Therapeutic Rinses May Help Curb SARS-CoV-2 Cross-Transmission Risks
While therapeutic mouthrinse is often prescribed to help control oral biofilm and for other preventive uses, researchers continue to investigate whether rinses may reduce or help neutralize SARS-CoV-2 in the oral cavity. For example, a 2020 study by O’Donnell et al, “Potential Role of Oral Rinses Targeting the Viral Lipid Envelope in SARS-CoV-2 Infection,” published in Function (Oxf), focused on the coronavirus’ lipid membrane to determine if these agents — including chlorhexidine, ethanol, povidone-iodine, cetylpyridinium chloride and hydrogen peroxide — could disturb the pathogen’s lipid envelope. The results indicate that, to varying degrees, select rinses may disrupt and reduce concentrations of the virus, and should thus be considered as a potential means of curbing COVID-19 transmission.
Appearing in the British Journal of Oral and Maxillofacial Surgery, a paper by Vergara-Buenaventura and Castro-Ruiz, “Use of Mouthwashes Against COVID-19 in Dentistry,” investigated the use of preprocedural rinses containing hydrogen peroxide, povidone-iodine, cetylpyridinium chloride or chlorhexidine. Their analysis of in vitro data supports the potential of this approach in reducing SARS-CoV-2 viral loads in the oral cavity — although efficacy varied by agent. Encouraging further studies and pointing to the dearth of clinical research, the authors suggest preprocedural rinsing may limit viral loads and cross-infection risk.
Similarly, a 2021 study by Chopra et al published in Japanese Dental Science Review, “Can Povidone Iodine Gargle/Mouthrinse Inactivate SARS-CoV-2 and Decrease the Risk of Nosocomial and Community Transmission During the COVID-19 Pandemic? An Evidence-Based Update,” found that povidone-iodine rinses are a promising modality for limiting the spread of COVID-19. Noting that in vitro studies and patient-based clinical trials confirm povidone-iodine’s virucidal properties against SARS-CoV-2, the authors assert that using a virucidal mouthrinse is “imperative” during the pandemic.
While the results of existing and ongoing research are encouraging, most studies have been conducted in vitro, which further underscores the need for large-scale clinical and population-based trials to establish or refute the efficacy of these modalities in reducing the spread of COVID-19.
From Decisions in Dentistry. November 2021;7(11)7.