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Poleti ML, Gregório D, Bistaffa AGI, Vilhena FV, Simão ANC, Mori MTE, Stadtlober NP, Lozovoy MAB, da Silva Santos PS, Tatibana BT, Fernandes TMF. Can toothbrushing reduce the intraoral viral load of SARS-CoV-2? A pilot study with a dentifrice containing an antimicrobial phthalocyanine derivative. GMS HYGIENE AND INFECTION CONTROL 2024; 19:Doc32. [PMID: 38993377 PMCID: PMC11238404 DOI: 10.3205/dgkh000487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
The aim of this study was to assess whether toothbrushing with a dentifrice containing an antimicrobial phthalocyanine derivative (APD) can reduce the intraoral viral load of SARS-CoV-2. Twenty COVID-19-positive dentate patients aged ≥18 years were selected instructed to brush their teeth for 2 min with a dentifrice containing APD. Self-collected samples of unstimulated saliva were carried out three times: T0 (baseline), T5 (5 min after toothbrushing), and T30 (30 min after toothbrushing). The analysis of viral RNA was performed by RT-qPCR for detection of three viral genes (ORF1ab, N and S genes). Results were statistically tested using Friedman's test and pairwise comparison with Bonferroni corrections, with a significance level of 5%. There was an increase in the cycle threshold (Ct) value from T0 to T5 in 13 patients (72.2%), and from T0 to T30 in 14 patients (77.8%). In two patients (11.1%) no SARS-CoV-2 was detected at T5 and five patients (27.8%) at T30. The Ct values were statistically significantly higher (p=0.020) at T30 in comparison to T0 and T5. This pilot study suggests that toothbrushing with a dentifrice containing APD could reduce the SARS-CoV-2 viral load in the oral cavity. However, further studies are needed to confirm this possible beneficial effect against SARS-CoV-2.
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Affiliation(s)
| | - Danielle Gregório
- Postgraduate Program in Dentistry, School of Dentistry, University of North Paraná – UNOPAR/UNIDERP, Londrina, Brazil
| | | | | | - Andréa Name Colado Simão
- Research Laboratory in Applied Immunology, Department of Pathology, Clinical Analysis and Toxicology, State University of Londrina, Londrina, Brazil
| | - Mayara Tiemi Enokida Mori
- Research Laboratory in Applied Immunology, Department of Pathology, Clinical Analysis and Toxicology, State University of Londrina, Londrina, Brazil
| | - Nicole Perugini Stadtlober
- Research Laboratory in Applied Immunology, Department of Pathology, Clinical Analysis and Toxicology, State University of Londrina, Londrina, Brazil
| | - Marcell Alysson Batisti Lozovoy
- Research Laboratory in Applied Immunology, Department of Pathology, Clinical Analysis and Toxicology, State University of Londrina, Londrina, Brazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology, and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | - Thais Maria Freire Fernandes
- Postgraduate Program in Dentistry, School of Dentistry, University of North Paraná – UNOPAR/UNIDERP, Londrina, Brazil
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Vitiello F, Monterubbianesi R, Sparabombe S, Bourgeois D, Tosco V, Alshehri FA, Carrouel F, Putignano A, Orsini G. Use of over-the-counter mouthwashes as an additional measure in individual oral prophylaxis on adults with plaque-induced gingivitis: a double-blind, parallel, randomized controlled trial. BMC Oral Health 2024; 24:83. [PMID: 38229032 DOI: 10.1186/s12903-023-03779-1] [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: 09/11/2023] [Accepted: 12/14/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Plaque-induced gingivitis is a chronic inflammatory condition characterized by complete reversibility of tissue damage once the periodontal biofilm has been disorganised. The aim of this study was to evaluate the efficacy of two commercially available mouthwashes (MWs) versus a chlorhexidine (CHX) 0.12% MW in reducing gingival bleeding (GB) in adults with plaque-induced gingivitis. METHODS The present study was a double-blind, parallel, randomized controlled trial involving 6492 gingival sites (i.e. 39 subjects × 28 teeth × 6 sites/tooth) aged 18-75 years. During a 2-week period, subjects were randomized to receive MWs: a control CHX 0.12% MW (group C, 1818 sites); a MW test containing CHX 0.09% + Citrox®/P complex (group CX, 2628 sites); a MW test based on natural compounds (group P, 2016 sites). GB was assessed at the inclusion visit (T0) and after 2 weeks of MW use (T1). Analyses of GB were compared between groups and then restricted to subjects with bleeding sites between 10 and 30% (moderate gingivitis) or ≥ 30% (severe gingivitis) at T0. Pairwise comparisons were made between groups and logistic regression was used to identify correlates of GB (T1). RESULTS For total bleeding site analysis, GB reduction between T0 and T1 ranged from 23% (C), 26% (CX) and 36% (P), respectively (all p < 0.05). Multiple comparison between groups showed that group C was significantly less effective (p < 0.05) than groups CX and P. Splitting the analysis, in patients with severe gingivitis (≥ 30% bleeding sites at T0), all MWs had a positive effect on GB with a reduction at T1 of 36% (C), 33% (CX) and 42% (P), respectively. While GB reduction between T0 and T1, was significant for all groups, the comparison among groups showed no significant difference between group C and CX, whereas the improvement was significant for group P. On the other hand, in adults with moderate gingivitis (< 30% bleeding sites at T0), only CX and P had a positive effect on GB reduction at T1(9% in CX and 2% in P, respectively), although the differences between the three groups were not significant. CONCLUSION The daily use of MWs with natural components (groups P and CX) for 2 weeks should be considered positively as an adjunct to individual oral prophylaxis to reduce GB compared to the control MW containing CHX 0.12% (group C) in healthy adults with plaque-induced gingivitis. For subjects with severe gingivitis, it is advisable to first use natural MW (P) and then MW based on CHX 0.09% with natural components (CX), compared to MW with CHX 0.12% (C). For adults with moderate gingivitis, P and CX can be advisable, even if no definitive recommendations can be drawn. TRIAL REGISTRATION ACTRN12622000215729, 07/02/2022.
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Affiliation(s)
- Flavia Vitiello
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
- Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, 69008, France
| | - Riccardo Monterubbianesi
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
| | - Scilla Sparabombe
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
| | - Denis Bourgeois
- Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, 69008, France
| | - Vincenzo Tosco
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
| | - Fahad Ali Alshehri
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, 12372, Saudi Arabia
| | - Florence Carrouel
- Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, 69008, France
| | - Angelo Putignano
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
- National Institute of Health and Science of Aging (INRCA), Ancona, 60124, Italy
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy.
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Shafiee A, Jafarabady K, Moltazemi H, Amini MJ, Rafiei MA, Akhondi A, Mozhgani SH. Alkalinization Using Sodium Bicarbonate for COVID-19 Treatment: A Systematic Review and Meta-Analysis. J Evid Based Integr Med 2024; 29:2515690X241258403. [PMID: 38826036 PMCID: PMC11145993 DOI: 10.1177/2515690x241258403] [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: 05/14/2023] [Revised: 03/12/2024] [Accepted: 05/12/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND A systematic review and meta-analysis have been conducted to evaluate the efficacy of alkalinization for COVID-19 patients based on current evidence to determine the impact of alkalinization on COVID-19 outcomes. METHODS We searched MEDLINE (Pubmed), Web of Science, Cochrane Library, and Clinicaltrials.gov for studies evaluating the efficacy of alkalinization up to 30 April 2023. Based on the PRISMA 2020 statement criteria a systematic review and meta-analysis of studies were performed. RESULTS The results of our meta-analysis showed a significant reduction in mortality rate in the alkalinization group compared to controls (RR 0.73, 95% CI: 0.56-0.95; I2 = 0%). However, our subgroup analysis showed no significant improvement in RCT-only studies (RR 0.78, 95% CI: 0.59-1.05; I2 = 0%), the recovery rate was significantly higher in the alkalinization group (RR 2.13, 95% CI: 1.39-3.26; I2 = 0%), duration of recovery also has improved in alkalinization group (SMD 0.76, 95% CI: 0.33-1.18; I2 = 0%). The results of our meta-analysis showed a significant reduction in the duration of hospitalization in the alkalinization group compared to controls with very low certainty of evidence (SMD -0.66, 95% CI: -0.97 to -0.35; I2 = 36%). CONCLUSION With low certainty of evidence, alkalinization (by sodium bicarbonate) can be an efficient and safe adjuvant treatment for COVID-19 patients. Future randomized controlled trials are needed to strengthen the available evidence.
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Affiliation(s)
- Arman Shafiee
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Kyana Jafarabady
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Hassan Moltazemi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Javad Amini
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Ali Rafiei
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirhossein Akhondi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Sayed-Hamidreza Mozhgani
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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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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Zhang M, Meng N, Duo H, Yang Y, Dong Q, Gu J. Efficacy of mouthwash on reducing salivary SARS-CoV-2 viral load and clinical symptoms: a systematic review and meta-analysis. BMC Infect Dis 2023; 23:678. [PMID: 37821800 PMCID: PMC10568889 DOI: 10.1186/s12879-023-08669-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND COVID-19 has been a public health emergency of international concern (PHEIC) for a lengthy period of time. The novel coronavirus is primarily spread via aerosols at a short distance, with infected individuals releasing large amounts of aerosols when speaking and coughing. However, there is an open question regarding whether mouthwash could effectively reduce virus transmission during the COVID-19 pandemic and support the prevention of infection among medical workers. METHODS Cochrane Library, PubMed, Web of Science, and Embase databases were systematically searched from the inception of each database to January 12, 2023 for currently available randomized clinical trials (RCTs) on the effect of mouthwash on novel coronavirus load in the oral cavity in COVID-19 patients. The treatment group received mouthwash for rinsing the mouth, while the control group received a placebo or distilled water for COVID-19 patients. The primary outcomes were CT value and viral load. Odds ratios (ORs) were estimated using a random-effects model. Subgroup and sensitivity analyses were performed to minimize the bias and the impact of heterogeneity. RESULTS Thirteen RCTs were included. Seven studies reported the intervention effect of mouthwash on the CT value of novel coronavirus. The analysis results showed that the mouthwash group had a positive impact on the CT value of novel coronavirus [ SMD = 0.35, 95% CI (0.21, 0.50)] compared with the control group. In addition, subgroup analysis showed a significant positive effect of mouthwash on CT values in the treatment group compared with the control group, with chlorhexidine (CHX) [SMD = 0.33, 95% CI (0.10, 0.56)], povidone-iodine (PVP-I) [SMD = 0.61, 95% CI (0.23, 0.99)], or hydrogen peroxide (HP) [SMD = 1.04, 95% CI (0.30, 1.78)] as an ingredient of the mouthwash. Six studies reported the intervention effect of mouthwash on the viral load, 263 cases in the treatment group and 164 cases in the control group. The analysis results showed that there was no statistical difference between the mouthwash group and the control group in the viral load of novel coronavirus [SMD = -0.06, 95% CI (-0.18, 0.05)]. In the subgroup analysis by measurement time, there were statistically significant differences between the mouthwash and control groups for CT values [SMD = 0.52, 95% CI (0.31, 0.72)] and viral load [SMD = - 0.32, 95% CI (- 0.56, - 0.07)] within 30 min of gargling. CONCLUSIONS In summary, mouthwash has some efficacy in reducing the viral load of novel coronavirus, especially within 30 min after rinsing the mouth. Mouthwash containing CHX, PVP-I and HP all had significant positive effects on CT values, and PVP-I-containing mouthwash may be a promising option to control novel coronavirus infections and relieve virus-related symptoms. However, studies on the dose and frequency of use of mouthwash for infection control are still lacking, which may limit the clinical application of mouthwash. TRIAL REGISTRATION Protocol registration: The protocol was registered at PROSPERO (CRD42023401961).
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Affiliation(s)
- Mingrui Zhang
- North China University of Science and Technology, No. 21, Bohai Avenue, Caofeidian New Town, Tangshan City, 063000, Hebei, China
| | - Nan Meng
- North China University of Science and Technology, No. 21, Bohai Avenue, Caofeidian New Town, Tangshan City, 063000, Hebei, China
| | - Hong Duo
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, The Second Clinical College of Wuhan University, Wuhan, 430071, China
| | - Yuanbo Yang
- Department of Stomatology, Tangshan Workers Hospital, Tangshan, 063000, Hebei, China
| | - Qing Dong
- North China University of Science and Technology, No. 21, Bohai Avenue, Caofeidian New Town, Tangshan City, 063000, Hebei, China.
| | - Jianqi Gu
- Department of Stomatology, HeBei General Hospital, Shijiazhuang, 050000, Hebei, China.
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Uraguchi K, Mitsuhashi T, Matsumoto N, Takao S, Makihara S, Ando M, Yorifuji T. Association between handwashing and gargling education for children and prevention of respiratory tract infections: a longitudinal Japanese children population-based study. Eur J Pediatr 2023; 182:4037-4047. [PMID: 37395829 DOI: 10.1007/s00431-023-05062-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/04/2023] [Accepted: 06/08/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE A longitudinal study was conducted to examine the effects of handwashing and gargling education for children on the prevention of respiratory tract infections (RTIs) in children in Japan. METHODS The study included 38,554 children born in 2010 who were enrolled in a longitudinal study. Information on children's hygiene education regarding handwashing and gargling was collected in a survey at the age of 3.5 years. Based on parents' reports of doctors' diagnoses, airway infections and influenza events in the 12-month duration before the survey were evaluated for RTIs at the ages of 4.5 and 9 years. Poisson regression with robust variance was performed to examine the effects of hygiene education on RTIs prevention. The supplementary analysis was stratified by household income. RESULTS Children were categorized into different groups: 38% in the handwashing and gargling group, 29% in the handwashing group, 0.1% in the gargling group, and 9.7% in the no-education group. Exclusions were made for non-respondent children (23%) and those in the gargling group. Hygiene education was associated with decreased influenza at the age of 4.5 years in the handwashing (adjusted RR [aRR] = 0.8; 95% CI, 0.8-0.9) and handwashing and gargling groups (aRR = 0.8; 95% CI, 0.8-0.9) compared with no education. However, no preventive effects on airway infections at the age of 4.5 and 9, influenza at the age of 9, or hospitalization between the ages of 3.5 and 9 years were detected. Handwashing and gargling could significantly prevent influenza in low-income households (aRR = 0.7; 95% CI, 0.6-0.8). Conclusions: Gargling education was widespread and mostly combined with handwashing education in Japan. Hygiene education significantly affected prevention of influenza infections at the age of 4.5 years, especially in low-income households. WHAT IS KNOWN • Previous intervention studies showed handwashing and gargling are effective in preventing respiratory tract infections. WHAT IS NEW • We conducted a longitudinal study on handwashing and gargling education in Japanese children and found that handwashing and gargling were widely practiced together. • Handwashing and gargling education were related to a reduction in influenza, particularly in low-income households.
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Affiliation(s)
- Kensuke Uraguchi
- Department of Epidemiology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan.
- Department of Otolaryngology-Head and Neck Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.
| | - Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Naomi Matsumoto
- Department of Epidemiology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
| | - Soshi Takao
- Department of Epidemiology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
| | - Seiichiro Makihara
- Department of Otolaryngology-Head and Neck Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Mizuo Ando
- Department of Otolaryngology-Head and Neck Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Takashi Yorifuji
- Department of Epidemiology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
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Lin SY, Sun JS, Hung MC, Chang JZC. Effectiveness of mouth rinses against COVID-19: a systematic review and network meta-analysis. J Hosp Infect 2023; 139:175-191. [PMID: 37419189 DOI: 10.1016/j.jhin.2023.06.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/21/2023] [Accepted: 06/25/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVE This systematic review and network meta-analysis (NMA) comprehensively compared the effectiveness of different mouth rinses in reducing the viral load/infectivity of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) (Part I), alleviating clinical symptoms or severity of disease (Part II), and decreasing the incidence of SARS-CoV-2 infection (Part III). METHODS Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) with restrictions were searched up to 3rd March 2023. Twenty-three studies (22 RCTs and one NRCT) met the inclusion criteria for this systematic review. RESULTS Five RCTs (454 patients and nine interventions) in Part I were eligible for NMA. The NMA results showed that, in comparison with no rinse, sodium chloride (NaCl) was the most effective mouth rinse for reducing the viral load, followed by povidone-iodine (PVP-I), ß-cyclodextrin + citrox (CDCM), hydrogen peroxide (HP), chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), placebo and hypochlorous acid (HClO). However, these results were not significant. Based on surface under the cumulative ranking curve scores, PVP-I was likely to be the most efficacious mouth rinse for reducing SARS-CoV-2 viral load, followed by CDCM, HP, NaCl, CHX, CPC, placebo, no rinse and HClO. CONCLUSION Due to heterogeneity of the primary studies, the effectiveness of different mouth rinses to reduce viral infectivity, improve clinical symptoms or prevent SARS-CoV-2 infection remains inconclusive.
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Affiliation(s)
- S-Y Lin
- Department of Dentistry, MacKay Memorial Hospital, Taipei, Taiwan
| | - J-S Sun
- Department of Orthopaedic Surgery, College of Medicine, China Medical University, Taichung, Taiwan; Department of Orthopaedic Surgery, En Chu Kong Hospital, New Taipei City, Taiwan
| | - M-C Hung
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - J Z-C Chang
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Braga SS. Cyclodextrins as Multi-Functional Ingredients in Dentistry. Pharmaceutics 2023; 15:2251. [PMID: 37765220 PMCID: PMC10534413 DOI: 10.3390/pharmaceutics15092251] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Cyclodextrins are present in a variety of oral hygiene compositions. The present work describes the role of cyclodextrins in several toothpastes and mouthwashes that are already available in the market, as well as their prospective use in other applications as investigated in studies in the literature. Moreover, cyclodextrins are under study for the development of materials used in various techniques of dental repair, such as fillings, cements and binders therein. Their role in each of the innovative materials is presented. Finally, the prospect of the use of cyclodextrin-based delivery systems for the oral cavity is introduced, with a focus on new cyclodextrin molecules with dual action as bone-targeting agents and osteogenic drugs, and on new cross-linked cyclodextrin particles with a high drug loading and sustained drug delivery profile for the treatment of diseases that require prolonged action, such as periodontitis. In conclusion, cyclodextrins are herein demonstrated to act as versatile and multi-action ingredients with a broad range of applications in dentistry.
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Affiliation(s)
- Susana Santos Braga
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
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Ebrahimi T, Shamshiri AR, Alebouyeh M, Mohebbi SZ. Effectiveness of mouthwashes on reducing SARS-CoV-2 viral load in oral cavity: a systematic review and meta-analysis. BMC Oral Health 2023; 23:443. [PMID: 37400836 PMCID: PMC10318743 DOI: 10.1186/s12903-023-03126-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 06/10/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND The risk of SARS-COV-2 transmission is relatively high during dental procedures. A study was conducted to investigate the effects of mouthwashes on SARS-COV-2 viral load reduction in the oral cavity. METHODS A systematic search was performed in PubMed, EMBASE, Scopus, Web of Science, and Cochrane library for relevant studies up to 20 July, 2022. Randomized and non-randomized clinical trial and quasi-experimental studies evaluating patients with Covid-19 infection (patients) who used mouthwashes (intervention) compared to the same patients before using the mouthwash (comparison) for reducing the SARS-COV-2 load or increasing the cycle threshold (Ct) value (outcome) were searched according to PICO components. Three independent reviewers conducted literature screening and data extraction. The Modified Downs and Black checklist was used for quality assessment. A meta-analysis was performed with a random effects model in the Revman 5.4.1software using the mean difference (MD) of cycle threshold (Ct) values. RESULTS Of 1653 articles, 9 with a high methodological quality were included. A meta-analysis indicated that 1% Povidone-iodine (PVP-I) was an effective mouthwash for reducing the SARS-COV-2 viral load [MD 3.61 (95% confidence interval 1.03, 6.19)]. Cetylpyridinium chloride (CPC) [MD 0.61 (95% confidence interval -1.03, 2.25)] and Chlorhexidine gluconate (CHX) [MD -0.04 95% confidence interval (-1.20, 1.12)] were not effective against SARS-COV-2. CONCLUSION Using mouthwashes containing PVP-I may be recommended for reducing the SARS-COV-2 viral load in the oral cavity of patients before and during dental procedures, while the evidence is not sufficient for such effects for CPC and CHX-containing mouthwashes.
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Affiliation(s)
- Tayebe Ebrahimi
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Shamshiri
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Alebouyeh
- Pediatric Infections Research Centre, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Simin Z Mohebbi
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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10
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Riveira-Muñoz E, Garcia-Vidal E, Bañó-Polo M, León R, Blanc V, Clotet B, Ballana E. Cetylpyridinium Chloride-Containing Mouthwashes Show Virucidal Activity against Herpes Simplex Virus Type 1. Viruses 2023; 15:1433. [PMID: 37515121 PMCID: PMC10383790 DOI: 10.3390/v15071433] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023] Open
Abstract
The oral cavity is particularly susceptible to viral infections that are self-recovering in most cases. However, complications may appear in severe cases and/or immunocompromised subjects. Cetylpyridinium chloride (CPC)-containing mouthwashes are able to decrease the infectivity of the SARS-CoV-2 virus by disrupting the integrity of the viral envelope. Here, we show that CPC, as the active ingredient contained in commercialized, exerts significant antiviral activity against enveloped viruses, such as HSV-1, but not against non-enveloped viruses, such as HPV. CPC-containing mouthwashes have been used as antiseptics for decades, and thus, they can represent a cost-effective measure to limit infection and spread of enveloped viruses infecting the oral cavity, aiding in reducing viral transmission.
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Affiliation(s)
- Eva Riveira-Muñoz
- IrsiCaixa AIDS Research Institute, Health Research Institute Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
| | - Edurne Garcia-Vidal
- IrsiCaixa AIDS Research Institute, Health Research Institute Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
| | - Manuel Bañó-Polo
- Department of Microbiology, Dentaid Research Center, 08290 Cerdanyola del Vallès, Spain
| | - Rubén León
- Department of Microbiology, Dentaid Research Center, 08290 Cerdanyola del Vallès, Spain
| | - Vanessa Blanc
- Department of Microbiology, Dentaid Research Center, 08290 Cerdanyola del Vallès, Spain
| | - Bonaventura Clotet
- IrsiCaixa AIDS Research Institute, Health Research Institute Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
| | - Ester Ballana
- IrsiCaixa AIDS Research Institute, Health Research Institute Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
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11
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Tarim EA, Oksuz C, Karakuzu B, Appak O, Sayiner AA, Tekin HC. Electromechanical RT-LAMP device for portable SARS-CoV-2 detection. Talanta 2023; 254:124190. [PMID: 36521325 PMCID: PMC9733968 DOI: 10.1016/j.talanta.2022.124190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
Rapid point-of-care tests for infectious diseases are essential, especially in pandemic conditions. We have developed a point-of-care electromechanical device to detect SARS-CoV-2 viral RNA using the reverse-transcription loop-mediated isothermal amplification (RT-LAMP) principle. The developed device can detect SARS-CoV-2 viral RNA down to 103 copies/mL and from a low amount of sample volumes (2 μL) in less than an hour of standalone operation without the need for professional labor and equipment. Integrated Peltier elements in the device keep the sample at a constant temperature, and an integrated camera allows automated monitoring of LAMP reaction in a stirring sample by using colorimetric analysis of unfocused sample images in the hue/saturation/value color space. This palm-fitting, portable and low-cost device does not require a fully focused sample image for analysis, and the operation could be stopped automatically through image analysis when the positive test results are obtained. Hence, viral infections can be detected with the portable device produced without the need for long, expensive, and labor-intensive tests and equipment, which can make the viral tests disseminated at the point-of-care.
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Affiliation(s)
- E. Alperay Tarim
- Department of Bioengineering, Izmir Institute of Technology, Izmir 35430, Turkey
| | - Cemre Oksuz
- Department of Bioengineering, Izmir Institute of Technology, Izmir 35430, Turkey
| | - Betul Karakuzu
- Department of Bioengineering, Izmir Institute of Technology, Izmir 35430, Turkey
| | - Ozgur Appak
- Department of Medical Microbiology, Dokuz Eylul University, Faculty of Medicine, Izmir 35330, Turkey
| | - Ayca Arzu Sayiner
- Department of Medical Microbiology, Dokuz Eylul University, Faculty of Medicine, Izmir 35330, Turkey
| | - H. Cumhur Tekin
- Department of Bioengineering, Izmir Institute of Technology, Izmir 35430, Turkey,METU MEMS Center, Ankara 06520, Turkey,Corresponding author. Department of Bioengineering, Izmir Institute of Technology, Izmir 35430, Turkey
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12
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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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13
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Buonavoglia A, Camero M, Lanave G, Catella C, Trombetta CM, Gandolfi MG, Palazzo G, Martella V, Prati C. Virucidal activity in vitro of mouthwashes against a feline coronavirus type II. Oral Dis 2022; 28 Suppl 2:2492-2499. [PMID: 34739171 PMCID: PMC9788155 DOI: 10.1111/odi.14067] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/12/2021] [Accepted: 11/01/2021] [Indexed: 12/30/2022]
Abstract
Transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can occur through saliva and aerosol droplets deriving from the upper aerodigestive tract during coughing, sneezing, talking, and even during oral inspection or dental procedures. The aim of this study was to assess in vitro virucidal activity of commercial and experimental mouthwashes against a feline coronavirus (FCoV) strain. Commercial and experimental (commercial-based products with addition of either sodium dodecyl sulfate (SDS) or thymus vulgaris essential oil (TEO) at different concentrations) mouthwashes were placed in contact with FCoV for different time intervals, that is, 30 s (T30), 60 s (T60), and 180 s (T180); subsequently, the virus was titrated on Crandell Reese Feline Kidney cells. An SDS-based commercial mouthwash reduced the viral load by 5 log10 tissue culture infectious dose (TCID)50 /50 µl at T30 while a cetylpyridinium (CPC)-based commercial mouthwash was able to reduce the viral titer of 4.75 log10 at T60. Furthermore, five experimental mouthwashes supplemented with SDS reduced the viral titer by 4.75-5 log10 according to a dose- (up to 4 mM) and time-dependent fashion.
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Affiliation(s)
- Alessio Buonavoglia
- Dental SchoolDepartment of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - Michele Camero
- Department of Veterinary MedicineUniversity of BariValenzanoItaly
| | - Gianvito Lanave
- Department of Veterinary MedicineUniversity of BariValenzanoItaly
| | | | | | - Maria Giovanna Gandolfi
- Dental SchoolDepartment of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - Gerardo Palazzo
- Department of Chemistry, and CSGI (Center for Colloid and Surface Science)University of BariBariItaly
| | - Vito Martella
- Department of Veterinary MedicineUniversity of BariValenzanoItaly
| | - Carlo Prati
- Dental SchoolDepartment of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
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14
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Pizarro MO, Mejia CR, Rodríguez-Díaz DR, Herrera YM, Cabrejo AB, Serna-Alarcon V. Mouthwashes and the Effect on the Viral Load of SARS-CoV-2 in Saliva: A Literature Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND: At present, several active ingredients have been investigated in mouthwashes having certain virucidal properties, which could reduce the viral load of SARS-CoV-2 to avoid contamination in medical or dental practice.
AIM: The objective of this review is to analyze the available evidence regarding mouthwashes and their effect on the salivary viral load of SARS-CoV-2.
METHODS: Records were retrieved from databases such as PubMed, Scopus, Web of Science, and Virtual Health Library up to June 21, 2022. Randomized or non-randomized clinical trials were included where saliva samples and laboratory or in vitro studies were used in the presence of saliva.
RESULTS: After a systematic selection process, 11 clinical studies that evaluated at least one mouthwash within clinical protocols and three laboratory studies that evaluated the virucidal efficacy against SARS-CoV-2 in the presence of saliva were finally included.
CONCLUSION: There are oral disinfectants with virucidal action in saliva samples, under clinical and laboratory conditions, capable of reducing the viral load of SARS-CoV-2. Cetylpyridinium chloride, chlorhexidine, and povidone-iodine present the best results so far. However, it was also possible to find active principles of recent appearance that, based on favorable exploratory results, needs further investigation on their efficacy and possible adverse events.
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15
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Cimolai N. Disinfection and decontamination in the context of SARS-CoV-2-specific data. J Med Virol 2022; 94:4654-4668. [PMID: 35758523 PMCID: PMC9350315 DOI: 10.1002/jmv.27959] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/13/2022] [Accepted: 06/24/2022] [Indexed: 11/08/2022]
Abstract
Given the high transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as witnessed early in the coronavirus disease 2019 (COVID-19) pandemic, concerns arose with the existing methods for virus disinfection and decontamination. The need for SARS-CoV-2-specific data stimulated considerable research in this regard. Overall, SARS-CoV-2 is practically and equally susceptible to approaches for disinfection and decontamination that have been previously found for other human or animal coronaviruses. The latter have included techniques utilizing temperature modulation, pH extremes, irradiation, and chemical treatments. These physicochemical methods are a necessary adjunct to other prevention strategies, given the environmental and patient surface ubiquity of the virus. Classic studies of disinfection have also allowed for extrapolation to the eradication of the virus on human mucosal surfaces by some chemical means. Despite considerable laboratory study, practical field assessments are generally lacking and need to be encouraged to confirm the correlation of interventions with viral eradication and infection prevention. Transparency in the constitution and use of any method or chemical is also essential to furthering practical applications.
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Affiliation(s)
- Nevio Cimolai
- Department of Pathology and Laboratory Medicine, Faculty of MedicineThe University of British ColumbiaVancouverBritish ColumbiaCanada
- Department of Pathology and Laboratory MedicineChildren's and Women's Health Centre of British ColumbiaVancouverBritish ColumbiaCanada
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16
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Idrees M, McGowan B, Fawzy A, Abuderman AA, Balasubramaniam R, Kujan O. Efficacy of Mouth Rinses and Nasal Spray in the Inactivation of SARS-CoV-2: A Systematic Review and Meta-Analysis of In Vitro and In Vivo Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912148. [PMID: 36231450 PMCID: PMC9566636 DOI: 10.3390/ijerph191912148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 05/14/2023]
Abstract
Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is a global and evolving pandemic associated with heavy health and financial burdens. Considering the oral cavity as the major reservoir for SARS-CoV-2, a systematic review and meta-analysis were conducted to assess the efficacy of mouth rinses and nasal sprays in reducing the salivary viral load of SARS-CoV-2. All in vivo and in vitro studies that assessed the virucidal efficacy of mouth rinses and nasal sprays against SARS-CoV-2 and were published in the English language from December 2019 to April 2022 were considered for analyses. Special Medical Subject Headings terms were used to search Pubmed, Scopus, Embase Ovid, and Web of Science databases. The toxicological data reliability assessment tool (ToxRToool) was used to assess the quality of the included studies. Thirty-three studies (11 in vivo and 22 in vitro) were deemed eligible for inclusion in this analysis. Results of the pooled data showed that povidone-iodine is the most efficacious intervention in vivo in terms of reducing the SARS-CoV-2 salivary viral load, followed by chlorhexidine. The mean difference in the viral load was 86% and 72%, respectively. Similarly, povidone-iodine was associated with the highest log10 reduction value (LRV) in vitro, followed by cetylpyridinium chloride, (LRV = 2.938 (p < 0.0005) and LRV = 2.907 (p = 0.009), respectively). Povidone-iodine-based oral and nasal preparations showed favourable results in terms of reducing SARS-CoV-2 viral loads both in vivo and in vitro. Considering the limited number of patients in vivo, further studies among larger cohorts are recommended.
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Affiliation(s)
- Majdy Idrees
- UWA Dental School, The University of Western Australia, Nedlands, WA 6009, Australia
| | | | - Amr Fawzy
- UWA Dental School, The University of Western Australia, Nedlands, WA 6009, Australia
| | | | | | - Omar Kujan
- UWA Dental School, The University of Western Australia, Nedlands, WA 6009, Australia
- Correspondence:
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17
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Kramer A, Eggers M, Exner M, Hübner NO, Simon A, Steinmann E, Walger P, Zwicker P. Recommendation of the German Society of Hospital Hygiene (DGKH): Prevention of COVID-19 by virucidal gargling and virucidal nasal spray - updated version April 2022. GMS HYGIENE AND INFECTION CONTROL 2022; 17:Doc13. [PMID: 35909651 PMCID: PMC9285112 DOI: 10.3205/dgkh000416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The German Society of Hospital Hygiene develops guidelines, recommendations and standard operation procedures on a voluntary basis, published on the DGKH-website (https://www.krankenhaushygiene.de/). The original German version of this recommendation was published in April 2022 and has now been made available to the international professional public in English. Evaluating the current data on the efficacy of virucidal gargle/mouthwash solutions and nasal sprays against SARS-CoV-2 in vitro and in clinical trials, conducted with preventive or therapeutic objectives, recommendations are given for the prevention of COVID-19. The following areas are considered: Protection of the community when regional clusters or high incidences of infection become knownProtection of the community at low risk of infectionPre-exposure prophylaxis for the protection of healthcare workersPost-exposure prophylaxis.
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Affiliation(s)
- Axel Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany,German Society of Hospital Hygiene, Berlin, Germany,*To whom correspondence should be addressed: Axel Kramer, , E-mail:
| | - Maren Eggers
- Labor Prof. Gisela Enders MVZ GbR, Stuttgart, Germany
| | - Martin Exner
- German Society of Hospital Hygiene, Berlin, Germany,Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Nils-Olaf Hübner
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany,German Society of Hospital Hygiene, Berlin, Germany,Central Unit for Infection Prevention and Control, University Medicine Greifswald, Greifswald, Germany
| | - Arne Simon
- Pediatric Oncology and Hematology, Children’s Hospital Medical Center, Saarland University Hospital, Homburg/Saar, Germany
| | - Eike Steinmann
- Institute of Hygiene and Microbiology, Department for Molecular & Medical Virology, Ruhr-University Bochum, Bochum, Germany
| | - Peter Walger
- German Society of Hospital Hygiene, Berlin, Germany,Bonn, Germany
| | - Paula Zwicker
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany,Section Clinical Antisepsis of the German Society of Hospital Hygiene, Berlin, Germany
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18
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Orcina BDF, Pietro ECIN, Kuroda JPG, Alves LMDC, Zangrando MSR, Oliveira RCD, Simão ANC, Vilhena FV, Santos PSDS. Oral Antiseptic Spray Containing Phthalocyanine Solution Reduced Saliva SARS-CoV-2 Viral Load: Case Series. Int Arch Otorhinolaryngol 2022; 26:e293-e295. [PMID: 35846829 PMCID: PMC9282974 DOI: 10.1055/s-0042-1750202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Bernardo da Fonseca Orcina
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru da Universidade deSão Paulo, São Paulo, SP, Brazil
| | | | | | | | | | - Rodrigo Cardoso de Oliveira
- Department of Oral Biology, Faculdade de Odontologia de Bauru da Universidade de São Paulo, Bauru, SP, Brazil
| | | | | | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru da Universidade deSão Paulo, São Paulo, SP, Brazil
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19
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Alemany A, Perez-Zsolt D, Raïch-Regué D, Muñoz-Basagoiti J, Ouchi D, Laporte-Villar C, Baro B, Henríquez N, Prat N, Gianinetto MO, Gutiérrez MV, Sánchez-Paniagua MG, Henríquez NL, Vicente JM, Ara J, Rodriguez-Arias MA, Puig J, Blanco I, Lopez CC, Hernández Á, Bordoy AE, Redondo CE, Soler VG, Giménez M, Blanc V, León R, Gispert J, Clotet B, Izquierdo-Useros N, Mitjà O. Cetylpyridinium Chloride Mouthwash to Reduce Shedding of Infectious SARS-CoV-2: A Double-Blind Randomized Clinical Trial. J Dent Res 2022; 101:1450-1456. [PMID: 35727681 DOI: 10.1177/00220345221102310] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via respiratory fluids and droplets suggests that mouthwashes containing substances with virucidal activity can help reduce viral spread. We conducted a multicenter, double-blind, placebo-controlled, randomized trial to assess the virucidal activity of cetylpyridinium chloride (CPC) mouthwashes. Outpatients who tested positive for SARS-CoV-2 infection with or without symptoms were randomized to perform washes and gargles for 1 min with 15 mL of either colored distilled water or 0.07% CPC (Vitis CPC Protect) mouthwash. The study outcomes were the SARS-CoV-2 log10 viral RNA load and the nucleocapsid protein levels, both in saliva at 1 and 3 h after the intervention. In total, 118 patients were enrolled and randomized (mean [SD], age 46 [14] y). Thirteen of 118 participants (11%) did not complete follow-up or had insufficient sample volume for testing and were excluded from the analysis. The assessment of the viral load showed no significant differences between groups at any of the investigated points. However, the levels of SARS-CoV-2 nucleocapsid protein of lysed viruses were significantly higher in the CPC group compared with the control group at 1 h (adjusted difference 269.3 pg/mL; 95% confidence interval [CI], 97.1-441.5) and at 3 h postintervention (561.1 pg/mL; 95% CI, 380.0-742.2). In nonhospitalized patients with asymptomatic or mild symptomatic SARS-CoV-2 infection, a 0.07% CPC mouthwash, compared to placebo, was associated with a significant increase of nucleocapsid protein levels in saliva, indicating enhanced disruption of viral particles.
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Affiliation(s)
- A Alemany
- Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.,Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Facultat de Medicina-Universitat de Barcelona, Barcelona, Spain
| | | | | | | | - D Ouchi
- Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - B Baro
- ISGlobal, Hospital Clinic Universitat de Barcelona, Barcelona, Spain
| | - N Henríquez
- Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - N Prat
- Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - M Ochoa Gianinetto
- Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - M Viaplana Gutiérrez
- Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | | | - N Larrosa Henríquez
- Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - J Moreno Vicente
- Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - J Ara
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - M A Rodriguez-Arias
- Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.,Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - J Puig
- Fight AIDS and Infectious Diseases Foundation, Badalona, Spain
| | - I Blanco
- Metropolitana Nord Laboratory, Institut Català de la Salut, Badalona, Spain
| | - C Casañ Lopez
- Microbiology Department, Clinical Laboratory Metropolitana Nord, Badalona, Barcelona, Spain
| | - Á Hernández
- Universitat Autònoma de Barcelona, Barcelona, Spain.,Microbiology Department, Clinical Laboratory Metropolitana Nord, Badalona, Barcelona, Spain
| | - A E Bordoy
- Microbiology Department, Clinical Laboratory Metropolitana Nord, Badalona, Barcelona, Spain
| | - C Esteban Redondo
- Microbiology Department, Clinical Laboratory Metropolitana Nord, Badalona, Barcelona, Spain
| | - V González Soler
- Microbiology Department, Clinical Laboratory Metropolitana Nord, Badalona, Barcelona, Spain.,Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain.,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - M Giménez
- Microbiology Department, Clinical Laboratory Metropolitana Nord, Badalona, Barcelona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - V Blanc
- DENTAID Research Center, Cerdanyola del Vallès, Spain
| | - R León
- DENTAID Research Center, Cerdanyola del Vallès, Spain
| | - J Gispert
- DENTAID Research Center, Cerdanyola del Vallès, Spain
| | | | - B Clotet
- Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.,Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,IrsiCaixa AIDS Research Institute, Badalona, Spain.,Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain
| | - N Izquierdo-Useros
- IrsiCaixa AIDS Research Institute, Badalona, Spain.,Germans Trias i Pujol Research Institute, Badalona, Spain
| | - O Mitjà
- Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.,Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain.,Lihir Medical Centre, International SOS, Lihir Island, Papua New Guinea
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20
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Mezarina Mendoza JPI, Trelles Ubillús BP, Salcedo Bolívar GT, Castañeda Palacios RDP, Herrera Lopez PSG, Padilla Rodríguez DA, Uchima Koecklin KH. ANTIVIRAL EFFECT OF MOUTHWASHES AGAINST SARS-COV-2: A SYSTEMATIC REVIEW. Saudi Dent J 2022; 34:167-193. [PMID: 35125835 PMCID: PMC8806023 DOI: 10.1016/j.sdentj.2022.01.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 01/05/2023] Open
Abstract
Objective This systematic review aimed to evaluate the antiviral effect of mouthwashes against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Material and methods An electronic search was performed on PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ProQuest, and Google Scholar, and was complemented by a manual search. Both clinical and in vitro studies that focused on the antiviral effect of mouthwashes against SARS-CoV-2 were included. Risk of bias assessment was performed only on the clinical studies using the RoB-2 and ROBINS-I tools. Results A total of 907 records were found; after initial selection by title and abstract, 33 full-text articles were selected to be evaluated for eligibility. Finally, a total of 27 studies were included for the qualitative synthesis, including 16 in vitro studies and 11 clinical trials. Antiviral effects were evaluated separately for the in vitro and clinical studies. In vitro studies included mouthwashes containing hydrogen peroxide, chlorhexidine digluconate, povidone-iodine, essential oils, cetylpyridinium chloride, and other compounds; in vivo studies included mouthwashes containing hydrogen peroxide, chlorhexidine digluconate, povidone-iodine, cetylpyridinium chloride, essential oils, chlorine dioxide, β-cyclodextrin-citrox, and sorbitol with xylitol. Povidone-iodine, cetylpyridinium chloride, and essential oils were effective in vitro, while hydrogen peroxide, chlorhexidine digluconate, povidone-iodine, cetylpyridinium chloride, β-cyclodextrin-citrox, and sorbitol with xylitol were effective in vivo. Unclear or high risk of bias was found for almost all clinical studies, and only one study presented with a low risk of bias. No further quantitative analysis was performed. Conclusion Although povidone-iodine, cetylpyridinium chloride, and essential oils may be an alternative to reduce the viral load in vitro and in vivo, more studies are needed to determine the real antiviral effect of these different mouthwashes against SARS-CoV-2. This work was not funded. The protocol was registered in PROSPERO (identification number: CRD42021236134).
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Affiliation(s)
- Jhon Paul Iakov Mezarina Mendoza
- Faculty of Dentistry, National University of San Marcos, Lima, Perú
- Corresponding author at: Faculty of Dentistry, National University of San Marcos, Av. German Amezaga No. 375 – Ciudad Universitaria, Cercado de Lima, Lima, Peru.
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21
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Ziaeefar P, Bostanghadiri N, Yousefzadeh P, Gabbay J, Shahidi Bonjar AH, Ghazizadeh Ahsaie M, Centis R, Sabeti M, Sotgiu G, Migliori GB, Nasiri MJ. The efficacy of mouthwashes in reducing SARS-CoV-2 viral loads in human saliva: A systematic review. New Microbes New Infect 2022; 49:101064. [PMID: 36530834 PMCID: PMC9743687 DOI: 10.1016/j.nmni.2022.101064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
This systematic review aimed to evaluate existing randomized controlled trials (RCT) and cohort studies on the efficacy of mouthwashes in reducing SARS-CoV-2 viral loads in human saliva. Searches with pertinent search terms were conducted in PubMed, MEDLINE, Scopus, and Web of Science databases for relevant records published up to Oct 15, 2022. Google Scholar and ProQuest were searched for grey literature. Manual searches were conducted as well for any pertinent articles. The protocol was prospectively registered at PROSPERO (CRD42022324894). Eligible studies were critically appraised for risk of bias and quality of evidence to assess the efficacy of mouthwash in reducing the SARS-CoV-2 viral load in human saliva. Eleven studies were included. The effect on viral load using various types of mouthwash was observed, including chlorhexidine (CHX), povidone-iodine (PI), cetylpyridinium chloride (CPC), hydrogen peroxide (HP), ß-cyclodextrin-citrox mouthwash (CDCM), and Hypochlorous acid (HCIO). Eight articles discussed CHX use. Five were found to be significant and three did not show any significant decrease in viral loads. Eight studies reviewed the use of PI, with five articles identifying a significant decrease in viral load, and three not showing a significant decrease in viral load. HP was reviewed in four studies, two studies identified significant viral load reductions, and two did not. CPC was reviewed in four studies, two of which identified significant viral load reductions, and two did not. CDCM was reviewed in one article which found a significant decrease in viral load reduction. Also, HCIO which was evaluated in one study indicated no significant difference in CT value. The current systematic review indicates that based on these eleven studies, mouthwashes are effective at reducing the SARS-CoV-2 viral load in human saliva. However, further studies should be performed on larger populations with different mouthwashes. The overall quality of evidence was high.
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Affiliation(s)
- Pardis Ziaeefar
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Narjes Bostanghadiri
- Department of Microbiology, School of Medicine, Iran University of Medical Science, Tehran, Iran
| | - Parsa Yousefzadeh
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Julian Gabbay
- School of Dentistry, University of California, San Francisco, USA
| | - Amir Hashem Shahidi Bonjar
- Clinician Scientist of Dental Materials and Restorative Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Ghazizadeh Ahsaie
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rosella Centis
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - Mohammad Sabeti
- School of Dentistry, University of California, San Francisco, USA,Corresponding author
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Italy
| | - Giovanni Battista Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy,Corresponding author
| | - Mohammad Javad Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran,Corresponding author
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22
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Brito-Reia VC, da Silva Bastos R, Vieira Vilhena F, Marques Honório H, Marques da Costa Alves L, Frazão P, Sérgio da Silva Santos P. Population-based virucidal phthalocyanine gargling/rinsing protocol to reduce the risk of coronavirus disease-2019: a community trial. GMS HYGIENE AND INFECTION CONTROL 2022; 17:Doc23. [PMID: 36911232 PMCID: PMC9998956 DOI: 10.3205/dgkh000426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Aim In this community trial, the objective was to evaluate the incidence of coronavirus disease-2019 (COVID-19) cases in two similar communities in three distinct phases: 1 (before the intervention), 2 (during the intervention), and 3 (after the intervention). Methods The test community received the oral antiseptic intervention (experimental), while the control community did not. The official information agency ("Statewise System for Data Analysis") provided the number of confirmed COVID-19 cases. Data were analyzed according to the three phases per epidemiological week (epi) using the R Core Team (2021) program. The relative risk and 95% confidence intervals between the cumulative incidence values of the test and control communities were calculated for each period. In the test community, a total of 995 residents over 10 years of age received two bottles containing 600 ml of mouthwash containing antiviral phthalocyanine derivative (APD). The participants were asked to gargle/rinse with of 5 mL of the mouthwash containing ADP 3 to 5 times a day, for 1 min, until the bottles were empty. Results In phases 1 and 3, the disease risk between the two communities did not differ significantly (p>0.05), while in phase 2, the disease risk was 54% lower in the test community than in the control community. Conclusion The use of the APD mouthwash protocol seems to reduce the COVID-19 incidence at the population level, and further studies are needed to confirm its protective effect under more precisely controlled conditions.
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Affiliation(s)
- Verônica Caroline Brito-Reia
- Department of Surgery, Stomatology, Pathology, and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Roosevelt da Silva Bastos
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | - Paulo Frazão
- Department Public Health School at University of São Paulo, São Paulo, Brazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology, and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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Rodríguez-Casanovas HJ, la Rosa MD, Bello-Lemus Y, Rasperini G, Acosta-Hoyos AJ. Virucidal Activity of Different Mouthwashes Using a Novel Biochemical Assay. Healthcare (Basel) 2021; 10:63. [PMID: 35052227 PMCID: PMC8775226 DOI: 10.3390/healthcare10010063] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/06/2021] [Accepted: 12/21/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Saliva of patients with COVID-19 has a high SARS-CoV-2 viral load. The risk of spreading the virus is not insignificant, and procedures for reducing viral loads in the oral cavity have been proposed. Little research to date has been performed on the effect of mouthwashes on the SARS-CoV-2 virus, and some of their mechanisms of action remain unknown. METHODS SARS-CoV-2 positive nasopharyngeal swabs measured by RT-PCR were used for virucidal activity in a 1:1 ratio, with an incubation time of 1 min. The solutions used in this study were: iodopovidone (8 mg); * D-limonene, a terpene extracted from citrus peels (0.3%); † cetylpyridinium chloride (0.1%) (CPC); ‡ chlorhexidine gluconate (10%) (CHX); § a CPC (0.12%) and CHX (0.05%) containing formula; ** a formula containing essential oils; †† a CPC containing formula (0.07%); ‡‡ a D-limonene (0.2%) and CPC (0.05%) containing formula; §§ a solution containing sodium fluoride (0.05%) and CPC (0.075%); *** a solution containing CHX (0.12%) and; ††† a CHX (0.2%) containing formula. ‡‡‡ As a control reaction, saline solution or excipient solution (water, glycerin, citric acid, colorant, sodium citrate) was used. CONCLUSION Within the limitations of this study, we can conclude that a mouthwash containing both D-limonene and CPC reduced the virucidal activity in about 6 logs (>99.999% reduction). Hence, establishing a clinical protocol for dentists is suggested, where all patients to be treated rinse pre-operatively with a mouthwash containing both D-limonene and CPC to reduce the likelihood of infection with SARS-CoV-2 for dentists. This is a relatively inexpensive way to reduce viral transmission of SARS-CoV-2 from infected individuals within the community. It is also a simple way to decrease infections from asymptomatic and pre-symptomatic patients.
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Affiliation(s)
| | - Manuel De la Rosa
- Department of Periodontics, AME University Monterrey, Monterrey 64060, Mexico;
| | - Yesit Bello-Lemus
- School of Basic and Biomedical Sciences, Universidad Simón Bolívar, Barranquilla 080002, Colombia;
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy;
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Antonio J. Acosta-Hoyos
- School of Basic and Biomedical Sciences, Universidad Simón Bolívar, Barranquilla 080002, Colombia;
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Nireeksha N, Gollapalli P, Varma SR, Hegde MN, Kumari NS. Utilizing the Potential of Antimicrobial Peptide LL-37 for Combating SARS-COV- 2 Viral Load in Saliva: an In Silico Analysis. Eur J Dent 2021; 16:478-487. [PMID: 34937110 PMCID: PMC9507610 DOI: 10.1055/s-0041-1739444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Limiting the spread of virus during the recent pandemic outbreak was a major challenge. Viral loads in saliva, nasopharyngeal and oropharyngeal swabs were the major cause for droplet transmission and aerosols. Saliva being the major contributor for the presence of viral load is the major key factor; various mouthwashes and their combination were analyzed and utilized in health care centers to hamper the spread of virus and decrease viral load. The compositions of these mouthwashes to an extent affected the viral load and thereby transmission, but there is always a scope for other protocols which may provide better results. Here we evaluated the potential of antimicrobial peptide LL-37 in decreasing the viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through an in silico work and evidence from other studies. This narrative review highlighted a brief nonsystematic methodology to include the selected articles for discussion. Accessible electronic databases (Medline, Scopus, Web of Science, SciELO, and PubMed) were used to find studies that reported the salivary viral load of SARS-CoV-2 published between December 2019 and June 2021. The following keywords were utilized for brief searching of the databases: "saliva," "viral load," and "SARS-CoV-2." Articles in English language, in vitro cell-line studies, ex vivo studies, and clinical trials explaining the viral load of SARS-CoV-2 in saliva and strategies to decrease viral load were included in this review. The search was complemented by manual searching of the reference lists of included articles and performing a citation search for any additional reviews. The antiviral potential of cationic host defense peptide LL-37 was evaluated using computational approaches providing in silico evidence. The analysis of docking studies and the display of positive interfacial hydrophobicity of LL-37 resulting in disruption of COVID-19 viral membrane elucidate the fact that LL-37 could be effective against all variants of SARS-CoV-2. Further experimental studies would be needed to confirm the binding of the receptor-binding domain with LL-37. The possibility of using it in many forms further to decrease the viral load by disrupting the viral membrane is seen.
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Affiliation(s)
- Nireeksha Nireeksha
- Department of Conservative Dentistry and Endodontics, AB Shetty Memorial Institute of Dental Sciences, NITTE (deemed to be) University, Deralakatte, Mangaluru, Karnataka, India
| | - Pavan Gollapalli
- Central Research Laboratory, K.S. Hegde Medical Academy, NITTE (deemed to be) University, Deralakatte, Mangaluru, Karnataka, India
| | - Sudhir Rama Varma
- Department of Clinical Sciences, Ajman University, Ajman, United Arab Emirates.,Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Mithra N Hegde
- Department of Conservative Dentistry and Endodontics, AB Shetty Memorial Institute of Dental Sciences, NITTE (deemed to be) University, Deralakatte, Mangaluru, Karnataka, India
| | - N Suchetha Kumari
- Department of Biochemistry, K.S. Hegde Medical Academy, NITTE (deemed to be) University, Deralakatte, Mangaluru, Karnataka, India
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25
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Vilhena FV, Orcina BDF, Reia VCB, Zangrando MR, Oliveira RCD, Santos PSDS. Importance of oral health care in times of COVID-19. EINSTEIN-SAO PAULO 2021; 19:eCE6706. [PMID: 34932758 PMCID: PMC8664280 DOI: 10.31744/einstein_journal/2021ce6706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/06/2021] [Indexed: 11/07/2022] Open
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Fraticelli L, Smentek C, Tardivo D, Masson J, Clément C, Roy S, Dussart C, Bourgeois D, Carrouel F. Characterizing the Content Related to Oral Health Education on TikTok. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13260. [PMID: 34948869 PMCID: PMC8701928 DOI: 10.3390/ijerph182413260] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 12/11/2022]
Abstract
Neglecting oral hygiene in adolescents negatively affects dental caries and periodontal diseases, in addition to social and emotional well-being. Thus, the TikTok platform (ByteDance, Beijing, China)as a social media could be a powerful channel to provide health-related information and educational content. This study aims to assess the quality of the TikTok videos corresponding to #oralhealtheducation. Sixty-nine videos were identified. Three oral health professionals (OHP), three health education professionals (HEP), and ten of TikTok's target audience watched and evaluated the videos from a qualitative questionnaire. OHP detected false or incorrect information in 11.6% (8/69) of the videos. At least two HEPs reported being unable to detect this type of content or whether the video met dental ethics standards in both the videos. Disagreement was observed among the professionals themselves. The evaluation indicated that TikTok's target audience was satisfied with the products viewed with an average score of >2.5, unlike the professionals, whose average score was <2.5 on a scale of 0 to 5. Users are advised to think critically and to consider the content of TikTok oral health videos with caution. The involvement of health professionals in the writing and validation of the videos could be an added value to positively respond to the needs of the adolescents.
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Affiliation(s)
- Laurie Fraticelli
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (L.F.); (C.S.); (J.M.); (C.C.); (S.R.); (C.D.); (D.B.)
| | - Colette Smentek
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (L.F.); (C.S.); (J.M.); (C.C.); (S.R.); (C.D.); (D.B.)
| | - Delphine Tardivo
- ADES UMR 7268, Aix-Marseille University, 13344 Marseille, France;
| | - Julien Masson
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (L.F.); (C.S.); (J.M.); (C.C.); (S.R.); (C.D.); (D.B.)
| | - Céline Clément
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (L.F.); (C.S.); (J.M.); (C.C.); (S.R.); (C.D.); (D.B.)
- “Interpsy” Laboratory, University of Lorraine, EA 4432, 54015 Nancy, France
| | - Sylvain Roy
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (L.F.); (C.S.); (J.M.); (C.C.); (S.R.); (C.D.); (D.B.)
| | - Claude Dussart
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (L.F.); (C.S.); (J.M.); (C.C.); (S.R.); (C.D.); (D.B.)
| | - Denis Bourgeois
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (L.F.); (C.S.); (J.M.); (C.C.); (S.R.); (C.D.); (D.B.)
| | - Florence Carrouel
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (L.F.); (C.S.); (J.M.); (C.C.); (S.R.); (C.D.); (D.B.)
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Silva A, Azevedo M, Sampaio-Maia B, Sousa-Pinto B. The effect of mouthwashes on SARS-CoV-2 viral load: a systematic review. J Am Dent Assoc 2021; 153:635-648.e16. [PMID: 35287944 PMCID: PMC8716175 DOI: 10.1016/j.adaj.2021.12.007] [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: 10/13/2021] [Revised: 12/17/2021] [Accepted: 12/26/2021] [Indexed: 11/30/2022]
Abstract
Background Considering that the oral cavity is a major entryway and reservoir for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the aim of the authors was to perform a systematic review of in vivo and in vitro studies to assess the effectiveness of mouthrinses on SARS-CoV-2 viral load. Types of Studies Reviewed The authors searched PubMed, Web of Science, Scopus, MedRxiv, and bioRxiv databases, including in vitro and in vivo studies assessing the virucidal effect of mouthrinses on SARS-CoV-2 or surrogates. From a total of 1,622 articles retrieved, the authors included 39 in this systematic review. Results Povidone-iodine was the most studied mouthrinse (14 in vitro and 9 in vivo studies), frequently showing significant reductions in viral load in in vitro assays. Similarly, cetylpyridinium chloride also showed good results, although it was evaluated in fewer studies. Chlorhexidine gluconate and hydrogen peroxide showed conflicting results on SARS-CoV-2 load reduction in both in vitro and in vivo studies. Practical Implications Povidone-iodine–based mouthrinses appear to be the best option as an oral prerinse in the dental context for SARS-CoV-2 viral load reduction. Although the results of primary studies are relevant, there is a need for more in vivo studies on mouthrinses, in particular, randomized controlled clinical trials, to better understand their effect on SARS-CoV-2 viral load and infection prevention.
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The effectiveness of mouthwash against SARS-CoV-2 infection: A review of scientific and clinical evidence. J Formos Med Assoc 2021; 121:879-885. [PMID: 34666923 PMCID: PMC8498745 DOI: 10.1016/j.jfma.2021.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND/PURPOSE The COVID-19 pandemic, caused by the spread of SARS-CoV-2 infection that is mainly through the airborne transmission, is a worldwide health concern. This review seeks to assess the potential effectiveness of mouthwash in reducing the oropharyngeal load of SARS-CoV-2 based on the available evidence. METHODS Articles related to mouthwash and COVID-19 in PubMed were electronically searched in July, 2021. After manually excluding articles lacking sufficient scientific evidence or validation processes, those with inaccessible online full text, those that did not test the effectiveness of mouthwash against SARS-CoV-2, and those not written in English, 17 original and 13 review articles were chosen for this review. RESULTS The eligible articles revealed that the main virucidal mechanism of mouthwash was via interactions with the viral envelope. Povidone-iodine (PVP-I), cetylpyridinium chloride (CPC), and essential oils with ethanol showed virucidal effects on SARS-CoV-2 in vitro, potentially by interfering with the viral envelope. A few clinical studies demonstrated that PVP-I, CPC, hydrogen peroxide, and chlorhexidine reduced the oropharyngeal load of SARS-CoV-2. CONCLUSION Although the available evidence is limited, mouthwash containing PVP-I or CPC shows potential for reducing the oropharyngeal load of SARS-CoV-2 and thus may present a risk-mitigation strategy for COVID-19 patients.
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Indian Herb-Derived Phytoconstituent-Based Antiviral, Antimicrobial and Antifungal Formulation: An Oral Rinse Candidate for Oral Hygiene and the Potential Prevention of COVID-19 Outbreaks. Pathogens 2021; 10:pathogens10091130. [PMID: 34578161 PMCID: PMC8467774 DOI: 10.3390/pathogens10091130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/06/2021] [Accepted: 08/10/2021] [Indexed: 01/08/2023] Open
Abstract
Outbreaks of emerging infectious diseases continue to challenge human health. Novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has triggered a global coronavirus pandemic, known as COVID-19. Multiple variants of SARS-CoV-2 virus are circulating, thus raising questions with respect to the effectiveness of different lines of treatment, such as vaccines and antiviral drugs. To find the appropriate prevention/treatment, 21 plant-based ingredients (Glycyrrhizin, Withanone, Aloe-emodin, Rhein, Emodin, Chrysophanol, Physcion, Kaempferol, Progallin A, Gallic acid, Naringin, Quercetin, Luteolin, and Apigenin) having antiviral, antibacterial and antifungal properties were identified. We pseudo-typed SARS-CoV-2 on a lentiviral vector plasmid and tested the impact of five different herbal formulations in mammalian HEK293T cells. Viral inactivation assay showed that the natural extracts in a herb-derived phytoconstituent-based formulation, BITS-003, comprising Bacopa monnieri, Glycyerrhiza glabra, Asparagus racemosus-wild, and Nigella sativa had strong virucidal properties, inactivating enveloped viruses from 2log10 (or 99%) to >4log10 (or 99.99%). Moreover, bacterial and yeast cells treated with BITS-003 displayed reduced growth. Topical use of the formulation as a mouthwash/gargle could be effective in reducing symptoms of respiratory viral infections, with the potential to decrease the viral load in the buccal/oral cavity. This may inhibit the coronavirus spreading to the lungs of infected persons and at the same time may reduce the risk of viral transmission to other susceptible persons through micro-droplets originating from the oral cavity of the infected person.
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Beneficial Role of Antioxidant Secondary Metabolites from Medicinal Plants in Maintaining Oral Health. Antioxidants (Basel) 2021; 10:antiox10071061. [PMID: 34209152 PMCID: PMC8300643 DOI: 10.3390/antiox10071061] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/15/2021] [Accepted: 06/25/2021] [Indexed: 12/19/2022] Open
Abstract
Plant-derived phytochemicals have been touted as viable substitutes in a variety of diseases. All over the world, dentists have turned to natural remedies for dental cure due to the negative possessions of certain antibacterial mediators used in dentistry. Antimicrobial and other drugs are currently in use, but they show some side effects. Since ancient times, antioxidant EOs have been used for different ailments and have grown in popularity over time. Several in vitro, in vivo, and clinical trials have shown the safety and effectiveness of antioxidant essential oils (EOs) in oral health obtained from medicinal plants. The current review of literature provides a summary of secondary metabolites, more specifically EOs from 20 most commonly used medicinal plants and their applications in maintaining oral health. Dental caries and periodontal diseases are the most common and preventable global infectious diseases, with diseases of the oral cavity being considered major diseases affecting a person's health. Several clinical studies have shown a connection between oral diseases and oral microbiota. This review discusses the role of antioxidant secondary metabolites in inhibiting the growth of oral pathogens and reducing the formation of dental plaque, and as well as reducing the symptoms of oral diseases. This review article contributes a basic outline of essential oils and their healing actions.
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