Povidone iodine gargle and mouthwash
study showing undiluted PVP-I (1% w/v) achieved >5 log10 reduction in SARS-CoV-2 virus titres at 15, 30 and 60 seconds treatment exposure under both clean and dirty conditions. In contrast, when PVP-I was tested at 1:2 dilution a >4 log10 kill at 15 seconds and >5 log10 kill at 30 and 60 seconds in comparison to control was seen in both clean and dirty conditions.8 In Vitro studies
support the efficacy of povidone-iodine [Anderson, Bidra, Frank, Hassandarvish, Meister, Pelletier, Tucker, Xu]
Hassandarvish et al., 26 Jun 2020, peer-reviewed, 8 authors.
In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
Letters to the editor
Send your letters to the Editor, British Dental Journal, 64 Wimpole Street, London, W1G 8YS. Email email@example.com.
Priority will be given to letters less than 500 words long. Authors must sign the letter, which may be edited for reasons of space.
Special care and new environments
Sir, patients with autism and other
special care needs often rely on familiar
surroundings, processes and faces when
attending the dentist to reduce the sensory
burden and anxiety of being in the dental
environment. Any change to the ‘routine’
of attending may present such patients with
difficulties that the dental team should have
awareness of and be sensitive to. We must
make every effort to prepare patients for the
changes to the dental environment that they
are used to attending such as the increased
use of PPE.
Sending photographs and advice of how
layouts and processes may have changed
within the practice and what to expect
regarding PPE and infection control
procedures ahead of their appointment to
patients and carers could prove invaluable
in maintaining both attendance for this
potentially higher risk group, as well as
talking through any new steps during their
visit or procedure to maximise compliance.
Technology can also be utilised to facilitate
this, such as 360 degree photographs or video
tours on practice websites or social media.
Although aerosol generating procedures
would ideally be carried out in a single visit,
this may not be possible or practicable for this
Any additional barriers to attending for
regular preventive dental care could have
significant longer term risks to the dental
health of this already vulnerable patient
cohort. A decrease in regular professional
preventive input risks increasing the need
for invasive procedures and sedation or
general anaesthesia, in turn increasing risks
to both dental and general health. We must
therefore do everything we can to minimise
the impact of these changes for patients
with special care needs.
S. Carr, South Tyneside, UK
Povidone iodine gargle and
Sir, a recent letter in your journal by
Challacombe et al. highlighted the potential
of povidone iodine (PVP-I) mouthwash
and nasal spray in reducing the risk of
cross-infection of COVID-19 among the
dentists and their assistants.1 The evidence
used was based on in vitro data of PVP-I’s
virucidal activity against coronaviruses such
as SARS-CoV and MERS-CoV. Here, we
demonstrate in vitro virucidal activity of an
oral PVP-I product against SARS-CoV-2, the
virus causing COVID-19.
BETADINE Gargle and Mouth Wash in two
concentrations, undiluted (PVP-I 1% w/v) and
at a 1:2 dilution (PVP-I 0.5% w/v) was tested
for virucidal activity (≥4 log10 reduction in
viral titres) against SARS-CoV-2 in both clean
(0.3 g/l BSA) and dirty (3.0 g/l BSA + 3 mL/L
human erythrocytes) conditions at time points
of 15, 30 and 60 seconds in a BSL-3 laboratory
of the Tropical Infectious Diseases Research
and Education Center (TIDREC), University
of Malaya, Malaysia. The SARS-CoV-2 was
isolated and propagated in Vero-E6 cells in
TIDREC. The cytotoxicity of the product to
the Vero-E6 cells was evaluated and taken into
account when performing the kill time assay.
Virus kill time assay was performed based
on the established EN14476 methodology.2
Virus titres were calculated as 50% tissue
culture infectious dose (TCID50/mL) using
the Spearman-Karber method.2 The..
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