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Brunello G, Wolf V, Kerberger R, Bernhard M, Lübke N, Becker J, Schwarz-Herzke B, Timm J, Becker K. Eligibility and efficacy of a CPC- and CHX-based antiviral mouthwash for the elimination of SARS-CoV-2 from the saliva: A randomized, double-blind, controlled clinical trial. J Clin Periodontol 2024; 51:158-166. [PMID: 38058254 DOI: 10.1111/jcpe.13905] [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: 09/06/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 12/08/2023]
Abstract
AIM This study aimed at investigating the efficacy of a 0.05% cetylpyridinium chloride-0.05% chlorhexidine (CPC-CHX) mouthwash in reducing viral load in the saliva as compared with sterile water. MATERIALS AND METHODS Forty SARS-CoV-2 positive patients were asked to dispense 4 mL of saliva. Half the patients rinsed for 60 s with 15 mL CPC-CHX, and the remaining patients rinsed with sterile water (control). Four millilitres of saliva were collected after 15, 30 and 60 min after rinsing. Quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA) specific for SARS-CoV-2 nucleocapsid protein were performed. For ELISA, the intact (representing the active virus) to total virus load (I/T) was calculated. RESULTS SARS-CoV-2 copy numbers/mL from RT-qPCR tended to decrease in the control group, whereas in the CPC-CHX group, an increase was observed after T30. However, mixed linear model analysis revealed no statistical differences between groups (p = .124), time points (p = .616) and vaccinated or non-vaccinated patients (p = .953). Similarly, no impact of group (p = .880), time points (p = .306) and vaccination (p = .711) was observed for I/T ratio values. CONCLUSIONS Within the limitation of this study, there was no evidence that the intervention reduced salivary SARS-CoV-2 viral load during the course of 60 min. Therefore, commonly used pre-procedural rinsing might not be clinically relevant.
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Affiliation(s)
- Giulia Brunello
- Department of Oral Surgery, University Hospital Düsseldorf, Düsseldorf, Germany
- Department of Neurosciences, Dentistry Section, University of Padua, Padua, Italy
| | - Viktoria Wolf
- Department of Oral Surgery, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Robert Kerberger
- Department of Orthodontics and Dentofacial Orthopaedics, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Orthodontics, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Michael Bernhard
- Emergency Department, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Nadine Lübke
- Institute of Virology, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Jürgen Becker
- Department of Oral Surgery, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Beryl Schwarz-Herzke
- Institute for Anatomy II, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Jörg Timm
- Institute of Virology, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Kathrin Becker
- Department of Orthodontics and Dentofacial Orthopaedics, Charité-Universitätsmedizin Berlin, Berlin, Germany
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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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Vogt LC, Reske KA, Park D, Habrock Bach T, Stewart HB, Arter OG, Stoeckel D, Steinkamp HM, Liang SY, Durkin MJ, Kwon JH. Personal protective equipment use among dental healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic and the impact of an educational video in clinical practice. Infect Control Hosp Epidemiol 2023; 44:1472-1480. [PMID: 36924218 PMCID: PMC10507497 DOI: 10.1017/ice.2023.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Dental healthcare personnel (DHCP) are at high risk of exposure to coronavirus disease 2019 (COVID-19). We sought to identify how DHCP changed their use of personal protective equipment (PPE) as a result of the COVID-19 pandemic, and to pilot an educational video designed to improve knowledge of proper PPE use. DESIGN The study comprised 2 sets of semistructured qualitative interviews. SETTING The study was conducted in 8 dental clinics in a Midwestern metropolitan area. PARTICIPANTS In total, 70 DHCP participated in the first set of interviews; 63 DHCP participated in the second set of interviews. METHODS In September-November 2020 and March-October 2021, we conducted 2 sets of semistructured interviews: (1) PPE use in the dental community during COVID-19, and (2) feedback on the utility of an educational donning and doffing video. RESULTS Overall, 86% of DHCP reported having prior training. DHCP increased the use of PPE during COVID-19, specifically N95 respirators and face shields. DHCP reported real-world challenges to applying infection control methods, often resulting in PPE modification and reuse. DHCP reported double masking and sterilization methods to extend N95 respirator use. Additional challenges to PPE included shortages, comfort or discomfort, and compatibility with specialty dental equipment. DHCP found the educational video helpful and relevant to clinical practice. Fewer than half of DHCP reported exposure to a similar video. CONCLUSIONS DHCP experienced significant challenges related to PPE access and routine use in dental clinics during the COVID-19 pandemic. An educational video improved awareness and uptake of appropriate PPE use among DHCP.
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Affiliation(s)
- Lucy C. Vogt
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Kimberly A. Reske
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Daniel Park
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Tracey Habrock Bach
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Henry B. Stewart
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Olivia G. Arter
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Daniel Stoeckel
- St. Louis University Center for Advanced Dental Education, St. Louis, Missouri
- St. Louis Children’s Hospital, St. Louis, Missouri
| | - Heidi M. Steinkamp
- St. Louis University Center for Advanced Dental Education, St. Louis, Missouri
| | - Stephen Y. Liang
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Michael J. Durkin
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Jennie H. Kwon
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
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Hoseinzadeh M, Sa’adAbadi Z, Maleki Kambakhsh S, Babazadeh S. Dentists' lived experience of providing dental care during the COVID-19 pandemic: A qualitative study in Mashhad, Iran. FRONTIERS IN ORAL HEALTH 2023; 4:1095240. [PMID: 36937504 PMCID: PMC10015384 DOI: 10.3389/froh.2023.1095240] [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: 11/15/2022] [Accepted: 01/31/2023] [Indexed: 03/05/2023] Open
Abstract
Background This study aimed to explore the lived experiences of dentists practicing in Mashhad, Iran, during the COVID-19 pandemic and identify possible influencing factors for providing dental health in this era. Methods Sixteen dentists took part in this qualitative phenomenological study. Semi-structured face-to-face interviews were performed and evaluated using a qualitative content analysis approach. The MAXQDA program (2020) was used to code and classify the data. Purposive sampling, audio recording, member checking, and peer review were employed to verify transferability, reliability, and validity. The interview transcripts were transcribed, and sentences and remarks relevant to the study's goal were retrieved and classified. Results Six hundred twenty-eight codes were extracted after several readings of the texts. Five core themes and fourteen sub-themes were determined after deleting repeated themes and axial coding. The main five themes included: "Coping with the COVID-19 pandemic", "Alternations in providing dental care," "Infection control," "COVID-19-related news and information sources", and "Positive and negative aspects of COVID-19 in dental care ". Conclusions During the COVID-19 pandemic, dentists noted various challenges in delivering routine dental treatment, including a lack of resources, reliable and straightforward guidelines for dentists, and governmental policies for dental facility restrictions. Dentists concluded that financial, educational, and financial support from the government would significantly enhance the delivery of community dental care services. With the right strategies and lessons learned, dentists may be better prepared for future challenges in global health care.
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Affiliation(s)
- Melika Hoseinzadeh
- Student Research Committee, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Sara Maleki Kambakhsh
- Dental Caries Prevention Research Center, Faculty of Dentistry, Qazvin University Medical Sciences, Qazvin, Iran
| | - Saber Babazadeh
- Department of Community Oral Health, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
- Correspondence: Saber Babazadeh
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Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2022; 128:248-330. [PMID: 36096911 DOI: 10.1016/j.prosdent.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2021 dental literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to coverage of this broad topical area. Specific subject areas addressed, in order of the appearance in this report, include COVID-19 and the dental profession (new); prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence daily dental treatment decisions with an emphasis on future trends in dentistry. With the tremendous volume of dentistry and related literature being published daily, this review cannot possibly be comprehensive. Rather, its purpose is to update interested readers and provide important resource material for those interested in pursuing greater details on their own. It remains our intent to assist colleagues in negotiating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the patients and dental problems they encounter.
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The Effect of the COVID-19 Pandemic on Patient Selection, Surgical Procedures, and Postoperative Complications in a Specialized Dental Implant Clinic. J Clin Med 2022; 11:jcm11030855. [PMID: 35160306 PMCID: PMC8837166 DOI: 10.3390/jcm11030855] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/26/2022] [Accepted: 02/02/2022] [Indexed: 11/27/2022] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, aerosol-generating procedures, including dental implant treatments, are considered high-risk. With dental implant treatment mostly an elective procedure, we aimed to assess whether the pandemic influenced patient selection, surgical procedures, and postoperative complications. We compared dental implant treatments during (March to December 2020) and before (December 2018 to February 2020) the COVID-19 pandemic based on patient and implant parameters, as well as postoperative complications. For analysis, we used the Chi-squared test with the Holm–Sidak correction for multiple comparisons. The number of implants placed during the COVID-19 pandemic (696 implants in 406 patients, 70 implants per month) was comparable to pre-pandemic levels (1204 implants in 616 patients, 80 implants per month). Regarding patient parameters, there were no significant differences in respiratory (p = 0.69) and cardiovascular conditions (p = 0.06), diabetes (p = 0.69), and smoking (p = 0.68). Regarding implant parameters, there was a significant difference in the distribution of augmentative procedures (no augmentation, guided bone regeneration, and sinus floor elevation, p = 0.01), but no significant differences in the types of edentulous spaces (p = 0.19) and the timing of implant placement (p = 0.52). Regarding complications, there were significantly fewer minor complications (p < 0.001) and early (i.e., before loading) implant failures (p = 0.02) compared with pre-pandemic levels. Our results suggest that the COVID-19 pandemic had no effect on patient selection and only a slight effect on the surgical procedures. However, postoperative complications, including early failures, were significantly less prevalent during the pandemic.
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Gurzawska-Comis K, Becker K, Brunello G, Klinge B. COVID-19: Review of European recommendations and experts' opinion on dental care. Summary and consensus statements of group 5. The 6th EAO Consensus Conference 2021. Clin Oral Implants Res 2021; 32 Suppl 21:382-388. [PMID: 34196063 PMCID: PMC8444925 DOI: 10.1111/clr.13780] [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: 03/07/2021] [Accepted: 05/14/2021] [Indexed: 11/27/2022]
Abstract
Objectives The present work reports the EAO workshop group 5 and consensus plenary discussions and statements based on two reviews summarising European guidelines and experts’ opinion on infection control and prevention (ICP) in dentistry during the pandemic. Material Two manuscripts were presented at the 6th EAO Consensus Conference. The first study compared the most recent national guidelines/recommendations of European countries. The second paper was an experts’ opinion‐based survey on application of ICP regulation during the second wave. The outcome of COVID‐19 group discussion was presented to all participants of the consensus to come to an agreement about the consensus statements and clinical recommendation. Results The dynamic of the pandemic had an impact on rapidly published and frequently updated national guidelines in Europe. As guidelines were not based on solid evidence, they were supplemented by experts’ opinion on ICP in dentistry. The dental care should be guaranteed during the pandemic; however, in case of suspected or confirmed COVID‐19 disease, the treatment should be postponed if possible. Remote triage and patient‐related measures (i.e., social distancing, hand hygiene and mask wearing) were recommended to be the most efficient to reduce SARS‐CoV‐2 transmission. The type of personal protective equipment for dental staff should be adequate to the procedure and infection risk. Conclusions Adequate infection control protocols have to be followed by healthcare professionals and patients to minimise the spreading of COVID‐19. We foresee the importance of continuously updating the national dental guidelines, considering the evolution of the pandemic and new scientific evidence becoming available.
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Affiliation(s)
- Katarzyna Gurzawska-Comis
- Department of Oral Surgery, University of Birmingham, 5 Mill Pool Way, Edgbaston, Birmingham, B5 7EG, United Kingdom.,Birmingham Community Healthcare NHS Foundation Trust, Birmingham Dental Hospital, Oral Surgery Department
| | - Kathrin Becker
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Giulia Brunello
- Department of Neurosciences, Dentistry Section, University of Padova, Padova, Italy.,Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Björn Klinge
- Faculty of Odontology, Malmo University, Malmo, Sweden.,Karolinska Institutet, Department of Dental Medicine, Stockholm, Sweden
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