Efficacy of regular gargling with a cetylpyridinium chloride plus zinc containing mouthwash can reduce upper respiratory symptoms
Francisco Wilker Mustafa Gomes Muniz, Maísa Casarin, Natália Marcumini Pola, Cassiano Kuchenbecker Rösing, Taciane Menezes Da Silveira, Francisco Hecktheuer Silva, Guilherme Azario De Holanda, Larissa Viana De Oliveira, Pedro Paulo De Almeida Dantas, Bernal Stewart, Zilson Malheiros, Carlos Benítez, Lyndsay Schaeffer
PLOS ONE, doi:10.1371/journal.pone.0316807
Gargling with cetylpyridinium chloride plus zinc containing mouthwash
References
Abe, Ishihara, Adachi, Sasaki, Tanaka et al., Professional oral care reduces influenza infection in elderly, Arch Gerontol Geriatr,
doi:10.1016/j.archger.2005.10.004
Alonso, Viboud, Simonsen, Hirano, Daufenbach et al., Seasonality of influenza in Brazil: a traveling wave from the Amazon to the subtropics, Am J Epidemiol,
doi:10.1093/aje/kwm012
Assunção, Freguglia R Da, Vieira M De, Marioni, Da, Prevalence of flu-like syndrome in healthcare workers in Brazil: a national study, Rev Saude Publica,
doi:10.11606/s1518-8787.2023057004384
Audi, Alibrahim, Kaddoura, Hijazi, Yassine et al., Seasonality of respiratory viral infections: will COVID-19 follow suit?, Front Public Health
Azarpazhooh, Leake, Systematic review of the association between respiratory diseases and oral health, J Periodontol
Barrett, Brown, Mundt, Thomas, Barlow et al., Validation of a short form Wisconsin Upper Respiratory Symptom Survey (WURSS-21), Health Qual Life Outcomes,
doi:10.1186/1477-7525-7-76
Chang, Chung, Park, Song, Association of oral health with risk of rheumatoid arthritis: a nationwide cohort study, J Pers Med,
doi:10.3390/jpm13020340
Díez-Gandía, Gómez-Álvarez, López-Lacort, Muñoz-Quiles, Úbeda-Sansano et al., The impact of childhood RSV infection on children's and parents' quality of life: a prospective multicenter study in Spain, BMC Infect Dis,
doi:10.1186/s12879-021-06629-z
Eduardo F De, Corrêa, Heller, Daep, Benitez et al., Salivary SARS-CoV-2 load reduction with mouthwash use: a randomized pilot clinical trial, Heliyon,
doi:10.1016/j.heliyon.2021.e07346
Fendrick, Monto, Nightengale, Sarnes, The economic burden of non-influenza-related viral respiratory tract infection in the United States, Arch Intern Med
García-Arroyo, Prim, Cuerpo, Marín, Roig et al., Prevalence and seasonality of viral respiratory infections in a temperate climate region: a 24-year study (1997-2020), Influenza Other Respir Viruses
Haps, Slot, Berchier, Van Der Weijden, The effect of cetylpyridinium chloride-containing mouth rinses as adjuncts to toothbrushing on plaque and parameters of gingival inflammation: a systematic review, Int J Dent Hyg,
doi:10.1111/j.1601-5037.2008.00344.x
Henriquez, Hayney, Xie, Zhang, Barrett, Association of interleukin-8 and neutrophils with nasal symptom severity during acute respiratory infection, J Med Virol,
doi:10.1002/jmv.24042
Hodgson, Atkins, Baguelin, Panovska-Griffiths, Thorrington et al., Estimates for quality of life loss due to Respiratory Syncytial Virus, Influenza Other Respir Viruses,
doi:10.1111/irv.12686
Imai, Iinuma, Sato, Fernandez, Guedes et al., Relationship between the oral cavity and respiratory diseases: aspiration of oral bacteria possibly contributes to the progression of lower airway inflammation, Jpn Dent Sci Rev,
doi:10.1007/s10266-021-00660-x
Iuliano, Roguski, Chang, Muscatello, Palekar et al., Estimates of global seasonal influenza-associated respiratory mortality: a modelling study, Lancet,
doi:10.1016/S0140-6736(17)33293-2
Jin, Ren, Li, Gao, Zhang et al., Global burden of upper respiratory infections in 204 countries and territories, from 1990 to 2019, EClinicalMedicine,
doi:10.1016/j.eclinm.2021.100986
Kawamoto, Tanaka, Sakurai, Otagiri, Karasawa et al., Exploration of correlation of oral hygiene and condition with influenza infection, PLoS One,
doi:10.1371/journal.pone.0254981
Kawana, Kitamura, Nakagomi, Matsumoto, Arita et al., Inactivation of human viruses by povidone-iodine in comparison with other antiseptics, Dermatology,
doi:10.1159/000246027
Langa, Cavagni, Muniz, Oballe, Friedrich et al., Antiplaque and antigingivitis efficacy of cetylpyridinium chloride with zinc lactate compared with essential oil mouthrinses: randomized clinical trial, J Am Dent Assoc
Langa, Muniz, Costa, Da Silveira, Rösing, The effect of cetylpyridinium chloride mouthrinse as adjunct to toothbrushing compared to placebo on interproximal plaque and gingival inflammation-a systematic review with meta-analyses, Clin Oral Investig,
doi:10.1007/s00784-020-03661-2
Li, Reeves, Wang, Bassat, Brooks et al., Global patterns in monthly activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus: a systematic analysis, Lancet Global Health
Lindberg, Nelson, Ranstam, Riker, Early intervention with ColdZyme mouth spray after self-diagnosis of common cold: a randomized, double-blind, placebo-controlled study, PLoS One,
doi:10.1371/journal.pone.0279204
Lindberg, Nelson, Ranstam, Riker, Early intervention with a glycerol throat spray containing cold-adapted cod trypsin after self-diagnosis of common cold: a randomised trial, PLoS One,
doi:10.1371/journal.pone.0270699
Mao, Li, Korsten, Bont, Butler et al., Economic burden and health-related quality of life of respiratory syncytial virus and influenza infection in European Community-Dwelling PLOS ONE Gargling with cetylpyridinium chloride plus zinc containing mouthwash and upper respiratory symptoms Older Adults, J Infect Dis,
doi:10.1093/infdis/jiac069
Molinari, Ortega-Sanchez, Messonnier, Thompson, Wortley et al., The annual impact of seasonal influenza in the US: measuring disease burden and costs, Vaccine,
doi:10.1016/j.vaccine.2007.03.046
Mukherjee, Esper, Buchheit, Arters, Adkins et al., Randomized, doubleblind, placebo-controlled clinical trial to assess the safety and effectiveness of a novel dual-action oral topical formulation against upper respiratory infections, BMC Infect Dis,
doi:10.1186/s12879-016-2177-8
Niederman, Torres, Respiratory infections, Eur Respir Rev
Popkin, Zilka, Dimaano, Fujioka, Rackley et al., Cetylpyridinium chloride (CPC) exhibits potent, rapid activity against influenza viruses, Pathog Immun
Pragman, Fieberg, Reilly, Wendt, Chlorhexidine oral rinses for symptomatic COPD: a randomised, blind, placebo-controlled preliminary study, BMJ Open,
doi:10.1136/bmjopen-2021-050271
Sundell, Andersson, Brittain-Long, Lindh, Westin, A four year seasonal survey of the relationship between outdoor climate and epidemiology of viral respiratory tract infections in a temperate climate, J Clin Virol,
doi:10.1016/j.jcv.2016.10.005
Zhao, Wu, Zhang, Li, Worthington et al., Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia, Cochrane Database Syst Rev,
doi:10.1002/14651858.CD008367.pub4
DOI record:
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"abstract": "<jats:p>The posterior oral cavity serves as an entry point to both the digestive and respiratory systems. Optimal oral hygiene, particularly by means of gargling, has been shown to effectively reduce transmission and duration of respiratory illnesses (Clinical Trials registration: NCT06479226). Previous studies have demonstrated the effectiveness of gargling with an antimicrobial mouthwash in preventing the development of respiratory symptoms. To assess the impact of using an antimicrobial mouthwash for gargling in lowering the incidence of upper respiratory symptoms. A total of 150 individuals were recruited and randomly assigned to two groups: Control group: participants were requested to brush their teeth twice daily for two minutes using a commercially available fluoride toothpaste; and the Test Group, which also brushed their teeth twice daily for two minutes with a commercially available fluoride toothpaste and additional gargling twice a day with a mouthwash containing 0.075% Cetylpyridinium chloride and 0.28% Zinc Lactate (CPC+Zn). Individuals were asked to complete the WURSS-21 Daily Symptom Report over the course of the three-month study period using a diary. Regular gargling with the mouthwash containing CPC+Zn was efficacious in decreasing both the frequency (21.5% lower) and severity (11% lower) of respiratory symptoms throughout the study. Additionally, individuals that performed consistent cleansing of the posterior oral cavity with mouthwash had greater interference in daily activities, which should be further investigated. Adding gargling with a mouthwash containing 0.075% CPC + 0.28% Zn to a normal oral hygiene routine proves beneficial in lowering the incidence of upper respiratory symptoms commonly associated with cold and the flu.</jats:p>\n<jats:p><jats:bold>Trial registration:</jats:bold> ClinicalTrials.gov <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://clinicaltrials.gov/ct2/show/NCT06479226\" xlink:type=\"simple\">NCT06479226</jats:ext-link></jats:p>",
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"DOI": "10.1016/S2214-109X(19)30264-5",
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"first-page": "29",
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"key": "pone.0316807.ref012",
"year": "1997"
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"article-title": "Cetylpyridinium chloride (CPC) exhibits potent, rapid activity against influenza viruses",
"author": "D Popkin",
"first-page": "252",
"journal-title": "Pathog Immun",
"key": "pone.0316807.ref013",
"volume": "2",
"year": "2017"
},
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"DOI": "10.1186/s12879-016-2177-8",
"article-title": "Randomized, double-blind, placebo-controlled clinical trial to assess the safety and effectiveness of a novel dual-action oral topical formulation against upper respiratory infections",
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"article-title": "Salivary SARS-CoV-2 load reduction with mouthwash use: a randomized pilot clinical trial",
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"key": "pone.0316807.ref015",
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"DOI": "10.1016/j.adaj.2020.09.021",
"article-title": "Antiplaque and antigingivitis efficacy of cetylpyridinium chloride with zinc lactate compared with essential oil mouthrinses: randomized clinical trial",
"author": "GPJ Langa",
"doi-asserted-by": "crossref",
"first-page": "105",
"journal-title": "J Am Dent Assoc",
"key": "pone.0316807.ref016",
"volume": "152",
"year": "2021"
},
{
"DOI": "10.1590/1807-3107bor-2017.vol31.0047",
"article-title": "Efficacy of two mouthwashes with cetylpyridinium chloride: a controlled randomized clinical trial",
"author": "CK Rösing",
"doi-asserted-by": "crossref",
"first-page": "e47",
"journal-title": "Braz Oral Res",
"key": "pone.0316807.ref017",
"volume": "31",
"year": "2017"
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{
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{
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"article-title": "Validation of a short form Wisconsin Upper Respiratory Symptom Survey (WURSS-21)",
"author": "B Barrett",
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"first-page": "76",
"journal-title": "Health Qual Life Outcomes",
"key": "pone.0316807.ref019",
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"year": "2009"
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{
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"article-title": "Systematic review of the association between respiratory diseases and oral health",
"author": "A Azarpazhooh",
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"first-page": "1465",
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"key": "pone.0316807.ref020",
"volume": "77",
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{
"DOI": "10.1016/j.archger.2005.10.004",
"article-title": "Professional oral care reduces influenza infection in elderly",
"author": "S Abe",
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"first-page": "157",
"issue": "2",
"journal-title": "Arch Gerontol Geriatr",
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"first-page": "745",
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"key": "pone.0316807.ref023",
"volume": "25",
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{
"DOI": "10.1016/S0300-5712(10)70004-X",
"article-title": "Clinical efficacy of antimicrobial mouthrinses",
"author": "JC Gunsolley",
"doi-asserted-by": "crossref",
"first-page": "S6",
"journal-title": "J Dent",
"key": "pone.0316807.ref024",
"year": "2010"
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{
"DOI": "10.1111/j.1601-5037.2008.00344.x",
"article-title": "The effect of cetylpyridinium chloride-containing mouth rinses as adjuncts to toothbrushing on plaque and parameters of gingival inflammation: a systematic review",
"author": "S Haps",
"doi-asserted-by": "crossref",
"first-page": "290",
"issue": "4",
"journal-title": "Int J Dent Hyg",
"key": "pone.0316807.ref025",
"volume": "6",
"year": "2008"
},
{
"DOI": "10.1136/bmjopen-2021-050271",
"article-title": "Chlorhexidine oral rinses for symptomatic COPD: a randomised, blind, placebo-controlled preliminary study",
"author": "AA Pragman",
"doi-asserted-by": "crossref",
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"article-title": "Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia",
"author": "T Zhao",
"first-page": "CD008367",
"issue": "12",
"journal-title": "Cochrane Database Syst Rev",
"key": "pone.0316807.ref027",
"volume": "12",
"year": "2020"
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{
"DOI": "10.1111/irv.12972",
"article-title": "Prevalence and seasonality of viral respiratory infections in a temperate climate region: a 24-year study (1997-2020)",
"author": "L García-Arroyo",
"doi-asserted-by": "crossref",
"first-page": "756",
"journal-title": "Influenza Other Respir Viruses",
"key": "pone.0316807.ref028",
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"DOI": "10.3389/fpubh.2020.567184",
"article-title": "Seasonality of respiratory viral infections: will COVID-19 follow suit?",
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