of oropharyngeal flora. Microbial colonization of toothpastes as a result of secondary contamination following use is observed only in exceptional cases due to their preservative content. Significant germination of stagnated residual water in waterpicks often occurs, achieving germ counts up to more than 10(7) cfu per ml. Moreover, waterpicks can represent a biotope for Pseudomonas aeruginosa, and should be used neither by patients with open wounds or mucous membrane lesions in the oropharyngeal area, nor by patients with reduced immune resistance. Manufacturers of waterpicks are urged to impede or prevent the stagnation of residual water more effectively by introducing constructive improvements. Denture and retainer cleansing agents presently on the market display a sufficient antimicrobial effect within the frame of their application, however do not meet the standards set for disinfectants. Dental hygiene products are without relevance for the epidemiology of Legionnaires' disease.