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Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review

Ting et al., Biomedicines, doi:10.3390/biomedicines11061694
Jun 2023  
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Systematic review of 14 RCTs, showing significant reductions in short-term viral load with mouth rinses cetylpyridinium chloride, β-cyclodextrin and citrox, hydrogen peroxide, chlorhexidine, povidone-iodine, hypochlorous acid, saline, and water.
Study covers povidone-iodine, cetylpyridinium chloride, chlorhexidine, and hydrogen peroxide.
Ting et al., 12 Jun 2023, peer-reviewed, 5 authors. Contact: thinkdentallearninginstitute@gmail.com (corresponding author), abdahlkemper@gmail.com, schwartzjj1@gmail.com, manzel.woodfork@jefferson.edu, jon.suzuki@temple.edu.
This PaperCetylpyridin..All
Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review
Miriam Ting, Alex Dahlkemper, Jeremy J Schwartz, Manzel Woodfork, Jon B Suzuki
Biomedicines, doi:10.3390/biomedicines11061694
1) There are limited clinical trials to support the effectiveness of mouth rinses when used as a preprocedural rinse against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This systematic review aims to evaluate the efficacy of antiseptic mouth rinses as a preprocedural rinse in reducing SARS-CoV-2 oral viral load in-vivo. (2) Methods: A literature search was conducted through November 2022 for the following databases: PubMed, Web of Science, Cochrane Library, and Google Scholar. The evaluated outcomes were quantitative changes in viral load and the statistical significance of that change after using antiseptic mouth rinses. (3) Results: 14 randomized controlled trials (RCT) were selected for risk of bias assessment and data extraction. (4) Conclusion: Within the limits of this systematic review, preprocedural mouth rinses may significantly reduce SARS-CoV-2 in the mouth, thus, reducing the viral particles available for airborne dispersion. Preprocedural mouth rinses may be an effective strategy for reducing airborne SARS-CoV-2 dispersion in the environment. Their use may be a preventive strategy to reduce the spread of COVID-19 in selected medical and healthcare facilities, including dental clinics. Potential preprocedural mouth rinses are identified for use as an integral part of safe practice for healthcare protocols.
Author Contributions: Conceptualization, M.T. and J.B.S.; resources, A.D., J.J.S., M.W., M.T. and J.B.S.; data curation, M.T.; writing-original draft preparation, A.D., J.J.S. and M.T.; writing-review and editing, A.D., J.J.S., M.W., M.T. and J.B.S.; visualization, M.W. and M.T.; supervision, J.B.S. and M.T.; project administration, M.T. All authors have read and agreed to the published version of the manuscript. Conflicts of Interest: The authors declare no conflict of interest.
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{ 'indexed': {'date-parts': [[2023, 6, 14]], 'date-time': '2023-06-14T04:20:28Z', 'timestamp': 1686716428194}, 'reference-count': 144, 'publisher': 'MDPI AG', 'issue': '6', 'license': [ { 'start': { 'date-parts': [[2023, 6, 12]], 'date-time': '2023-06-12T00:00:00Z', 'timestamp': 1686528000000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'abstract': '<jats:p>(1) There are limited clinical trials to support the effectiveness of mouth rinses ' 'when used as a preprocedural rinse against severe acute respiratory syndrome coronavirus 2 ' '(SARS-CoV-2). This systematic review aims to evaluate the efficacy of antiseptic mouth rinses ' 'as a preprocedural rinse in reducing SARS-CoV-2 oral viral load in-vivo. (2) Methods: A ' 'literature search was conducted through November 2022 for the following databases: PubMed, ' 'Web of Science, Cochrane Library, and Google Scholar. The evaluated outcomes were ' 'quantitative changes in viral load and the statistical significance of that change after ' 'using antiseptic mouth rinses. (3) Results: 14 randomized controlled trials (RCT) were ' 'selected for risk of bias assessment and data extraction. (4) Conclusion: Within the limits ' 'of this systematic review, preprocedural mouth rinses may significantly reduce SARS-CoV-2 in ' 'the mouth, thus, reducing the viral particles available for airborne dispersion. ' 'Preprocedural mouth rinses may be an effective strategy for reducing airborne SARS-CoV-2 ' 'dispersion in the environment. Their use may be a preventive strategy to reduce the spread of ' 'COVID-19 in selected medical and healthcare facilities, including dental clinics. Potential ' 'preprocedural mouth rinses are identified for use as an integral part of safe practice for ' 'healthcare protocols. This systematic review was registered with the National Institute for ' 'Health Research, international prospective register of systematic reviews (PROSPERO): ' 'CRD42022315177.</jats:p>', 'DOI': '10.3390/biomedicines11061694', 'type': 'journal-article', 'created': {'date-parts': [[2023, 6, 13]], 'date-time': '2023-06-13T05:35:30Z', 'timestamp': 1686634530000}, 'page': '1694', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A ' 'Systematic Review', 'prefix': '10.3390', 'volume': '11', 'author': [ { 'ORCID': 'http://orcid.org/0000-0001-8503-2279', 'authenticated-orcid': False, 'given': 'Miriam', 'family': 'Ting', 'sequence': 'first', 'affiliation': [ { 'name': 'Department of Periodontics, University of Pennsylvania, ' 'Philadelphia, PA 19104, USA'}, { 'name': 'General Practice Residency, Albert Einstein Medical Center, ' 'Philadelphia, PA 19141, USA'}, {'name': 'Think Dental Learning Institute, Paoli, PA 19301, USA'}]}, { 'ORCID': 'http://orcid.org/0000-0003-1009-244X', 'authenticated-orcid': False, 'given': 'Alex', 'family': 'Dahlkemper', 'sequence': 'additional', 'affiliation': [ { 'name': 'General Practice Residency, Albert Einstein Medical Center, ' 'Philadelphia, PA 19141, USA'}]}, { 'given': 'Jeremy J.', 'family': 'Schwartz', 'sequence': 'additional', 'affiliation': [ { 'name': 'General Practice Residency, Albert Einstein Medical Center, ' 'Philadelphia, PA 19141, USA'}]}, { 'given': 'Manzel', 'family': 'Woodfork', 'sequence': 'additional', 'affiliation': [ { 'name': 'General Practice Residency, Albert Einstein Medical Center, ' 'Philadelphia, PA 19141, USA'}]}, { 'ORCID': 'http://orcid.org/0000-0003-3348-8893', 'authenticated-orcid': False, 'given': 'Jon B.', 'family': 'Suzuki', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Graduate Periodontics, University of Maryland, ' 'Baltimore, MD 21201, USA'}, { 'name': 'Department of Graduate Prosthodontics, University of Washington, ' 'Seattle, WA 98015, USA'}, { 'name': 'Department of Graduate Periodontics, Nova Southeastern ' 'University, Ft. Lauderdale, FL 33314, USA'}]}], 'member': '1968', 'published-online': {'date-parts': [[2023, 6, 12]]}, 'reference': [ { 'key': 'ref_1', 'doi-asserted-by': 'crossref', 'first-page': '2063', 'DOI': '10.1056/NEJMc2009324', 'article-title': 'Droplets and Aerosols in the Transmission of SARS-CoV-2', 'volume': '382', 'author': 'Meselson', 'year': '2020', 'journal-title': 'N. Engl. J. Med.'}, { 'key': 'ref_2', 'doi-asserted-by': 'crossref', 'first-page': '1177', 'DOI': '10.1056/NEJMc2001737', 'article-title': 'SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected ' 'Patients', 'volume': '382', 'author': 'Zou', 'year': '2020', 'journal-title': 'N. Engl. J. Med.'}, { 'key': 'ref_3', 'doi-asserted-by': 'crossref', 'unstructured': 'Ting, M., and Suzuki, J.B. (2021). SARS-CoV-2: Overview and Its Impact ' 'on Oral Health. Biomedicines, 9.', 'DOI': '10.3390/biomedicines9111690'}, { 'key': 'ref_4', 'unstructured': 'Ting, M., and Suzuki, J.B. (2022). 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Dent.'}], 'container-title': 'Biomedicines', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://www.mdpi.com/2227-9059/11/6/1694/pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2023, 6, 13]], 'date-time': '2023-06-13T09:03:37Z', 'timestamp': 1686647017000}, 'score': 1, 'resource': {'primary': {'URL': 'https://www.mdpi.com/2227-9059/11/6/1694'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2023, 6, 12]]}, 'references-count': 144, 'journal-issue': {'issue': '6', 'published-online': {'date-parts': [[2023, 6]]}}, 'alternative-id': ['biomedicines11061694'], 'URL': 'http://dx.doi.org/10.3390/biomedicines11061694', 'relation': {}, 'ISSN': ['2227-9059'], 'subject': ['General Biochemistry, Genetics and Molecular Biology', 'Medicine (miscellaneous)'], 'container-title-short': 'Biomedicines', 'published': {'date-parts': [[2023, 6, 12]]}}
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