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Di Profio B, Lotto M, Ayala Aguirre PE, Villar CC, Romito GA, Cruvinel T, Pannuti CM. Digital surveillance: The interest in mouthwash-related information. Int J Dent Hyg 2024; 22:414-422. [PMID: 37721314 DOI: 10.1111/idh.12755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND The comprehension of the interests of Internet users regarding their health-related searches may reveal the community's demands about oral health. The study aimed to characterize the interests of Google users related to mouthwash in Australia, Brazil, Chile, Japan, Mexico, Russia, the United Kingdom, the United States, Saudi Arabia and South Africa applying the Google Trends. METHODS This longitudinal retrospective study analysed the mouthwash-related interest of Google users from January 2004 to December 2020. The monthly variation of relative search volume (RSV) and the main queries related were determined using Google Trends. Autoregressive integrated moving average (ARIMA) forecasting models were built to establish the predictive RSV values for mouthwash for additional 12 months. Auto-correlation plots and a general additive model (GAM) were used to diagnose trends and seasonality in RSV curves. In addition, the influence of social isolation related to the outbreak of COVID-19 were analysed. RESULTS The RSVs curves showed a considerable increase in searches related to mouthwash to AUS, BRA, JAP, MEX, GBR and USA (RSV > 25), while the growth was slight to CHI, KSA, RSA and RUS (RSV < 25) over the years, without influence of monthly seasonality. All countries showed a significant increase in mouthwash interest after the outbreak of COVID-19, except for KSA and RUS. The mouthwash-related searches were associated to specific brands or chemical compositions, treatments, whitening agents, homemade mouthwash and indications for the 'best mouthwash'. CONCLUSIONS In general, there was an increasing interest of Google users in mouthwash-related topics between 2004 and 2020. In addition, in most countries, there was an expansion in searches during the social isolation of the COVID-19 pandemics.
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Affiliation(s)
- Bruna Di Profio
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo-FO-USP, São Paulo, Brazil
| | - Matheus Lotto
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo FOB-USP, Bauru, Brazil
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Patricia E Ayala Aguirre
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo FOB-USP, Bauru, Brazil
- Universidad de especialidades Espíritu Santo-UEES, Samborondón, Ecuador
| | - Cristina C Villar
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo-FO-USP, São Paulo, Brazil
| | - Giuseppe A Romito
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo-FO-USP, São Paulo, Brazil
| | - Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo FOB-USP, Bauru, Brazil
| | - Cláudio Mendes Pannuti
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo-FO-USP, São Paulo, Brazil
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Onozuka D, Takatera S, Matsuo H, Yoshida H, Hamaguchi S, Yamamoto S, Sada RM, Suzuki K, Konishi K, Kutsuna S. Oral mouthwashes for asymptomatic to mildly symptomatic adults with COVID-19 and salivary viral load: a randomized, placebo-controlled, open-label clinical trial. BMC Oral Health 2024; 24:491. [PMID: 38664718 PMCID: PMC11044332 DOI: 10.1186/s12903-024-04246-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/10/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Recent randomized clinical trials suggest that the effect of using cetylpyridinium chloride (CPC) mouthwashes on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load in COVID-19 patients has been inconsistent. Additionally, no clinical study has investigated the effectiveness of on-demand aqueous chlorine dioxide mouthwash against COVID-19. METHODS We performed a randomized, placebo-controlled, open-label clinical trial to assess for any effects of using mouthwash on the salivary SARS-CoV-2 viral load among asymptomatic to mildly symptomatic adult COVID-19-positive patients. Patients were randomized to receive either 20 mL of 0.05% CPC, 10 mL of 0.01% on-demand aqueous chlorine dioxide, or 20 mL of placebo mouthwash (purified water) in a 1:1:1 ratio. The primary endpoint was the cycle threshold (Ct) values employed for SARS-CoV-2 salivary viral load estimation. We used linear mixed-effects models to assess for any effect of the mouthwashes on SARS-CoV-2 salivary viral load. RESULTS Of a total of 96 eligible participants enrolled from November 7, 2022, to January 19, 2023, 90 were accepted for the primary analysis. The use of 0.05% CPC mouthwash was not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.640; 95% confidence interval [CI], -1.425 to 2.706; P = 0.543); 2 h (difference vs. placebo, 1.158; 95% CI, -0.797 to 3.112; P = 0.246); 4 h (difference vs. placebo, 1.283; 95% CI, -0.719 to 3.285; P = 0.209); 10 h (difference vs. placebo, 0.304; 95% CI, -1.777 to 2.385; P = 0.775); or 24 h (difference vs. placebo, 0.782; 95% CI, -1.195 to 2.759; P = 0.438). The use of 0.01% on-demand aqueous chlorine dioxide mouthwash was also not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.905; 95% CI, -1.079 to 2.888; P = 0.371); 2 h (difference vs. placebo, 0.709; 95% CI, -1.275 to 2.693; P = 0.483); 4 h (difference vs. placebo, 0.220; 95% CI, -1.787 to 2.226; P = 0.830); 10 h (difference vs. placebo, 0.198; 95% CI, -1.901 to 2.296; P = 0.854); or 24 h (difference vs. placebo, 0.784; 95% CI, -1.236 to 2.804; P = 0.447). CONCLUSIONS In asymptomatic to mildly symptomatic adults with COVID-19, compared to placebo, the use of 0.05% CPC and 0.01% on-demand aqueous chlorine dioxide mouthwash did not lead to a significant reduction in SARS-CoV-2 salivary viral load. Future studies of the efficacy of CPC and on-demand aqueous chlorine dioxide mouthwash on the viral viability of SARS-CoV-2 should be conducted using different specimen types and in multiple populations and settings.
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Affiliation(s)
- Daisuke Onozuka
- Department of Oral Microbe Control, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan.
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan.
| | - Satoko Takatera
- Department of Oral Microbe Control, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan
| | - Hiroo Matsuo
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan
| | - Hisao Yoshida
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan
| | - Shigeto Hamaguchi
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan
- Department of Transformative Analysis for Human Specimen, Graduate School of Medicine, Osaka University, Osaka, Japan
- Division of Fostering Required Medical Human Resources, Center for Infectious Disease Education and Research (CiDER), Osaka University, Osaka, Japan
| | - Shungo Yamamoto
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan
- Division of Fostering Required Medical Human Resources, Center for Infectious Disease Education and Research (CiDER), Osaka University, Osaka, Japan
- Department of Transformative Protection to Infectious Disease, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ryuichi Minoda Sada
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan
- Division of Fostering Required Medical Human Resources, Center for Infectious Disease Education and Research (CiDER), Osaka University, Osaka, Japan
- Department of Transformative Protection to Infectious Disease, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Koichiro Suzuki
- The Research Foundation for Microbial Diseases of Osaka University (BIKEN), Osaka, Japan
| | - Keiji Konishi
- Department of Oral Microbe Control, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan
| | - Satoshi Kutsuna
- Department of Oral Microbe Control, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan.
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan.
- Department of Transformative Analysis for Human Specimen, Graduate School of Medicine, Osaka University, Osaka, Japan.
- Division of Fostering Required Medical Human Resources, Center for Infectious Disease Education and Research (CiDER), Osaka University, Osaka, Japan.
- Department of Transformative Protection to Infectious Disease, Graduate School of Medicine, Osaka University, Osaka, Japan.
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Alzahrani AR, Ibrahim IAA, Shahzad N, Shahid I, Alanazi IM, Falemban AH, Azlina MFN. An application of carbohydrate polymers-based surface-modified gold nanoparticles for improved target delivery to liver cancer therapy - A systemic review. Int J Biol Macromol 2023; 253:126889. [PMID: 37714232 DOI: 10.1016/j.ijbiomac.2023.126889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/17/2023]
Abstract
Gold nanoparticles have been broadly investigated as cancer diagnostic and therapeutic agents. Gold nanoparticles are a favorable drug delivery vehicle with their unique subcellular size and good biocompatibility. Chitosan, agarose, fucoidan, porphyran, carrageenan, ulvan and alginate are all examples of biologically active macromolecules. Since they are biocompatible, biodegradable, and irritant-free, they find extensive application in biomedical and macromolecules. The versatility of these compounds is enhanced because they are amenable to modification by functional groups like sulfation, acetylation, and carboxylation. In an eco-friendly preparation process, the biocompatibility and targeting of GNPs can be improved by functionalizing them with polysaccharides. This article provides an update on using carbohydrate-based GNPs in liver cancer treatment, imaging, and drug administration. Selective surface modification of several carbohydrate types and further biological uses of GNPs are focused on.
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Affiliation(s)
- Abdullah R Alzahrani
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
| | - Ibrahim Abdel Aziz Ibrahim
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Naiyer Shahzad
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Imran Shahid
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ibrahim M Alanazi
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Alaa Hisham Falemban
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohd Fahami Nur Azlina
- Department of Pharmacology, Faculty of Medicine, University Kebangsaan Malaysia, Malaysia
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Sbricoli L, Schiavon L, Brunello G, Brun P, Becker K, Sivolella S. Efficacy of different mouthwashes against COVID-19: A systematic review and network meta-analysis. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:334-356. [PMID: 37854066 PMCID: PMC10579871 DOI: 10.1016/j.jdsr.2023.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 09/08/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023] Open
Abstract
To evaluate the effectiveness of antiseptic mouthwashes in reducing SARS-CoV-2 load clinically and in vitro. A systematic electronic search (MEDLINE/Scopus/Cochrane) was conducted to identify prospective clinical and in vitro studies published between 2019 included and 16 June 2023 assessing the effectiveness of mouthwashes in reducing SARS-CoV-2 load in saliva or surrogates. Data were summarized in tables and a network meta-analysis was performed for clinical trials. Thirty-five studies (14 RCTs, 21 in vitro) fulfilled the inclusion criteria. The risk of bias was judged to be high for 2 clinical and 7 in vitro studies. The most commonly test product was chlorhexidine alone or in combination with other active ingredients, followed by povidone-iodine, hydrogen peroxide and cetylpyridinium chloride. Overall, the descriptive analysis revealed the effectiveness of the mouthwashes in decreasing the salivary viral load both clinically and in vitro. Network meta-analysis demonstrated a high degree of heterogeneity. Among these studies, only chlorhexidine 0.20% was associated to a significant Ct increase in the saliva 5 min after rinsing compared to non-active control (p = 0.027). Data from clinical and in vitro studies suggested the antiviral efficacy of commonly used mouthwashes. Large well-balanced trials are needed to identify the best rinsing protocols.
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Affiliation(s)
- Luca Sbricoli
- Department of Neurosciences, School of Dentistry, University of Padua, 35128 Padua, Italy
| | - Lucia Schiavon
- Department of Neurosciences, School of Dentistry, University of Padua, 35128 Padua, Italy
| | - Giulia Brunello
- Department of Neurosciences, School of Dentistry, University of Padua, 35128 Padua, Italy
- Department of Oral Surgery, University Hospital of Düsseldorf, 40225 Düsseldorf, Germany
| | - Paola Brun
- Department of Molecular Medicine, University of Padua, 35128 Padua, Italy
| | - Kathrin Becker
- Department of Orthodontics and Dentofacial Orthopaedics, Charité - Universitätsmedizin Berlin, 14197 Berlin, Germany
| | - Stefano Sivolella
- Department of Neurosciences, School of Dentistry, University of Padua, 35128 Padua, Italy
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Cao R, Qiu P, Xu B, Lin J, Chu D, Fan Z. Effectiveness of interventions to reduce aerosol generation in dental environments: A systematic review. Prev Med Rep 2023; 35:102383. [PMID: 37680854 PMCID: PMC10480641 DOI: 10.1016/j.pmedr.2023.102383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023] Open
Abstract
Certain dental procedures produce high levels of aerosols containing pathogenic microorganisms, posing a risk for the transmission of infections in dental settings. This study aimed to assess the effectiveness of various aerosol mitigation interventions during clinical dental procedures in real-world environments. A systematic literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, and Embase for English studies up to March 2023 according to the PRISMA guidelines. Only peer-reviewed controlled clinical trials (CCT) or randomized controlled trials (RCT) studies involving human subjects were included. The risk of bias of selected researches were evaluated by two independent authors using the Cochrane Collaboration tool. The literature search yielded 3491 articles, of which 42 studies met the inclusion criteria and were included in this study. Most studies evaluated bacterial contamination in bio-aerosols, while the viral and fungal contamination was assessed in only three studies. Overall, various approaches have been applied in reducing aerosol contamination in clinical scenarios, including high-volume evacuators (HVE), mouse rinses and rubber dams, air cleaning systems, and high-efficiency particulate air (HEPA) filters. The available evidence suggests that various aerosol mitigation strategies could be implemented to decrease the risk of cross-infection during clinical dental procedures in real-world environments. However, further clinical trials are necessary to establish statistical validity in measuring aerosol contamination and mitigation, as well as to evaluate the risk of infection transmission for viral and fungal contamination.
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Affiliation(s)
- Rongkai Cao
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, No. 399, Middle Yanchang Rd, Shanghai 200072, PR China
| | - Piaopiao Qiu
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, No. 399, Middle Yanchang Rd, Shanghai 200072, PR China
| | - Borui Xu
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, No. 399, Middle Yanchang Rd, Shanghai 200072, PR China
| | - Jingying Lin
- College of Environmental Science and Engineering, Tongji University, Shanghai 200092, PR China
| | - Danna Chu
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, No. 399, Middle Yanchang Rd, Shanghai 200072, PR China
| | - Zhen Fan
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, No. 399, Middle Yanchang Rd, Shanghai 200072, PR China
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Cai X, Venkatesan JK, Schmitt G, Reda B, Cucchiarini M, Hannig M, Madry H. Cytotoxic effects of different mouthwash solutions on primary human articular chondrocytes and normal human articular cartilage - an in vitro study. Clin Oral Investig 2023; 27:4987-5000. [PMID: 37329464 PMCID: PMC10492729 DOI: 10.1007/s00784-023-05118-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/08/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES To compare the cytotoxicity of octenidine dihydrochloride and chlorhexidine gluconate at different concentrations on primary human articular chondrocytes and cartilage. MATERIALS AND METHODS Primary cultures of human normal adult articular chondrocytes were exposed to octenidine dihydrochloride (0.001562%, 0.003125%, 0.00625%, 0.0125%, 0.025%, 0.05%, and 0.1%), chlorhexidine gluconate (0.003125%, 0.00625%, 0.0125%, 0.025%, 0.05%, 0.1%, and 0.2%), and control (Dulbecco's modified Eagle medium or phosphate-buffered saline) for 30 s. Normal human articular cartilage explants were exposed to octenidine dihydrochloride (0.1% versus control) and chlorhexidine gluconate (0.1% versus control) for 30 s. The viability of human articular chondrocytes was measured by Trypan blue staining, Cell Proliferation Reagent WST-1, and Live/Dead staining. The proliferation of human chondrocytes was measured using the Cell Proliferation Reagent WST-1. The viability of human articular cartilage explants was measured by using Live/Dead staining. RESULTS Octenidine dihydrochloride and chlorhexidine gluconate exposure decreased cell viability and proliferation in a dose-dependent manner in primary human articular chondrocytes. Octenidine dihydrochloride and chlorhexidine gluconate exposure decreased cell viability in human articular cartilage explant cultures. CONCLUSION The degree of toxicity varied between octenidine dihydrochloride and chlorhexidine gluconate, with chlorhexidine gluconate being less toxic than octenidine dihydrochloride at the same concentration. Additionally, both octenidine dihydrochloride and chlorhexidine gluconate evaluation had cytotoxic effects on human articular cartilage. Therefore, dosing for the antimicrobial mouthwash ingredients administration would ideally be determined to remain below IC50. CLINICAL RELEVANCE These data support the in vitro safety of antimicrobial mouthwashes on primary adult human articular chondrocytes.
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Affiliation(s)
- Xiaoyu Cai
- Center of Experimental Orthopaedics, Saarland University, 66421, Homburg, Germany
- Department of Spine Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | | | - Gertrud Schmitt
- Center of Experimental Orthopaedics, Saarland University, 66421, Homburg, Germany
| | - Bashar Reda
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, 66421, Homburg, Germany
| | - Magali Cucchiarini
- Center of Experimental Orthopaedics, Saarland University, 66421, Homburg, Germany
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, 66421, Homburg, Germany
| | - Henning Madry
- Center of Experimental Orthopaedics, Saarland University, 66421, Homburg, Germany.
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Wu CY, Yang YH, Lin YS, Shu LH, Cheng YC, Liu HT, Lin YY, Lee IY, Shih WT, Yang PR, Tsai YY, Chang GH, Hsu CM, Yeh RA, Wu YH, Wu YH, Shen RC, Tsai MS. The anti-SARS-CoV-2 effect and mechanism of Chiehyuan herbal oral protection solution. Heliyon 2023; 9:e17701. [PMID: 37483781 PMCID: PMC10359827 DOI: 10.1016/j.heliyon.2023.e17701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 06/07/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Abstract
The Chiehyuan herbal oral protection solution (GB-2) is a herbal mixture commonly utilized in Taiwan for combating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as per traditional Chinese medicine practices. This study assessed the clinical impact of GB-2 through prospective clinical trials. With twice-daily use for a week, GB-2 was shown to diminish the expression of angiotensin-converting enzyme 2 (ACE2) in oral mucosal cells. Moreover, after two weeks of use, it could reduce transmembrane protease, serine 2 (TMRPSS2) expression in these cells. Additionally, in vitro experiments demonstrated that GB-2 lessened the entry efficiency of the Omicron, L452R-D614G, T478K-D614G, and L452R-T478K-D614G variants of the SARS-CoV-2 pseudotyped lentivirus. It also impeded the interaction between ACE2 and the receptor-binding domain (RBD) presenting N501Y-K417N-E484A-G339D-Q493R-G496S-Q498R and L452R-T478K mutations. Glycyrrhizic acid, a major compound in GB-2, also hindered the entry of the Omicron variant (BA.1) of the SARS-CoV-2 pseudotyped lentivirus by obstructing the binding between ACE2 and the RBD presenting the N501Y-K417N-E484A-G339D-Q493R-G496S-Q498R mutation. To sum up, these findings suggest that GB-2 can decrease ACE2 and TMPRSS2 expression in oral mucosal cells. Both glycyrrhizic acid and GB-2 were found to reduce the entry efficiency of the Omicron variant (BA.1) of the SARS-CoV-2 pseudotyped lentivirus and block the binding between ACE2 and the RBD with the N501Y-K417N-E484A-G339D-Q493R-G496S-Q498R mutation. This evidence implies that GB-2 might be a potential candidate for further study as a preventative measure against SARS-CoV-2 infection.
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Affiliation(s)
- Ching-Yuan Wu
- Department of Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Yao-Hsu Yang
- Department of Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Shih Lin
- Department of Pharmacy, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Li-Hsin Shu
- Department of Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yu-Ching Cheng
- Department of Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Otolaryngology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Hung-Te Liu
- Department of Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yin-Yin Lin
- Department of Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - I-Yun Lee
- Department of Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Wei-Tai Shih
- Department of Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Pei-Rung Yang
- Department of Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ying-Ying Tsai
- Department of Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Geng-He Chang
- Department of Otolaryngology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Cheng-Ming Hsu
- Department of Otolaryngology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Reming-Albert Yeh
- Department of Otolaryngology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yu-Huei Wu
- Department of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Heng Wu
- Department of Electrical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Rou-Chen Shen
- Department of Otolaryngology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Yeoh M, Lai JB, Ng CH. Learning from Covid 19 in a level 1 oral and maxillofacial trauma centre - Insights for the future. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2023; 35:195-200. [PMID: 36168323 PMCID: PMC9502433 DOI: 10.1016/j.ajoms.2022.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/21/2022] [Accepted: 09/05/2022] [Indexed: 12/02/2022]
Abstract
The coronavirus disease 2019 caused by the Severe Acute Respiratory Syndrome Coronavirus-2 has resulted in many confirmed cases around the world. Sars-CoV-2 remains viable and infectious in aerosols dispersed in air and is viable on surfaces up to several days. Symptomatic patients are the main reservoir for transmission. Evidence suggests that asymptomatic patients and patients during their incubation period can shed and transmit Sars-CoV-2. The infective potential can be reduced through the use of personal protective equipment. Healthcare professionals especially the oral maxillofacial surgeons are at increased risk of being infected by the virus. Oral maxillofacial injuries typically involve vital structures in the upper aerodigestive tract and are emergent. Facial trauma surgery cannot be delayed or deferred in a pandemic. This review focuses on precautions surgeons should adopt while managing facial trauma patients in the emergency department and whilst performing emergency surgeries on these patients during the current COVID-19 pandemic. Strict and effective infection control protocols for facial trauma management are needed to minimise this risk of transmission. This review was part of the lecture given by Professor Melvyn Yeoh at the 14th Asian congress on Oral and Maxillofacial Surgery recently held virtually in Singapore due to the pandemic.
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Affiliation(s)
- Melvyn Yeoh
- Division Chief of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, USA
| | - Juen Bin Lai
- Department of Oral and Maxillofacial Surgery, The National Dental Centre, Singapore
| | - Chee-Hon Ng
- Department of Oral and Maxillofacial Surgery, Novena Medical Centre, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Weber J, Bonn EL, Auer DL, Kirschneck C, Buchalla W, Scholz KJ, Cieplik F. Preprocedural mouthwashes for infection control in dentistry-an update. Clin Oral Investig 2023:10.1007/s00784-023-04953-z. [PMID: 37079156 PMCID: PMC10116478 DOI: 10.1007/s00784-023-04953-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/17/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVES Aerosols and splatter are routinely generated in dental practice and can be contaminated by potentially harmful bacteria or viruses such as SARS-CoV-2. Therefore, preprocedural mouthwashes containing antiseptic agents have been proposed as a potential measure for infection control in dental practice. This review article aims to summarize the clinical (and, if insufficient, preclinical) evidence on preprocedural mouthwashes containing antiseptic agents and to draw conclusions for dental practitioners. METHODS Literature on preprocedural mouthwashes for reduction of bacterial or viral load in dental aerosols was searched and summarized. RESULTS Preprocedural mouthwashes, particularly those containing chlorhexidine digluconate (CHX), cetylpyridinium chloride (CPC), or essential oils (EO), can significantly reduce the bacterial load in dental aerosols. With respect to viruses such as HSV-1, there are too little clinical data to draw any clear recommendations. On the other hand, clinical data is consolidating that CPC-containing mouthwashes can temporarily reduce the intraoral viral load and infectivity in SARS-CoV-2 positive individuals. Nevertheless, potential risks and side effects due to regular antiseptic use such as ecological effects or adaptation of bacteria need to be considered. CONCLUSIONS The use of preprocedural mouthwashes containing antiseptics can be recommended according to currently available data, but further studies are needed, particularly on the effects on other viruses besides SARS-CoV-2. When selecting a specific antiseptic, the biggest data basis currently exists for CHX, CPC, EO, or combinations thereof. CLINICAL RELEVANCE Preprocedural mouthwashes containing antiseptics can serve as part of a bundle of measures for protection of dental personnel despite some remaining ambiguities and in view of potential risks and side effects.
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Affiliation(s)
- Johanna Weber
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
- Department of Orthodontics, University Hospital Regensburg, Regensburg, Germany
| | - Eva L Bonn
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - David L Auer
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | | | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
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Agyekum BA, Tuglo LS. Effect of COVID-19 on dental care for children during the post-pandemic era in Ghana: A concern for policymaking. FRONTIERS IN DENTAL MEDICINE 2023. [DOI: 10.3389/fdmed.2023.1120685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
The impacts of COVID-19 have been felt globally, especially in the delivery of healthcare services such as dental care, although the incidence in Africa is comparatively low. This review article aims to explore the COVID-19 pandemic lockdown and its impact on dental care for children in Ghana. Some dental facilities in Ghana have been experiencing multiple challenges in service delivery, and the ongoing COVID-19 pandemic has aggravated the situation. The COVID-19 pandemic has interrupted all dental care in many parts of Ghana due to its impact on food insecurity, economic breakdown, depression, shortage of essential instrument supplies, inadequate health workers, and poor infection control practices, which present the main risks to dental care. Furthermore, the shutting of dental departments due to the COVID-19 lockdown has restricted the accessibility and utilization of dental services, especially for children. Hence, to avoid further and future pandemics and their impacts on dental care, there is a need to address the implications identified and prepare for the delivery of suitable dental healthcare in Ghana.
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11
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Adl A, Sedigh-Shams M, Jamalidoust M, Rajabzadeh Z. Evaluating the effect of gargling with hydrogen peroxide and povidone-iodine on salivary viral load of SARS-CoV-2: A pilot randomized clinical trial. Niger J Clin Pract 2023; 26:391-396. [PMID: 37203101 DOI: 10.4103/njcp.njcp_320_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Background and Aim This study evaluates the salivary viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in hospitalized patients and outpatients before and after gargling with 1% hydrogen peroxide and 0.25% povidone-iodine in comparison with normal saline. Patients and Methods This clinical trial was conducted on 120 participants with laboratory-confirmed coronavirus disease 2019 (COVID-19) in two groups: outpatients (n = 60) and hospitalized patients (n = 60). In each group, the patients were randomly divided into three subgroups of 20 based on their given mouthwash for gargling (hydrogen peroxide, povidone-iodine, or normal saline). Two saliva samples were taken from each patient: the first one before gargling and the second one 10 minutes after gargling 10 ml of the respected mouthwashes for 30 seconds. The TaqMan real-time polymerase chain reaction (PCR) amplification of SARS-CoV-2 was used to measure the viral load. Results Saliva samples from 46% of patients were positive for coronavirus before gargling the mouthwashes. The percentage of patients with an initial positive saliva sample was significantly higher in the outpatient group (83.3%) than in the hospitalized group (5.4%) (P = 0.01). According to the findings, gargling any mouthwash similar to saline did not reduce the viral load (P > 0.05). Conclusion The saliva of COVID-19 patients in the initial stage of the disease was more likely to contain SARS-CoV-2 than the saliva of the hospitalized patients. Gargling hydrogen peroxide or povidone-iodine did not reduce the salivary SARS-CoV-2 viral load.
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Affiliation(s)
- A Adl
- Department of Endodontics, Biomaterials Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M Sedigh-Shams
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M Jamalidoust
- Department of Virology, Clinical Microbiology Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Z Rajabzadeh
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Farmaha JK, James JN, Frazier K, Sahajpal NS, Mondal AK, Bloomquist DT, Kolhe R, Looney SW, Bloomquist R. Reduction of SARS-CoV-2 salivary viral load with pre-procedural mouth rinses: a randomised, controlled, clinical trial. Br Dent J 2023; 234:593-600. [PMID: 37117367 PMCID: PMC10141803 DOI: 10.1038/s41415-023-5741-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/17/2022] [Accepted: 01/09/2023] [Indexed: 04/30/2023]
Abstract
Introduction The purpose of this study was to test the short-term efficacy of four commercial mouthwashes versus water in reducing SARS-CoV-2 viral load in the oral cavity over clinically relevant time points.Methods In total, 32 subjects that were proven SARS-CoV-2-positive via polymerase chain reaction (PCR)-based diagnostic test were recruited and randomised into five parallel arms. Cycle threshold (Ct) values were compared in saliva samples between the groups, as well as within the groups at baseline (pre-rinse), zero hours, one hour and two hours post-rinse, using SARS-CoV-2 reverse transcription-PCR analysis.Results We observed a significant increase in Ct values in saliva samples collected immediately after rinsing with all the four mouthwashes - 0.12% chlorhexidine gluconate, 1.5% hydrogen peroxide, 1% povidone iodine, or Listerine - compared to water. A sustained increase in Ct values for up to two hours was only observed in the Listerine and chlorohexidine gluconate groups. We were not able to sufficiently power this clinical trial, so the results remain notional but encouraging and supportive of findings in other emerging mouthwash studies on COVID-19, warranting additional investigations.Conclusions Our evidence suggests that in a clinical setting, prophylactic rinses with Listerine or chlorhexidine gluconate can potentially reduce SARS-CoV-2 viral load in the oral cavity for up to two hours. While limited in statistical power due to the difficulty in obtaining this data, we advocate for pre-procedural mouthwashing, like handwashing, as an economical and safe additional precaution to help mitigate the transmission of SARS-CoV-2 from a potentially infected patient to providers.
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Affiliation(s)
- Jaspreet Kaur Farmaha
- Department of Clinical Research, Dental College of Georgia, Augusta University, Georgia, USA
| | - Jeffrey N James
- Department of Oral and Maxillofacial Surgery, Dental College of Georgia, Augusta University, Georgia, USA
| | - Kyle Frazier
- Department of Oral and Maxillofacial Surgery, Dental College of Georgia, Augusta University, Georgia, USA
| | - Nikhil Shri Sahajpal
- Department of Pathology, Medical College of Georgia, Augusta University, Georgia, USA
| | - Ashis K Mondal
- Department of Pathology, Medical College of Georgia, Augusta University, Georgia, USA
| | - Doan Tam Bloomquist
- Department of Ophthalmology, Charlie Norwood Veterans Affairs Medical Centre, Augusta, Georgia, USA
| | - Ravindra Kolhe
- Department of Pathology, Medical College of Georgia, Augusta University, Georgia, USA
| | - Stephen W Looney
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Ryan Bloomquist
- Department of Restorative Sciences, Dental College of Georgia, Augusta University, Georgia, USA.
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13
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Sakai H, Kondo E, Tanaka H, Shimane T, Yamada S, Kurita H. COVID-19 transmission in dental practice during the pandemic: A questionnaire-based survey in private dental clinics in Japan. J Dent Sci 2023; 18:497-502. [PMID: 36211024 PMCID: PMC9525217 DOI: 10.1016/j.jds.2022.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/16/2022] [Accepted: 09/17/2022] [Indexed: 01/08/2023] Open
Abstract
Background/purpose The global coronavirus disease 2019 (COVID-19) pandemic continues to cause a significant impact on patient care due to its considerable transmissibility, morbidity, and mortality. The aim of this study was to investigate whether dental procedures performed at private dental clinics were associated with the occurrence of COVID-19 clusters and measures taken to prevent nosocomial infection of COVID-19. Materials and methods An online questionnaire-based survey on clinical activities, infection control measures, and confirmed or probable COVID-19 cases among patients and clinical staff during the pandemic (February 2020 to September 2021) was administered to dentists at private dental clinics in Nagano prefecture, Japan. Almost all dentists engaged in dental treatment were actively implementing standard precautions. Results Twenty-seven dental clinics provided dental care to infected patients (nine confirmed and eighteen probable), but there was no transmission from patients to staff. Ten clinics had staff who were infected, but none exhibited disease transmission from staff to patients. Conclusion The results of this survey suggest that COVID-19 clusters might not occur in dental settings where appropriate protective measures are implemented.
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Affiliation(s)
- Hironori Sakai
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Eiji Kondo
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hirokazu Tanaka
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tetsu Shimane
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shinichi Yamada
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Hiroshi Kurita
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
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14
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Bonn EL, Rohrhofer A, Audebert FX, Lang H, Auer DL, Scholz KJ, Schuster P, Wenzel JJ, Hiller KA, Buchalla W, Gottsauner JM, Vielsmeier V, Schmidt B, Cieplik F. Efficacy of a Mouthwash Containing CHX and CPC in SARS-CoV-2-Positive Patients: A Randomized Controlled Clinical Trial. J Dent Res 2023; 102:608-615. [PMID: 36942423 PMCID: PMC10030878 DOI: 10.1177/00220345231156415] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Soon after the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, preprocedural mouthwashes were recommended for temporarily reducing intraoral viral load and infectivity of individuals potentially infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in order to protect medical personnel. Particularly, the antiseptic cetylpyridinium chloride (CPC) has shown virucidal effects against SARS-CoV-2 in vitro. Therefore, the aim of this randomized controlled clinical trial was to investigate the efficacy of a commercially available mouthwash containing CPC and chlorhexidine digluconate (CHX) at 0.05% each in SARS-CoV-2-positive patients as compared to a placebo mouthwash. Sixty-one patients who tested positive for SARS-CoV-2 with onset of symptoms within the last 72 h were included in this study. Oropharyngeal specimens were taken at baseline, whereupon patients had to gargle mouth and throat with 20 mL test or placebo (0.9% NaCl) mouthwash for 60 s. After 30 min, further oropharyngeal specimens were collected. Viral load was analyzed by quantitative reverse transcriptase polymerase chain reaction, and infectivity of oropharyngeal specimens was analyzed by virus rescue in cell culture and quantified via determination of tissue culture infectious doses 50% (TCID50). Data were analyzed nonparametrically (α = 0.05). Viral load slightly but significantly decreased upon gargling in the test group (P = 0.0435) but not in the placebo group. Viral infectivity as measured by TCID50 also significantly decreased in the test group (P = 0.0313), whereas there was no significant effect but a trend in the placebo group. Furthermore, it was found that the specimens from patients with a vaccine booster exhibited significantly lower infectivity at baseline as compared to those without vaccine booster (P = 0.0231). This study indicates that a preprocedural mouthwash containing CPC and CHX could slightly but significantly reduce the viral load and infectivity in SARS-CoV-2-positive patients. Further studies are needed to corroborate these results and investigate whether the observed reductions in viral load and infectivity could translate into clinically useful effects in reducing COVID-19 transmission (German Clinical Trials Register DRKS00027812).
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Affiliation(s)
- E L Bonn
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - A Rohrhofer
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - F X Audebert
- Praxiszentrum Alte Mälzerei, Regensburg, Germany
| | - H Lang
- Praxiszentrum Alte Mälzerei, Regensburg, Germany
| | - D L Auer
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - K J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - P Schuster
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - J J Wenzel
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - K-A Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - W Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - J M Gottsauner
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | - V Vielsmeier
- Department of Otorhinolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - B Schmidt
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - F Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
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15
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Karyadi E, Bouty AAV, Mutalazimah M. Effect of SARS CoV-2 Infection on Periodontal Tissue: A Systematic Review. Open Dent J 2023. [DOI: 10.2174/18742106-v17-230202-2022-85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Background:
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infection in human respiratory cells. The first spread of this disease first occurred in Wuhan, China, in December 2019, and on March 11, 2020, the World Health Organization declared the spread of the infection as a global pandemic. People who are infected experience mild to moderate clinical symptoms which are characterized by an increase in T cell, CD8, and IgM/IgG levels. The occurrence of severe clinical symptoms reflects an excessive and uncontrolled increase in the secretion of pro-inflammatory cytokines, which impacts the systemic condition and periodontal tissues of affected patients.
Objective:
The aim of this study is to describe the impact of SARS CoV-2 infection on periodontal tissues.
Methods:
In this study, we searched the NCBI, PubMed, Google Scholar, and Research Gate databases. The keywords used were “coronavirus disease” or “COVID-19” or “SARS-CoV-2” with “oral manifestations” and “periodontal,” and we screened the articles using the PRISMA flow diagram.
Results:
Patients with COVID-19 present with a variety of systemic symptoms, as well as manifestations in the periodontal tissues, especially in the gingival area.
Conclusion:
SARS CoV-2 infection can impact periodontal tissues in the form of necrotizing ulcerative gingivitis, aphthous stomatitis, gingival hyperpigmentation, edema and erythema, lichen planus, and aphthous-like ulcers.
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Marinković J, Rakašević D, Nemoda M, Nikolić B, Marković T, Matijević S, Marković D. EO-based mouthwashes: Is there something that should be known? BALKAN JOURNAL OF DENTAL MEDICINE 2023. [DOI: 10.5937/bjdm2301032m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
The possibility to utilize the antibacterial and antibiofilm potential of essential oils (EOs) in dentistry is recognized and best seen in the design of EO-based mouthwashes. The up-to-date results, obtained with the most commonly used formulation being consisted of thymol, eucalyptol, menthol, and methyl salicylate (Listerine), proved its efficacy against plaque and gingival inflammation. However, novel alcohol-free products remain to be further investigated. Commercially available mouthwash containing curcumin, clove oil, mentha oil, eucalyptol, thymol and tea tree oil, and the mouthwash based on ginger EO (a-zingiberene, b-bisabolene, b-sesquiphellandrene, curcumene), reduced plaque index and improved periodontal status of the patients. The plaque index was also reduced and overall healing was improved after the surgical removal of the third molar by mouthwash containing John wort oil. In addition, Cinnamomum zeylanicum EO-based mouthwash and mouthwash containing peppermint oil were efficient against stomatitis and xerostomia, respectively. In addition to beneficial effects achieved in the mouth, i.e. at the appropriate site of application, novel investigations pointed-out that EO-based mouthwashes could be recognized as efficient in the reduction of bacterial and viral aerosols. This has been shown for Listerine, and for several mouthwashes containing following active substances of plants' EO origin: a-farnesene, b-farnesene, farnesol, nerolidol, a-bulnesene, eremanthin, b-sesquiphellandrene, spiroether, cinnamylacetate, cinnamaldehyde, eugenol, menthol, and carvacrol. This finding could be of special interest, in order to be included in further clinical studies related to COVID -19 pandemic.
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17
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Pannuti CM, Reis INRD, Souza NV, Souto MLS, Silva CGB, Bezinelli LM, Machado CM, Romito GA, Villar CC. Efficacy of mouthrinses in reducing oral SARS-COV-2 load: a review. Braz Oral Res 2023; 37:e038. [PMID: 37132726 DOI: 10.1590/1807-3107bor-2023.vol37.0038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 11/21/2022] [Indexed: 05/04/2023] Open
Abstract
Accumulated evidence has shown that the oral cavity may be an important reservoir for SARS-CoV-2. Some authors have suggested that the use of mouthrinses could reduce SARS-CoV-2 viral load in the saliva. Thus, the aim of this review was to synthesize evidence about the efficacy of mouthrinses in reducing the salivary viral load of SARS-CoV-2. 2. Nine randomized controlled trials (RCTs) have investigated the efficacy of different mouthrinses in reducing salivary SARS-CoV-2 loads. Various active ingredients have been tested in these trials: 0.5%,1% and 2% povidone-iodine, 0.2% and 0.12% chlorhexidine (CHX), 0.075% cetylpyridinium chloride (CPC), 0.075% CPC with Zinc lactate, 1% and 1.5% hydrogen peroxide (HP), 1.5% HP + 0.12% CHX and ß-cyclodextrin and citrox. The studies reported an intra-group reduction in the salivary levels of the virus, when compared with the baseline. However, the majority of these trials failed to demonstrate a significant inter-group difference between active groups and the control group relative to the decrease in salivary SARS-CoV-2 loads. Although promising, these results should be confirmed by larger trials.
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Affiliation(s)
- Claudio Mendes Pannuti
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | | | - Nathalia Vilela Souza
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | | | | | | | | | - Giuseppe Alexandre Romito
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | - Cristina Cunha Villar
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
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Argyropoulos CD, Skoulou V, Efthimiou G, Michopoulos AK. Airborne transmission of biological agents within the indoor built environment: a multidisciplinary review. AIR QUALITY, ATMOSPHERE, & HEALTH 2022; 16:477-533. [PMID: 36467894 PMCID: PMC9703444 DOI: 10.1007/s11869-022-01286-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
The nature and airborne dispersion of the underestimated biological agents, monitoring, analysis and transmission among the human occupants into building environment is a major challenge of today. Those agents play a crucial role in ensuring comfortable, healthy and risk-free conditions into indoor working and leaving spaces. It is known that ventilation systems influence strongly the transmission of indoor air pollutants, with scarce information although to have been reported for biological agents until 2019. The biological agents' source release and the trajectory of airborne transmission are both important in terms of optimising the design of the heating, ventilation and air conditioning systems of the future. In addition, modelling via computational fluid dynamics (CFD) will become a more valuable tool in foreseeing risks and tackle hazards when pollutants and biological agents released into closed spaces. Promising results on the prediction of their dispersion routes and concentration levels, as well as the selection of the appropriate ventilation strategy, provide crucial information on risk minimisation of the airborne transmission among humans. Under this context, the present multidisciplinary review considers four interrelated aspects of the dispersion of biological agents in closed spaces, (a) the nature and airborne transmission route of the examined agents, (b) the biological origin and health effects of the major microbial pathogens on the human respiratory system, (c) the role of heating, ventilation and air-conditioning systems in the airborne transmission and (d) the associated computer modelling approaches. This adopted methodology allows the discussion of the existing findings, on-going research, identification of the main research gaps and future directions from a multidisciplinary point of view which will be helpful for substantial innovations in the field.
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Affiliation(s)
| | - Vasiliki Skoulou
- B3 Challenge Group, Chemical Engineering, School of Engineering, University of Hull, Cottingham Road, Hull, HU6 7RX UK
| | - Georgios Efthimiou
- Centre for Biomedicine, Hull York Medical School, University of Hull, Cottingham Road, Hull, HU6 7RX UK
| | - Apostolos K. Michopoulos
- Energy & Environmental Design of Buildings Research Laboratory, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
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19
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Aghili SS, Pourzal A, Mosaddad SA, Amookhteh S. COVID-19 Risk Management in Dental Offices: A Review Article. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND: As all the dental staff, including nurses and practitioners, are exposed to various routes of contamination due to the novel COVID-19 virus, which is still unknown to the scientific world, developing strategies to reduce the risk of transmission and decontaminate surfaces in a dental office would be of high importance. Although there is still insufficient data on managing this virus in dental offices, several studies have suggested protocols for improving care.
AIM: This study aimed to review present investigations and reach a conclusion on what we know and need to know to combat this virus.
MATERIALS AND METHODS: In this review, Scopus, PubMed, and MEDLINE databases were searched using the keywords “COVID-19,” “SARS-CoV-2,” “Medical Disinfectants,” “Personal Protective Equipment’s,” and “Surface Decontamination.” Articles were reviewed, and finally, relevant articles published during 2000–2022 were included in the final paper.
RESULTS: The present research concluded that using a combination of the face shield and N95 masks protected the eyes, nose, and mouth. To have more efficient protection, water-resistant long-sleeved gowns and gloves were highly suggested. To overcome aerosols, high-performance air filters and ultraviolet were found quite effective. Allowing the patient to use antiseptic mouthwash before starting the treatment could reduce oral microorganisms and the following airborne contamination.
CONCLUSION: This review has gathered all available data regarding dentistry and COVID-19 in order to conclude what has been achieved yet in the prevention of this virus through dental offices; however, more investigations are needed to have a definitive protocol against the virus.
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Kumbargere Nagraj S, Eachempati P, Paisi M, Nasser M, Sivaramakrishnan G, Francis T, Verbeek JH. Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental healthcare providers. Cochrane Database Syst Rev 2022; 8:CD013826. [PMID: 35994295 PMCID: PMC9394685 DOI: 10.1002/14651858.cd013826.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Aerosols and spatter are generated in a dental clinic during aerosol-generating procedures (AGPs) that use high-speed hand pieces. Dental healthcare providers can be at increased risk of transmission of diseases such as tuberculosis, measles and severe acute respiratory syndrome (SARS) through droplets on mucosae, inhalation of aerosols or through fomites on mucosae, which harbour micro-organisms. There are ways to mitigate and contain spatter and aerosols that may, in turn, reduce any risk of disease transmission. In addition to personal protective equipment (PPE) and aerosol-reducing devices such as high-volume suction, it has been hypothesised that the use of mouth rinse by patients before dental procedures could reduce the microbial load of aerosols that are generated during dental AGPs. OBJECTIVES To assess the effects of preprocedural mouth rinses used in dental clinics to minimise incidence of infection in dental healthcare providers and reduce or neutralise contamination in aerosols. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was 4 February 2022. SELECTION CRITERIA We included randomised controlled trials and excluded laboratory-based studies. Study participants were dental patients undergoing AGPs. Studies compared any preprocedural mouth rinse used to reduce contaminated aerosols versus placebo, no mouth rinse or another mouth rinse. Our primary outcome was incidence of infection of dental healthcare providers and secondary outcomes were reduction in the level of contamination of the dental operatory environment, cost, change in mouth microbiota, adverse events, and acceptability and feasibility of the intervention. DATA COLLECTION AND ANALYSIS Two review authors screened search results, extracted data from included studies, assessed the risk of bias in the studies and judged the certainty of the available evidence. We used mean differences (MDs) and 95% confidence intervals (CIs) as the effect estimate for continuous outcomes, and random-effects meta-analysis to combine data MAIN RESULTS: We included 17 studies with 830 participants aged 18 to 70 years. We judged three trials at high risk of bias, two at low risk and 12 at unclear risk of bias. None of the studies measured our primary outcome of the incidence of infection in dental healthcare providers. The primary outcome in the studies was reduction in the level of bacterial contamination measured in colony-forming units (CFUs) at distances of less than 2 m (intended to capture larger droplets) and 2 m or more (to capture droplet nuclei from aerosols arising from the participant's oral cavity). It is unclear what size of CFU reduction represents a clinically significant amount. There is low- to very low-certainty evidence that chlorhexidine (CHX) may reduce bacterial contamination, as measured by CFUs, compared with no rinsing or rinsing with water. There were similar results when comparing cetylpyridinium chloride (CPC) with no rinsing and when comparing CPC, essential oils/herbal mouthwashes or boric acid with water. There is very low-certainty evidence that tempered mouth rinses may provide a greater reduction in CFUs than cold mouth rinses. There is low-certainty evidence that CHX may reduce CFUs more than essential oils/herbal mouthwashes. The evidence for other head-to-head comparisons was limited and inconsistent. The studies did not provide any information on costs, change in micro-organisms in the patient's mouth or adverse events such as temporary discolouration, altered taste, allergic reaction or hypersensitivity. The studies did not assess acceptability of the intervention to patients or feasibility of implementation for dentists. AUTHORS' CONCLUSIONS: None of the included studies measured the incidence of infection among dental healthcare providers. The studies measured only reduction in level of bacterial contamination in aerosols. None of the studies evaluated viral or fungal contamination. We have only low to very low certainty for all findings. We are unable to draw conclusions regarding whether there is a role for preprocedural mouth rinses in reducing infection risk or the possible superiority of one preprocedural rinse over another. Studies are needed that measure the effect of rinses on infectious disease risk among dental healthcare providers and on contaminated aerosols at larger distances with standardised outcome measurement.
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Affiliation(s)
- Sumanth Kumbargere Nagraj
- Professor and Head, Department of Oral Medicine and Oral Radiology, Faculty of Dentistry, Manipal University College Malaysia, Melaka, Malaysia
- Honorary Research Fellow, Division of Surgery and Interventional Science, Department of Surgical Biotechnology, University College London, London, UK
| | - Prashanti Eachempati
- Professor and Head, Department of Prosthodontics, Faculty of Dentistry, Manipal University College Malaysia, Melaka, Malaysia
| | - Martha Paisi
- Peninsula Dental Social Enterprise, Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Mona Nasser
- Peninsula Dental School, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | | | - Tony Francis
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Manipal University College Malaysia, Melaka, Malaysia
| | - Jos H Verbeek
- Cochrane Work, Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Negucioiu M, Bucur A, Lucaciu O, Soanca A, Roman A. Management of SARS-CoV-2 Transmission in Emergency Dental Settings: Current Knowledge and Personal Experience. Disaster Med Public Health Prep 2022; 16:1604-1611. [PMID: 33722327 PMCID: PMC7985645 DOI: 10.1017/dmp.2020.483] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 11/11/2020] [Accepted: 11/24/2020] [Indexed: 02/06/2023]
Abstract
The coronavirus disease 2019 (COVID-19) has seen a violent and fast spread worldwide. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a predominantly respiratory transmission through droplets and aerosol with serious implications for dental settings. This article is based on recent research, guidelines issued by relevant authorities, as well as on the authors' experience acquired through their involvement in setting up an emergency dental care hub in Cluj-Napoca, Romania, during the COVID-19 lockdown. The present article aims to provide a brief description of COVID-19 implications in dental office and to recommend preventive protocols for dental practitioners to ensure a safe and healthful workplace. The recommendations for infection control presented in this article address the specific risks of exposure to SARS-CoV-2. The article provides a special customized guideline covering patient triage and entrance into the dental practice, personnel protection, dental treatment, and after-treatment management. The implementation of strict preventive measures has been found to be efficient in the prevention of SARS-CoV-2 contamination because no infections have been reported among our staff or patients. COVID-19 is a major emergency worldwide marked by a rapid evolution and warranting a need for further assessment of the implications of COVID-19 outbreak in dental practice.
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Affiliation(s)
- Marius Negucioiu
- Department of Prosthodontics, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emegency County Clinical Hospital, Cluj-Napoca, Romania
| | - Alexandru Bucur
- Department of Oro-Maxillo-Facial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Spitalul Clinic de Chirurgie Oro-Maxilo-Faciala “Prof. Dr. Dan Theodorescu” Oro-Maxillo-Facial Clinical Hospital, Bucharest, Romania
| | - Ondine Lucaciu
- Department of Oral Health, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrada Soanca
- Emegency County Clinical Hospital, Cluj-Napoca, Romania
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandra Roman
- Emegency County Clinical Hospital, Cluj-Napoca, Romania
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Al-Moraissi EA, Kaur A, Günther F, Neff A, Christidis N. Can aerosols-generating dental, oral and maxillofacial, and orthopedic surgical procedures lead to disease transmission? An implication on the current COVID-19 pandemic. FRONTIERS IN ORAL HEALTH 2022; 3:974644. [PMID: 35979536 PMCID: PMC9376374 DOI: 10.3389/froh.2022.974644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/04/2022] [Indexed: 12/01/2022] Open
Abstract
Various dental, maxillofacial, and orthopedic surgical procedures (DMOSP) have been known to produce bioaerosols, that can lead to the transmission of various infectious diseases. Hence, a systematic review (SR) aimed at generating evidence of aerosols generating DMOSP that can result in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), further investigating their infectivity and assessing the role of enhanced personal protective equipment (PPE) an essential to preventing the spreading of SARS-CoV-2 during aerosol-generating procedures (AGPs). This SR was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) guidelines based on a well-designed Population, Intervention, Comparison, Outcomes and Study (PICOS) framework, and various databases were searched to retrieve the studies which assessed potential aerosolization during DMOSP. This SR included 80 studies (59 dental and 21 orthopedic) with 7 SR, 47 humans, 5 cadaveric, 16 experimental, and 5 animal studies that confirmed the generation of small-sized < 5 μm particles in DMOSP. One study confirmed that HIV could be transmitted by aerosolized blood generated by an electric saw and bur. There is sufficient evidence that DMOSP generates an ample amount of bioaerosols, but the infectivity of these bioaerosols to transmit diseases like SARS-CoV-2 generates very weak evidence but still, this should be considered. Confirmation through isolation and culture of viable virus in the clinical environment should be pursued. An evidence provided by the current review was gathered by extrapolation from available experimental and empirical evidence not based on SARS-CoV-2. The results of the present review, therefore, should be interpreted with great caution.
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Affiliation(s)
- Essam Ahmed Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Dhamar, Yemen
- *Correspondence: Essam Ahmed Al-Moraissi ;
| | - Amanjot Kaur
- Oral and Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Frank Günther
- Medical Microbiology and Hygiene, Marburg University Hospital, Marburg, Germany
| | - Andreas Neff
- Department of Oral and Maxillofacial Surgery, University Hospital Marburg Universitätsklinikum Giessen und Marburg GmbH, Marburg, Germany
| | - Nikolaos Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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23
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Böke ES, Keleş A, Keskin C, Tanrıverdi Çaycı Y, Turk T. Are aerosol control devices effective in preventing the spread of dental aerosol? PeerJ 2022; 10:e13714. [PMID: 35855907 PMCID: PMC9288161 DOI: 10.7717/peerj.13714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/21/2022] [Indexed: 01/17/2023] Open
Abstract
Background In dental clinics, aerosols produced from dental instruments have become a matter of concern following breakout of coronavirus disease 19 (COVID-19) evolving into a pandemic. This study compared aerosol reduction systems and in terms of their ability to reduce Enterococcus faecalis (E. faecalis) contaminated aerosol in a simulated dental office set-up. Methods Closed clinic model with manikin and mandibular molar typodont was simulated. For 10 min, the air and water dispersed by the rotating bur mounted on an aerator was contaminated by pouring the suspension containing 1-3 × 108 CFU/mL E. faecalis directly on the bur. During and after the procedures, the air within the cabin was also sampled. CFU count was recorded and scored. The mean CFU scores obtained from agar plate count and air sampling device was compared using Kruskal-Wallis H test among groups with 5% significance threshold. Results The use of WS Aerosol Defender device led to greater CFU scores on the agars levelled to patient's chest compared to other directions (p = 0.001). Combined use of VacStation and WS Aerosol Defender resulted in significantly decreased CFU score in the air samples compared to experimental and positive control groups (p = 0 < 0.05). Conclusions Although the devices prevented the spread of aerosol around the patient to some extent, they could not completely eliminate the contaminated aerosol load in the cabin environment.
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Affiliation(s)
- Elif Seher Böke
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
| | - Ali Keleş
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
| | - Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
| | - Yeliz Tanrıverdi Çaycı
- Department of Medical Microbiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Tugba Turk
- Deapartment of Endodontics, Faculty of Dentistry, Ege University, İzmir, Türkiye
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Takenaka S, Sotozono M, Ohkura N, Noiri Y. Evidence on the Use of Mouthwash for the Control of Supragingival Biofilm and Its Potential Adverse Effects. Antibiotics (Basel) 2022; 11:727. [PMID: 35740134 PMCID: PMC9219991 DOI: 10.3390/antibiotics11060727] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/19/2022] [Accepted: 05/26/2022] [Indexed: 12/14/2022] Open
Abstract
Antimicrobial mouthwash improves supragingival biofilm control when used in conjunction with mechanical removal as part of an oral hygiene routine. Mouthwash is intended to suppress bacterial adhesion during biofilm formation processes and is not aimed at mature biofilms. The most common evidence-based effects of mouthwash on the subgingival biofilm include the inhibition of biofilm accumulation and its anti-gingivitis property, followed by its cariostatic activities. There has been no significant change in the strength of the evidence over the last decade. A strategy for biofilm control that relies on the elimination of bacteria may cause a variety of side effects. The exposure of mature oral biofilms to mouthwash is associated with several possible adverse reactions, such as the emergence of resistant strains, the effects of the residual structure, enhanced pathogenicity following retarded penetration, and ecological changes to the microbiota. These concerns require further elucidation. This review aims to reconfirm the intended effects of mouthwash on oral biofilm control by summarizing systematic reviews from the last decade and to discuss the limitations of mouthwash and potential adverse reactions to its use. In the future, the strategy for oral biofilm control may shift to reducing the biofilm by detaching it or modulating its quality, rather than eliminating it, to preserve the benefits of the normal resident oral microflora.
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Affiliation(s)
- Shoji Takenaka
- Division of Cariology, Operative Dentistry and Endodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan; (M.S.); (N.O.); (Y.N.)
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25
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Ghobadi A, Golshah A, Safaei M. The Effect of Hydrogen Peroxide and Povidone-Iodine on the Shear Bond Strength of Orthodontic Brackets: An In Vitro Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND: Chlorhexidine, which is the gold-standard antimicrobial mouthwash, cannot effectively decrease the count of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the causative agent for coronavirus disease-2019 (COVID-19). Since SARS-CoV-2 is susceptible to oxidation, mouthwashes containing oxidizing agents such as hydrogen peroxide (H2O2) or Povidone-iodine (PVP-I) are recommended to decrease the viral count.
AIM: This study aimed to assess the effects of H2O2 and PVP-I mouthwashes on the shear bond strength (SBS) of metal orthodontic brackets to the enamel.
MATERIALS AND METHODS: This in vitro experimental study evaluated 45 freshly extracted maxillary premolars. The teeth were cleaned and randomized into three groups (n = 15) for rinsing with distilled water (control group), 1% PVP-I (betadine), and 1.5% H2O2 for 60 s. All teeth were etched with 37% phosphoric acid gel, and metal orthodontic brackets were bonded to the teeth using the Transbond XT bonding system. The teeth were mounted in auto-polymerized acrylic resin and incubated in water at 37°C for 72 h. The teeth were then thermocycled for 48 h, and their SBS was measured in a universal testing machine. The adhesive remnant index (ARI) score was also calculated. The groups were compared by ANOVA and Chi-square Monte Carlo test.
RESULTS: No significant difference was noted among the three groups in SBS (p = 0.938) or the ARI score (p = 0.780).
CONCLUSION: Use of H2O2 and PVP-I mouthwashes has no adverse effect on SBS or mode of failure of metal orthodontic brackets bonded to enamel.
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Takenaka S, Sotozono M, Yashiro A, Saito R, Kornsombut N, Naksagoon T, Nagata R, Ida T, Edanami N, Noiri Y. Efficacy of Combining an Extraoral High-Volume Evacuator with Preprocedural Mouth Rinsing in Reducing Aerosol Contamination Produced by Ultrasonic Scaling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106048. [PMID: 35627588 PMCID: PMC9141298 DOI: 10.3390/ijerph19106048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/11/2022] [Accepted: 05/14/2022] [Indexed: 12/20/2022]
Abstract
The coronavirus disease pandemic has afforded dental professionals an opportunity to reconsider infection control during treatment. We investigated the efficacy of combining extraoral high-volume evacuators (eHVEs) with preprocedural mouth rinsing in reducing aerosol contamination by ultrasonic scalers. A double-masked, two-group, crossover randomized clinical trial was conducted over eight weeks. A total of 10 healthy subjects were divided into two groups; they received 0.5% povidone-iodine (PI), essential oil (EO), or water as preprocedural rinse. Aerosols produced during ultrasonic scaling were collected from the chest area (PC), dentist's mask, dentist's chest area (DC), bracket table, and assistant's area. Bacterial contamination was assessed using colony counting and adenosine triphosphate assays. With the eHVE 10 cm away from the mouth, bacterial contamination by aerosols was negligible. With the eHVE 20 cm away, more dental aerosols containing bacteria were detected at the DC and PC. Mouth rinsing decreased viable bacterial count by 31-38% (PI) and 22-33% (EO), compared with no rinsing. The eHVE prevents bacterial contamination when close to the patient's mouth. Preprocedural mouth rinsing can reduce bacterial contamination where the eHVE is positioned away from the mouth, depending on the procedure. Combining an eHVE with preprocedural mouth rinsing can reduce bacterial contamination in dental offices.
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Affiliation(s)
| | - Maki Sotozono
- Correspondence: ; Tel.: +81-25-227-2865; Fax: +81-25-227-2864
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COVID-19 transmission in dental and oral/maxillofacial surgical practice during pandemic: questionnaire survey in 51 university hospitals in Japan. J Hosp Infect 2022; 125:21-27. [PMID: 35429583 PMCID: PMC9005358 DOI: 10.1016/j.jhin.2022.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 01/08/2023]
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has become a major public health problem. Dental procedures that generate aerosols are considered to impose a high risk of infection; therefore, dental professionals, such as dentists and dental hygienists, may be at high risk of viral transmission. However, few studies have reported COVID-19 clusters in dental care settings. Aim To investigate whether dental and oral/maxillofacial procedures are associated with the occurrence of COVID-19 clusters and measures taken to prevent nosocomial infection in dental clinics. Methods An online questionnaire survey on clinical activities (administrative control), infection control measures (environmental/engineering control, personal protective equipment, etc.), and confirmed or probable COVID-19 cases among patients and clinical staff was administered to the faculties of the dental and oral/maxillofacial surgical departments of university hospitals. Findings Fifty-one faculty members completed the questionnaire. All members were engaged in the treatment of dental and oral surgical outpatients and actively implemented standard precautions. Fourteen faculty members treated patients with COVID-19, but no infections transmitted from the patients to the medical staff were observed. In seven facilities, patients were found to have the infection after treatment (medical staff came in close contact), but there was no transmission from patients to medical staff. Four facilities had medical staff with infections, but none of them exhibited disease transmission from staff to patients. Conclusion COVID-19 clusters are unlikely to occur in dental and oral surgical care settings if appropriate protective measures are implemented.
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Efficacy of Pre-Procedural Mouthwashes against SARS-CoV-2: A Systematic Review of Randomized Controlled Trials. J Clin Med 2022; 11:jcm11061692. [PMID: 35330016 PMCID: PMC8955331 DOI: 10.3390/jcm11061692] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/11/2022] [Accepted: 03/16/2022] [Indexed: 01/27/2023] Open
Abstract
The oral mucosa is one of the first sites to be affected by the SARS-CoV-2. For this reason, healthcare providers performing aerosol-generating procedures (AGPs) in the oral cavity are at high risk of infection with COVID-19. The aim of this systematic review is to verify whether there is evidence in the literature describing a decrease in the salivary viral load of SARS-CoV-2 after using different mouthwashes. An electronic search of the MEDLINE database (via PubMed), Web of Science, SCOPUS, and the Cochrane library database was carried out. The criteria used were those described by the PRISMA® Statement. Randomized controlled trial studies that have used mouthwashes as a form of intervention to reduce the viral load in saliva were included. The risk of bias was analyzed using the Joanna Briggs Institute Critical Appraisal Tool. Ultimately, eight articles were included that met the established criteria. Based on the evidence currently available in the literature, PVP-I, CHX and CPC present significant virucidal activity against SARS-CoV-2 in saliva and could be used as pre-procedural mouthwashes to reduce the risk of cross-infection.
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MARAŞ E, ARICIOĞLU B. INVESTIGATION OF PREVENTIVE MEASURES TAKEN BY FACULTY OF DENTISTRY STUDENTS IN CLINICAL PRACTICES AND PERCEIVED STRESS LEVELS DURING THE EPIDEMIC PERIOD. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.1032673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Transcriptomic Stress Response in Streptococcus mutans following Treatment with a Sublethal Concentration of Chlorhexidine Digluconate. Microorganisms 2022; 10:microorganisms10030561. [PMID: 35336136 PMCID: PMC8950716 DOI: 10.3390/microorganisms10030561] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 01/27/2023] Open
Abstract
Despite the widespread use of antiseptics such as chlorhexidine digluconate (CHX) in dental practice and oral care, the risks of potential resistance toward these antimicrobial compounds in oral bacteria have only been highlighted very recently. Since the molecular mechanisms behind antiseptic resistance or adaptation are not entirely clear and the bacterial stress response has not been investigated systematically so far, the aim of the present study was to investigate the transcriptomic stress response in Streptococcus mutans after treatment with CHX using RNA sequencing (RNA-seq). Planktonic cultures of stationary-phase S. mutans were treated with a sublethal dose of CHX (125 µg/mL) for 5 min. After treatment, RNA was extracted, and RNA-seq was performed on an Illumina NextSeq 500. Differentially expressed genes were analyzed and validated by qRT-PCR. Analysis of differential gene expression following pathway analysis revealed a considerable number of genes and pathways significantly up- or downregulated in S. mutans after sublethal treatment with CHX. In summary, the expression of 404 genes was upregulated, and that of 271 genes was downregulated after sublethal CHX treatment. Analysis of differentially expressed genes and significantly regulated pathways showed regulation of genes involved in purine nucleotide synthesis, biofilm formation, transport systems and stress responses. In conclusion, the results show a transcriptomic stress response in S. mutans upon exposure to CHX and offer insight into potential mechanisms that may result in development of resistances.
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Garcia-Sanchez A, Peña-Cardelles JF, Salgado-Peralvo AO, Robles F, Ordonez-Fernandez E, Ruiz S, Végh D. Virucidal Activity of Different Mouthwashes against the Salivary Load of SARS-CoV-2: A Narrative Review. Healthcare (Basel) 2022; 10:healthcare10030469. [PMID: 35326947 PMCID: PMC8956107 DOI: 10.3390/healthcare10030469] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/25/2022] [Accepted: 03/01/2022] [Indexed: 12/16/2022] Open
Abstract
The saliva of COVID-19-confirmed patients presents a high viral load of the virus. Aerosols generated during medical and dental procedures can transport the virus and are a possible causative agent of cross-infection. Since the onset of the pandemic, numerous investigations have been attempting to mitigate the risk of transmission by reducing the viral load in saliva using preprocedural mouthwashes. This study aims to review the most up-to-date in vitro and in vivo studies investigating the efficacy of different mouthwashes on reducing the salivary viral load of SARS-CoV-2, giving particular attention to the most recent randomized control trials published.
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Affiliation(s)
- Alvaro Garcia-Sanchez
- Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA
- Correspondence: (A.G.-S.); (J.-F.P.-C.)
| | - Juan-Francisco Peña-Cardelles
- Department of Health Sciences, Rey Juan Carlos University, 28040 Madrid, Spain
- Oral and Maxillofacial Surgery Department, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA
- Department of Prosthodontics, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA
- Correspondence: (A.G.-S.); (J.-F.P.-C.)
| | | | - Flor Robles
- Division of General Dentistry, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA; (F.R.); (E.O.-F.); (S.R.)
| | - Esther Ordonez-Fernandez
- Division of General Dentistry, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA; (F.R.); (E.O.-F.); (S.R.)
| | - Steve Ruiz
- Division of General Dentistry, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA; (F.R.); (E.O.-F.); (S.R.)
| | - Dániel Végh
- Department of Prosthodontics, Semmelweis University, 1085 Budapest, Hungary;
- Department of Dentistry and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, 8010 Graz, Austria
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Garcia-Sanchez A, Peña-Cardelles JF, Ordonez-Fernandez E, Montero-Alonso M, Kewalramani N, Salgado-Peralvo AO, Végh D, Gargano A, Parra G, Guerra-Guajardo LI, Kozuma W. Povidone-Iodine as a Pre-Procedural Mouthwash to Reduce the Salivary Viral Load of SARS-CoV-2: A Systematic Review of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2877. [PMID: 35270569 PMCID: PMC8909935 DOI: 10.3390/ijerph19052877] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/25/2022] [Accepted: 02/27/2022] [Indexed: 12/13/2022]
Abstract
The use of pre-procedural rinses has been investigated to reduce the number of viral particles and bacteria in aerosols, potentially decreasing the risk of cross-infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during medical and dental procedures. This review aims to confirm whether there is evidence in the literature describing a reduction in salivary load of SARS-CoV-2 when povidone-iodine (PVP-I) is used as a pre-intervention mouthwash. An search of the MEDLINE, Embase, SCOPUS, and the Cochrane library databases was conducted. The criteria used followed the PRISMA® Statement guidelines. Randomized controlled trials investigating the reduction of salivary load of SARS-CoV-2 using PVP-I were included. Ultimately, four articles were included that met the established criteria. According to the current evidence, PVP-I is effective against SARS-CoV-2 in saliva and could be implemented as a rinse before interventions to decrease the risk of cross-infection in healthcare settings.
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Affiliation(s)
- Alvaro Garcia-Sanchez
- Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA
| | - Juan-Francisco Peña-Cardelles
- Department of Health Sciences, Rey Juan Carlos University, 28040 Madrid, Spain;
- Oral and Maxillofacial Surgery Department, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA
- Department of Prosthodontics, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA;
| | - Esther Ordonez-Fernandez
- Division of General Dentistry, Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA; (E.O.-F.); (A.G.); (G.P.); (L.-I.G.-G.)
| | | | - Naresh Kewalramani
- Department of Nursery and Stomatology, Rey Juan Carlos University, 28922 Madrid, Spain;
| | | | - Dániel Végh
- Department of Prosthodontics, Semmelweis University, 1085 Budapest, Hungary;
- Division of Oral Surgery and Orthodontics, Department of Dentistry and Oral Health, Medical University of Graz, 8010 Graz, Austria
| | - Angélica Gargano
- Division of General Dentistry, Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA; (E.O.-F.); (A.G.); (G.P.); (L.-I.G.-G.)
| | - Gabriela Parra
- Division of General Dentistry, Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA; (E.O.-F.); (A.G.); (G.P.); (L.-I.G.-G.)
| | - Lourdes-Isabela Guerra-Guajardo
- Division of General Dentistry, Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA; (E.O.-F.); (A.G.); (G.P.); (L.-I.G.-G.)
| | - Wataru Kozuma
- Department of Prosthodontics, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA;
- Department of Regenerative and Reconstructive Dental Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
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Knowledge About Biosafety Measures in Clinical Setting During the COVID-19 Pandemic: A Cross-Sectional Study With Brazilian Dental Students. Disaster Med Public Health Prep 2022; 17:e108. [PMID: 35000654 PMCID: PMC8961069 DOI: 10.1017/dmp.2022.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the knowledge of Brazilian dental students about biosafety measures that should be adopted in the clinical setting during the coronavirus disease (COVID-19) pandemic. METHODS A cross-sectional study with 1050 dental students was conducted. A semi-structured questionnaire was shared with students. Mean knowledge score on biosafety guidelines during the COVID-19 pandemic was the outcome, with a maximum of 8 scores. Explanatory variables included sociodemographic and educational characteristics, aspects related to biosafety education, actions adopted by the dental schools during the pandemic, and sources of biosafety information. Multivariate linear regression analyses were performed. RESULTS Mean knowledge score was 5.19 (1.28). Female students (β = 0.346; 95% CI: 0.154-0.539), those enrolled in the intermediate (β = 0.525; 95% CI: 0.167-0.883) or final (β = 0.569; 95% CI: 0.200-0.937) stage of course, and those who had already received theoretical-practical training in biosafety (β = 0.464; 95% CI: 0.063-0.866) presented higher mean knowledge scores. Students who did not receive guidance on aerosol control measures before the pandemic (β = -0.324; 95% CI: -0.519 to -0.130) had the lowest score. CONCLUSION Students presented a medium level of knowledge about dental biosafety measures concerning the COVID-19 pandemic. Sociodemographic characteristics and those related to the institutional profile of the participants, and access to orientation and training in biosafety, may influence their knowledge.
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Raut AW, Meshram PV, Raut RA. Coronavirus disease (COVID-19) transmission through aerosols in restorative and endodontic practice: Strategies for prevention. Ann Afr Med 2022; 21:1-7. [PMID: 35313397 PMCID: PMC9020625 DOI: 10.4103/aam.aam_67_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/12/2021] [Accepted: 09/01/2021] [Indexed: 11/04/2022] Open
Abstract
Rapid spread of coronavirus disease 2019 (COVID-19) in several countries of the world has created a state of public health emergency. COVID-19 is principally a respiratory disease, and the virus is present in respiratory secretions. Oral health-care professionals are susceptible to being infected with the disease since they work in close proximity to patient's face and oral cavity for long period of time. Restorative dentists and endodontists play a significant role in delivering "urgent" or "emergency" dental care to patients. Occupational Safety and Health Administration has categorized dentists performing aerosol-generating treatment procedures at "very high exposure risk" whereas the dentists not performing aerosol-generating procedures at "high exposure risk." Most of the restorative and endodontic treatment procedures involve generation of aerosols. Owing to the possibility of transmission of virus through aerosols, these procedures may transmit the disease to clinician or other patients. A comprehensive search of literature was conducted with the help of PubMed/MEDLINE and Scopus databases using a combination of terms, "COVID-19," "severe acute respiratory syndrome coronavirus 2," "aerosols," "restorative dentistry," and "endodontics." Along with universal precautions, some additional precautions need to be taken to prevent such transmission and cross-infection. This article reviews the research evidence about the role of aerosols in the transmission of COVID-19 and various measures which should be implemented during restorative and endodontic practice for the prevention of such transmission.
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Affiliation(s)
- Ambar W. Raut
- Department of Conservative Dentistry and Endodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
| | - Priyatama V. Meshram
- Department of Dentistry, Government Medical College and Hospital, Gondia, Maharashtra, India
| | - Radha A. Raut
- Department of Oral Medicine and Radiology, Triveni Institute of Dental Sciences, Bilaspur, Chattisgarh, India
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Shashikumar P, Nisha S, Karmakar S, Das S, Jana D, Ali N. Comparison of chlorhexidine and hydrogen peroxide as preprocedural mouthrinse during ultrasonic scaling: A triple-blinded randomized controlled clinical trial. J Pharm Bioallied Sci 2022; 14:S110-S114. [PMID: 36110637 PMCID: PMC9469440 DOI: 10.4103/jpbs.jpbs_595_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/03/2021] [Accepted: 10/06/2021] [Indexed: 11/09/2022] Open
Abstract
Background: Every year, around 2 million people suffer from hospital-acquired infections worldwide. Aerosols are produced while performing ultrasonic scaling. They are potential source of infection and cross contamination. It can result in spread of several infections including hepatitis, HIV, SARS CoV 2, etc. Preprocedural rinse before scaling is considered an effective measure to reduce the microbial load in aerosols. Materials and Methods: This study was a triple-blinded randomized controlled trial performed on 90 participants diagnosed with chronic periodontitis. Random allocation of participants into three groups, i.e., Group-1, Group-2, and Group-3, was done, wherein 0.12% chlorhexidine (CHX), 1.5% hydrogen peroxide (HP), and distilled water (DW) were used, respectively, as preprocedural mouthrinse. The participants of each group were instructed to perform mouthrinse for 60 s before the start of ultrasonic scaling sessions. Blood agar plates were kept at three locations, i.e., operator's chest area, patient's chest area, and assistant's chest area for aerosol collection after scaling. Colony-forming units (CFUs) were counted for microbiological analysis. Results: Least number of CFUs was found in the CHX group, followed by HP and DW groups. Location wise, the patient's chest area had the highest CFU count and the least was at the assistant's chest area. CFU count between the groups was statistically significant. Conclusion: Preprocedural rinse using HP can effectively be used as a method to reduce dental aerosols generated during ultrasonic scaling.
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Gasmi Benahmed A, Gasmi A, Anzar W, Arshad M, Bjørklund G. Improving safety in dental practices during the COVID-19 pandemic. HEALTH AND TECHNOLOGY 2022; 12:205-214. [PMID: 35036281 PMCID: PMC8743069 DOI: 10.1007/s12553-021-00627-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 11/18/2021] [Indexed: 01/11/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It originated from the Chinese city of Wuhan and very quickly became a challenging public health problem. On 11 March 2020, the World Health Organization termed this potentially deadly disease a pandemic due to its rapid spread in various parts of the world, giving rise to international health emergencies. This virus is transmitted from human to human in the form of respiratory droplets, and in specific circumstances, airborne transmission may occur. Additional sources of exposure for dentists include blood and infected sharps. Due to the contagious nature of COVID-19 many health care providers have also been disproportionately affected, such as physicians, dentists, nurses, and paramedical staff. Dentists and dental staff are at high risk of cross-infection due to their nature of work. Therefore, they face a dual challenge in protecting themselves and their patients from infection transmission while ensuring that patients receive urgent dental care. In this review, the authors highlight the epidemiology, modes of cross-infection, and recent data on SARS-CoV-2 related to dental practice. The primary purpose is to make dental health care providers aware of the pathophysiology of COVID-19 and to increase their preparedness and understanding of this challenge, which will aid in controlling transmission. The information collected will be useful for the dental community in providing effective patient management through evidence-based recommendations for infection control and disinfection protocols.
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Affiliation(s)
| | - Amin Gasmi
- Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, Villeurbanne, France
| | - Wajiha Anzar
- Dow University of Health Sciences, Karachi, Pakistan
| | - Mehreen Arshad
- National University of Sciences and Technology, Islamabad, Pakistan
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
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Biofilm disruption and bactericidal activity of aqueous ozone coupled with ultrasonic dental scaling. JADA FOUNDATIONAL SCIENCE 2022. [PMID: 37520742 PMCID: PMC8820975 DOI: 10.1016/j.jfscie.2021.100003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background The COVID-19 pandemic has heightened the awareness of a common hazard encountered in the dental clinic: aerosol transmission of pathogens. Treatment of sources of infection before or during dental procedures is one means of decreasing pathogen load and aerosol transmission. Methods An ultrasonic scaler supplied with aqueous ozone was used to examine the effect of its viability on planktonic cultures and biofilms formed by 2 model bacteria: Rothia mucilaginosa and Escherichia coli. Results Both organisms showed susceptibility to aqueous ozone alone (97% and 99.5% lethality, respectively). When combined with manual scaling using an ultrasonic scaler, a greater than 99% reduction in colony-forming units (CFUs)/mL could be reached with an aqueous ozone concentration of approximately 2 mg/L (R. mucilaginosa) or 0.75 mg/L (E. coli) after 5 through 6 seconds of scaling. Conclusions Aqueous ozone coupled with ultrasonic scaling exhibited a higher efficiency of microbial kill than either method used alone. Both gram-positive and gram-negative species were affected by this treatment. Studies on other oral microbiota constituents, including fungi and viruses, will provide information on the efficacy of this method on a greater biological scale. Studies to verify concomitant reduction of microbial load in dispersed aerosols in clinical settings should be completed to support practical applications of this treatment.
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Reis GEDS, Petinati MFP, Santos KMD, Gerberb JT, Deliberador TM, Souza JFD, Rebellato NLB, Scariot R. Knowledge of Dentists and Dental Undergraduates Related to COVID-19. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
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Negi B, Singh R, Goel A, Pani P, Rajguru J, Somayaji N. Coronavirus: An emerging and future challenge for dental clinicians. Natl J Maxillofac Surg 2022; 13:20-26. [PMID: 35911812 PMCID: PMC9326194 DOI: 10.4103/njms.njms_58_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/08/2020] [Accepted: 09/04/2020] [Indexed: 11/04/2022] Open
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Is hydrogen peroxide an effective mouthwash for reducing the viral load of SARS-CoV-2 in dental clinics? Saudi Dent J 2022; 34:237-242. [PMID: 35136326 PMCID: PMC8800492 DOI: 10.1016/j.sdentj.2022.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/24/2021] [Accepted: 01/24/2022] [Indexed: 02/01/2023] Open
Abstract
RT-PCR was used to detect SARS-CoV-2 in HEPA filters in a dental clinic. SARS-CoV-2 was detected in the waiting room but not in the treatment rooms. CO2 levels indicated low ventilation and risk of COVID-19 transmission. The virucidal effect of H2O2 mouth rinsing was proven.
Background Previous studies have demonstrated that SARS-CoV-2 is mainly transmitted by inhalation of aerosols and can remain viable in the air for hours. Viruses can spread in dental settings and put professionals and patients at high risk of infection due to proximity and aerosol-generating procedures, and poor air ventilation. Objectives The aim of this study was to investigate the effects of a 1% hydrogen peroxide (H2O2) mouth rinse on reducing the intraoral SARS-CoV-2 load. Methods Portable air cleaners with HEPA filters exposed for 3 months were analysed to test for virus presence in a waiting room (where patients wore a face mask but did not undergo mouth rinsing) and three treatment rooms (where patients wore no mask but carried out mouth rinsing). As CO2 is co-exhaled with aerosols containing SARS-CoV-2 by COVID-19 infected people, we also measured CO2 as a proxy of infection risk indoors. Specific primer and probe RT-PCR were applied to detect viral genomes of the SARS-CoV-2 virus in the filters. Specifically, we amplified the nucleocapsid gene (Nuclv) of SARS-CoV-2. Results CO2 levels ranged from 860 to 907 ppm, thus indicating low ventilation and the risk of COVID-19 transmission. However, we only found viral load in filters from the waiting room and not from the treatment rooms. The results revealed the efficiency of 1-minute mouth rinsing with 1% H2O2 since patients rinsed their mouths immediately after removing their mask in the treatment rooms. Conclusions Our findings suggest that dental clinics would be safer and more COVID-19 free by implementing mouth rinsing 1 min with 1% H2O2 immediately after the patients arrive at the clinic.
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Guimarães TC, Marques BBF, de Castro MV, Secco DA, Porto LCMS, Tinoco JMM, Tinoco EMB, Fletcher P, Fischer RG. Reducing the viral load of SARS‐CoV‐2 in the saliva of patients with COVID‐19. Oral Dis 2021; 28 Suppl 2:2474-2480. [DOI: 10.1111/odi.14118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Taísa Coelho Guimarães
- Department of Periodontology Dental School Rio de Janeiro State University Rio de Janeiro Brazil
| | | | - Marcelle Viana de Castro
- Histocompatibility and Cryopreservation Laboratory Rio de Janeiro State University Rio de Janeiro Brazil
| | - Daniele Angst Secco
- Histocompatibility and Cryopreservation Laboratory Rio de Janeiro State University Rio de Janeiro Brazil
| | - Luís Cristóvão Moraes Sobrino Porto
- Histocompatibility and Cryopreservation Laboratory Rio de Janeiro State University Rio de Janeiro Brazil
- Service of Clinical Pathology Piquet Carneiro Polyclinic Rio de Janeiro State University Rio de Janeiro Brazil
| | | | | | - Paul Fletcher
- Department of Periodontology Stony Brook School of Dental Medicine USA
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Kshirsagar MM, Dodamani AS, Deokar RN, Garg Y, Khobragade VR, Garg K. Impact of COVID-19 on Dentistry. Int J Clin Pediatr Dent 2021; 14:711-714. [PMID: 34934288 PMCID: PMC8645626 DOI: 10.5005/jp-journals-10005-2025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Pandemic situations always impose devastating aftereffects on communities and cause chronic damaging effects on the healthcare system. Novel coronavirus disese-2019 (COVID-19) which has originated in China (Wuhan) is nowadays an emerging threat to public health across the world. It is spreading worldwide so rapidly and has started infecting people in all possible ways. Several dental care facilities in affected countries are completely closed or have been only providing minimal treatment for emergency cases since the whole lockdown has been announced. However, in some affected countries, they are still providing regular dental treatment. This discrepancy could be because of the dearth of proper awareness, knowledge, protocol, or guidelines. How to cite this article Kshirsagar MM, Dodamani AS, Deokar RN, et al. Impact of COVID-19 on Dentistry. Int J Clin Pediatr Dent 2021;14(5):711-714.
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Affiliation(s)
- Minal M Kshirsagar
- Department of Public Health Dentistry, Nair Hospital and Dental College, Mumbai, Maharashtra, India
| | - Arun S Dodamani
- Department of Public Health Dentistry, ACPM Dental College, Dhule, Maharashtra, India
| | - Rahul N Deokar
- Department of Public Health Dentistry, SMBT Dental College and Hospital, Igatpuri, Maharashtra, India
| | - Yogesh Garg
- Department of Public Health Dentistry, Surendera Dental College and Research Institute, Sriganganagar, Rajasthan, India
| | | | - Kamal Garg
- Department of Periodontics, Surendera Dental College and Research Institute, Sriganganagar, Rajasthan, India
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Ting M, Suzuki JB. SARS-CoV-2: Overview and Its Impact on Oral Health. Biomedicines 2021; 9:biomedicines9111690. [PMID: 34829919 PMCID: PMC8615973 DOI: 10.3390/biomedicines9111690] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/10/2021] [Accepted: 11/10/2021] [Indexed: 12/23/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its virulent variants causing coronavirus disease 2019 (COVID-19) COVID-19 has spread rapidly worldwide, and is highly contagious. A comprehensive search was conducted for the most current published information about SARS-CoV-2, COVID-19, and oral health. Clinical studies, case reports, in vivo studies, and any current published evidence on SARS-CoV-2 and COVID-19 were included in this review. Survival against SARS-CoV-2 infection may be partially dependent on periodontal health, good oral hygiene, and access to dental care. Optimum oral health, maintaining good systemic health, and elimination of smoking habits may be beneficial for the prevention and management of COVID-19 infections.
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Affiliation(s)
- Miriam Ting
- Think Dental Learning Institute, Paoli, PA 19301, USA
- Correspondence: ; Tel.: +1-610-601-8898
| | - Jon B. Suzuki
- School of Medicine and School of Dentistry, University of Maryland, Baltimore, MD 20742, USA;
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Fidler A, Steyer A, Manevski D, Gašperšič R. Virus transmission by ultrasonic scaler and its prevention by antiviral agent: an in vitro study. J Periodontol 2021; 93:e116-e124. [PMID: 34730843 PMCID: PMC8661989 DOI: 10.1002/jper.21-0335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/05/2021] [Accepted: 10/25/2021] [Indexed: 11/15/2022]
Abstract
Background It is well recognized that dental procedures represent a potential way of infection transmission. With the COVID‐19 pandemic, the focus of dental procedure associated transmission has rapidly changed from bacteria to viruses. The aim was to develop an experimental setup for testing the spread of viruses by ultrasonic scaler (USS) generated dental spray and evaluate its mitigation by antiviral coolants. Methods In a virus transmission tunnel, the dental spray was generated by USS with saline coolant and suspension of Equine Arteritis Virus (EAV) delivered to the USS tip. Virus transmission by settled droplets was evaluated with adherent RK13 cell lines culture monolayer. The suspended droplets were collected by a cyclone aero‐sampler. Antiviral activity of 0.25% NaOCl and electrolyzed oxidizing water (EOW) was tested using a suspension test. Antiviral agents' transmission prevention ability was evaluated by using them as a coolant. Results In the suspension test with 0.25% NaOCl or EOW, the TCID50/mL was below the detection limit after 5 seconds. With saline coolant, the EAV‐induced cytopathic effect on RK13 cells was found up to the distance of 45 cm, with the number of infected cells decreasing with distance. By aero‐sampler, viral particles were detected in concentration ≤4.2 TCID50/mL. With both antiviral agents used as coolants, no EAV‐associated RK‐13 cell infection was found. Conclusion We managed to predictably demonstrate EAV spread by droplets because of USS action. More importantly, we managed to mitigate the spread by a simple substitution of the USS coolant with NaOCl or EOW.
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Affiliation(s)
- Aleš Fidler
- University of Ljubljana, Faculty of Medicine, Department of Endodontic and Restorative Dentistry.,University Clinical Centre Ljubljana, Department of Endodontic and Restorative Dentistry
| | - Andrej Steyer
- University of Ljubljana, Faculty of Medicine, Institute of Microbiology and Immunology
| | - Damjan Manevski
- University of Ljubljana, Faculty of Medicine, Institute for Biostatistics and Medical Informatics
| | - Rok Gašperšič
- University of Ljubljana, Faculty of Medicine, Department of Oral Medicine and Periodontology.,University Clinical Centre Ljubljana, Department of Oral Medicine and Periodontology
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Abstract
This study aimed to systematically review the literature about the virucidal efficacy of CHX in comparison to other substances used in the oral cavity. Electronic searches were performed in four databases (PubMed, Scopus, Embase, and Web of Science). Only studies that presented the following characteristics were included: (1) verified virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1), any Influenza, or any human coronavirus (HcoV); and (2) compared the virucidal efficacy of CHX with essential oils (Listerine®), quaternary ammonium compounds, povidone-iodine, hydrogen peroxide, negative control substance, and absence of therapy. Two researchers independently selected the studies, extracted data and evaluated the risk of bias. A narrative data synthesis was used. Twenty-five studies were included, of which 21 were in vitro and four were randomized clinical trials (RCT). Studies assessed the virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1) (10 studies), Influenza A (InfluA) (4 studies), human coronavirus (HCoV) (4 studies) and Severe Acute Respiratory Syndrome-Related Coronavirus (SARS-CoV-2) (11 studies). Most studies demonstrated that CHX has a positive virucidal efficacy against HSV-1 and InfluA strains. However, lower efficacy was shown to InfluA strain in comparison to povidone-iodine. Lower to none virucidal efficacy of CHX is expected for HCoV and SARS-CoV-2 strains for in vitro studies. Three RCT demonstrated that CHX was able to significantly reduce the viral load of SARS-CoV-2 for a short period. CHX may present an interesting virucidal efficacy against HSV-1 and InfluA viruses. CHX also presents transient efficacy against SARS-CoV-2 when used as a mouthwash.
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Tan KS, Chew RJJ, Allen PF, Yu VSH. Aerosol-generating dental procedures: a reappraisal of analysis methods and infection control measures. J Hosp Infect 2021; 117:81-88. [PMID: 34534601 DOI: 10.1016/j.jhin.2021.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/01/2021] [Accepted: 09/01/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Dental aerosol-generating procedures (AGPs) have been associated with risk for transmitting infectious agents. However, existing infection control monitoring studies potentially underestimate the extent of contamination, due to methodological inadequacies. These studies employed settle plate methodology which only captures droplets that land on agar plates, but not those suspended in air. Furthermore, bacterial culture was used to determine the extent of contamination, without accounting for non-bacterial sources of contamination. AIMS This study sought to bridge these gaps by establishing a monitoring protocol involving active aerosol sampling and analysis of two dental AGPs, root canal treatment (RCT) and scaling. METHODS RCT and scaling were performed with standard aerosol mitigation precautions. Aerosols generated throughout each procedure were sampled using the air sampler device, while contamination of operatory fomites and personal protective equipment was sampled using surface swabs, before and post-treatment. The amount of contamination was quantified using bacterial culture and adenosine triphosphate (ATP) assay. FINDINGS RCT generated insignificant aerosol and splatter, supporting the infection control procedures' effectiveness. Conversely, scaling significantly increased the amount of aerosol and splatter. When comparing bacterial culture and ATP assay, the magnitude of contamination obtained with ATP assay was greater, suggesting that ATP assay may have detected additional contamination of human origin and bacteria that was not recovered by the culture conditions employed. CONCLUSIONS This monitoring protocol is feasible in the dental setting and determines the extent of contamination generated during AGPs. This could be adopted in future studies to overcome the limitations of the existing literature.
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Affiliation(s)
- K S Tan
- Faculty of Dentistry, National University of Singapore, Singapore.
| | - R J J Chew
- Faculty of Dentistry, National University of Singapore, Singapore
| | - P F Allen
- Faculty of Dentistry, National University of Singapore, Singapore
| | - V S H Yu
- Faculty of Dentistry, National University of Singapore, Singapore.
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Elzein R, Abdel-Sater F, Fakhreddine S, Hanna PA, Feghali R, Hamad H, Ayoub F. In vivo evaluation of the virucidal efficacy of chlorhexidine and povidone-iodine mouthwashes against salivary SARS-CoV-2. A randomized-controlled clinical trial. J Evid Based Dent Pract 2021; 21:101584. [PMID: 34479668 PMCID: PMC8080510 DOI: 10.1016/j.jebdp.2021.101584] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/18/2021] [Accepted: 04/21/2021] [Indexed: 12/15/2022]
Abstract
Objectives The oral cavity is potentially high-risk transmitter of COVID-19. Antimicrobial mouthrinses are used in many clinical preprocedural situations for decreasing the risk of cross-contamination in the dental setting. It is important to investigate the efficacy of mouthwash solutions against salivary SARS-CoV-2 in order to reduce the exposure of the dental team during dental procedures. Aims The aim of this in vivo study was to evaluate the efficacy of 2 preprocedural mouthrinses in the reduction of salivary SARS-CoV-2 viral load and to compare the results of the mouthwashes to a control group. Materials and Methods In this randomized-controlled clinical trial, studied group comprised laboratory-confirmed COVID-19 positive patients through nasopharyngeal swabs. Participants were divided into 3 groups. For 30 s, the control group mouthrinsed with distilled water, the Chlorhexidine group mouthrinsed with 0.2% Chlorhexidine and the Povidone-iodine group gargled with 1% Povidone-iodine. Saliva samples were collected before and 5 min after mouthwash. SARS-CoV-2 rRT-PCR was then performed for each sample. Evaluation of the efficacy was based on difference in cycle threshold (Ct) value. The analysis of data was carried out using GraphPad Prism version 5 for Windows. Kristal wullis and Paired t-test were used. A probability value of less than 0.05 was regarded as statistically significant. Results Sixty-one compliant participants (36 female and 25 male) with a mean age 45.3 ± 16.7 years-old were enrolled. A significant difference was noted between the delta Ct of distilled water wash and each of the 2 solutions Chlorhexidine 0.2% (P = .0024) and 1% Povidone-iodine (P = .012). No significant difference was found between the delta Ct of patients using Chlorhexidine 0.2% and 1% Povidone-iodine solutions (P = .24). A significant mean Ct value difference (P < .0001) between the paired samples in Chlorhexidine group (n = 27) and also in Povidone-iodine group (n = 25) (P < .0001) was found. In contrast, no significant difference (P = .566) existed before and after the experiment in the control group (n = 9). Conclusion Chlorhexidine 0.2% and 1% Povidone-iodine oral solutions are effective preprocedural mouthwashes against salivary SARS-CoV-2 in dental treatments. Their use as a preventive strategy to reduce the spread of COVID-19 during dental practice should be considered.
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Affiliation(s)
- Rola Elzein
- Department of Pediatric Dentistry and Public Dental Health, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon.
| | - Fadi Abdel-Sater
- Laboratory of Cancer Biology and Cellular Immunology, Department of Biological Sciences, Faculty of Sciences, Lebanese University, Beirut, Lebanon
| | - Soha Fakhreddine
- Infectious Diseases division, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Pierre Abi Hanna
- Infectious Diseases division, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Rita Feghali
- Department of Laboratory Medicine, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Hassan Hamad
- Medical care Laboratory, Faculty of Public Health IV, Lebanese University, Zahle, Lebanon
| | - Fouad Ayoub
- Department of Forensic Odontology, Human Identification and Anthropology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
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48
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Durner J, Beikler T, Watts DC, Becker M, Draenert ME. SARS-CoV-2 and regular patient treatment - from the use of rapid antigen testing up to treatment specific precaution measures. Head Face Med 2021; 17:39. [PMID: 34481505 PMCID: PMC8417659 DOI: 10.1186/s13005-021-00289-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/24/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic poses a continued challenge for all parties involved especially for the dentist as routine operation must be resumed. Rapid Antigen Tests (RATs) are actually recommended to identify and minimize infectious risks. However, there is still no guideline on the implementation of RATs in a dental or medical setting. METHODS Based on data and an extensive literature research regarding rapid antigen testing and reflecting the recommendations given by the various professional societies a task force was formed to determine a specific testing and treatment strategy. RESULTS A comprehensive test and treatment strategy and risk analysis was developed with practical suggestions for a wide range of typical activities in dental and medical offices. The transmission of SARS-CoV-2 and its variants via aerosols and droplets as well as the difficulties to maintain the minimum distance form special challenges to the dental routine. RATs might in addition to optimal and necessary hygienic standards in combination with the use of adequate personal protection equipment be an important instrument in managing the challenges. CONCLUSIONS The present work gives recommendations for dental routine operation (dental practices, outpatient clinics) to provide the necessary dental care for the population while protecting the doctor, practice team and patient at the same time.
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Affiliation(s)
- Jürgen Durner
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Ludwig-Maximilians-University Munich, Goethestr. 70, Goethestraße 70, 80336, Munich, Germany.
- Laboratory Becker & Colleagues, Führichstr. 70, 81671, Munich, Germany.
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Martinistraße 52 (Building O58), 20246, Hamburg, Germany
| | - David C Watts
- School of Medical Sciences and Photon Science Institute, University of Manchester, Manchester, UK
| | - Marc Becker
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Ludwig-Maximilians-University Munich, Goethestr. 70, Goethestraße 70, 80336, Munich, Germany
- Laboratory Becker & Colleagues, Führichstr. 70, 81671, Munich, Germany
| | - Miriam E Draenert
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Ludwig-Maximilians-University Munich, Goethestr. 70, Goethestraße 70, 80336, Munich, Germany
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49
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Hegde MN, Parmar G, Logani A, Hegde ND, Ballal S, Krithikadatta J, Nawal R, Amalavathy K, Devadiga D, Bhat R. Dental practice management during COVID-19 times-Now and beyond. Int J Clin Pract 2021; 75:e14251. [PMID: 33887076 PMCID: PMC8250248 DOI: 10.1111/ijcp.14251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 04/16/2021] [Indexed: 12/23/2022] Open
Abstract
AIM Coronavirus disease 2019 (COVID-19) being declared a global public health emergency has become a significant challenge for all healthcare workers, including dentistry, recognised as a high-risk profession during these times. This consensus statement aims to highlight and provide guidelines necessary to be implemented for a clinical dental practice. MATERIALS AND METHODS A total of nine conservative Dentists and Endodontists and one Oral and Maxillofacial Surgeon; with four panelists from government dental colleges, one each from the North, South, East and West India and six resource persons from private colleges in South India, all of them being clinicians and administrators practicing dentistry since the inception of the pandemic, collaborated in this consensus statement. The consensus statement was developed through a symposium conducted on the topics; general dental practice during COVID-19 times, the importance of aerosols in clinical dental practice in the spread of COVID-19, effective standard operating protocols for clinical dental practice and Institutional settings with scientific evidence-based justifications, followed by a panel discussion with to devise mandatory protocols to be followed in clinical and institutional settings. The symposium was attended by 46 practitioners who participated in the deliberation. RESULTS This consensus statement provides clinicians and researchers with protocols for the dental practice, agreed upon by experts in the field. The Consensus Statement has been formulated according to the AGREE Reporting checklist for the formulation of guidelines. CONCLUSION The experts and panelists reached a Consensus on the protocols and guidelines for the safe clinical and institutional dental practice.
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Affiliation(s)
- Mithra N. Hegde
- Department of Conservative Dentistry & Endodontics, Nitte (Deemed to be University)AB Shetty Memorial Institute of Dental Sciences (ABSMIDS)MangaloreKarnatakaIndia
| | - Girish Parmar
- Department of Conservative Dentistry and EndodonticsGovernment Dental College and Hospital AhmedabadAhmedabadIndia
| | - Ajay Logani
- Department of Conservative Dentistry and EndodonticsAll India Institute of Medical SciencesNew DelhiIndia
| | - Nidarsh D. Hegde
- Department of Oral and Maxillofacial SurgeryJawaharlal Nehru Institute of Medical SciencesImphalIndia
| | - Suma Ballal
- Department of Cariology, Department of Conservative Detistry & EndodonticsSaveetha Dental College and Hospitals.ChennaiIndia
| | - Jogikalmat Krithikadatta
- Department of Cariology, Department of Conservative Detistry & EndodonticsSaveetha Dental College and Hospitals.ChennaiIndia
| | - Ruchika Nawal
- Department of Conservative Dentistry and EndodonticsMaulana Azad Dental College and HospitalNew DelhiIndia
| | - Kurunji Amalavathy
- Department of Conservative Dentistry and EndodonticsSathyabama University Dental College and HospitalChennaiIndia
| | - Darshana Devadiga
- Department of Conservative Dentistry & Endodontics, Nitte (Deemed to be University)AB Shetty Memorial Institute of Dental Sciences (ABSMIDS)MangaloreKarnatakaIndia
| | - Raksha Bhat
- Department of Conservative Dentistry & Endodontics, Nitte (Deemed to be University)AB Shetty Memorial Institute of Dental Sciences (ABSMIDS)MangaloreKarnatakaIndia
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50
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Aravind A, Nair S, Aparna TK, Thomas AJ, Oommen S, Vijayan A. Attention to COVID-19 Pandemic among Dental Experts of Kerala State, India: A Knowledge, Attitude, and Practice Study. J Pharm Bioallied Sci 2021; 13:S836-S840. [PMID: 34447211 PMCID: PMC8375809 DOI: 10.4103/jpbs.jpbs_831_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/23/2021] [Accepted: 02/01/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Dentists are the common preys for the transmission of pandemic disease because of the airborne spread via routine dental checkups. This study which is a cross-sectional one gives the idea about awareness and alertness of dentists about COVID-19 in Kerala, India. Materials and Methods: The survey comprised 25 closed-ended questions. The survey was separated into two sections. The initial segment of the poll was identified with the socio-segment qualities that were researched, while the subsequent part was worried about dental practitioners' perspectives toward the management of COVID-19 and the apparent danger of defilement in dental facilities. Results: Coronavirus management in dental clinics differs regarding adherence to the rules. An aggregate of 750 respondents finished the form, out of which 686 (91.46%) complete reactions were incorporated. The majority of the respondents concurred on inquiries regarding the knowledge, practice, and mentality of dental specialists toward the COVID-19 pandemic. Conclusion: The feedback of most dental specialists with respect to the readiness and view of disease control measures against the COVID-19 pandemic was positive. Dental facilities need to adhere more to the central and state government suggestions in alertness of their facilities or by tutoring their dental specialists and staff.
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Affiliation(s)
- A Aravind
- Assistant Professor, Department of Public Health Dentistry, Kannur Dental College, Anjarakandy, Kerala, India
| | - Samyukta Nair
- Consultant Endodontist, Sunshine Dental Specialists, Trivandrum, Kerala, India
| | - T K Aparna
- Senior Lecturer, Department of Periodontics, KMCT Dental College, Kozhikode, Kerala, India
| | - Arun Jacob Thomas
- Reader, Department of Oral Pathology and Microbiology, Noorul Islam College of Dental Science, Thiruvananthapuram, Kerala, India
| | - Sajna Oommen
- Reader, Department of Prosthodontics, Noorul Islam College of Dental Science, Thiruvananthapuram, Kerala, India
| | - Aravind Vijayan
- Assistant Professor, Department of Dentistry, Mount Zion Medical College, Pathanamthitta, Kerala, India
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