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CC BY 4.0 · European Journal of General Dentistry 2022; 11(02): 094-101
DOI: 10.1055/s-0042-1747958
Original Article

Reduction in SARS-CoV-2 Oral Viral Load with Prophylactic Mouth Rinse

Shohreh Ghasemi
1   Department of Oral and Maxillofacial Surgery, The Dental College of Georgia, Augusta University, Augusta, Georgia, USA
,
Seyed Alireza Nadji
2   Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
Ali Heidari
3   Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
,
Jeffrey N. James
1   Department of Oral and Maxillofacial Surgery, The Dental College of Georgia, Augusta University, Augusta, Georgia, USA
,
Mahboobeh Karimi-Galougahi
2   Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
Negar Raygani
4   Department of Otolaryngology, Masih Daneshvari Hospital, Tehran, Iran
,
Salman Khazaei
5   Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
,
Freshteh Mehri
3   Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
,
Ali Poormohammadi
3   Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
,
Saeid Bashirian
3   Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
,
Maryam Mehrpooya
3   Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
,
Amirfarhang Miresmaeili
3   Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
,
Farid Azizi Jalilian
3   Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
,
Samaneh Shirahmadi
3   Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
,
Fariba Keramat
3   Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
,
Alireza Soltanian
6   Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
,
Nastaran Ansari
3   Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
,
Farhad Zeynalzadeh
7   PostDoc Position at Department of Oral and Maxillofacial Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
,
Amirali Ebrahimi
2   Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
Amirreza Dashti
8   Nutrition Health Research Center, Health Sciences & Technology Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran
,
Ryan F. Bloomquist
9   Department of Restorative Sciences, The Dental College of Georgia, Augusta University, Augusta, Georgia, USA
,
Mahmood Dashti
10   Postgraduate Orthodontics Resident, Georgia School of Orthodontics, Atlanta, Georgia, USA
› Author Affiliations Funding None.
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Abstract

Objectives The medical and health facilities are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study tested the preprocedural prophylactic mouthwash rinses to reduce the oral viral load. The findings from this study will help the practitioners to select the best mouthwash for the patients to mitigate the risk of transmission during aerosolizing. This study aimed to evaluate the effectiveness of four commonly used types of mouthwash in reducing intraoral viral load among hospitalized coronavirus disease 2019 patients.

Materials and Methods This prospective cohort study was conducted with 116 patients referred to the Masih Daneshvari Hospital in Tehran, Hamadan University of Medical Sciences of Hamadan City, and Mashhad University of Medical Sciences. Patients were randomized into four groups with each group rinsed their mouth with 20 mL of 2% povidone-iodine, 1% hydrogen peroxide, normal saline as a control study group, or 0.12% chlorhexidine, respectively, for 20 seconds. The standard reverse transcription polymerase chain reaction method evaluated the virus load before and at 1 hour, 2 hours, and 4 hours after using the mentioned mouthwash.

Results Our results revealed that chlorhexidine and H2O2 showed the highest efficiency in reducing SARS-Co-2 load in the oral cavity and nasopharyngeal region of patients; they increased the Ct values by 9 to 10 (before: 25.84 vs. after 32. 4, p < 0.455) (17.333 vs. after 26.497, p <0.097).

Conclusion Our findings suggest that chlorhexidine and H2O2 could be used in dental clinics to reduce the risk of transmitting the SARS-CoV-2 virus from infected individuals to dentists before dental procedures.

Keywords

mouthwashes - viral load - COVID-19 - chlorhexidine - povidone-iodine - hydrogen peroxide

Note

The manuscript has not been submitted to more than one journal for consideration. The manuscript has not been published previously (partly or in full) unless the new work concerns an expansion of previous work; there is no transparency on the reuse of material to avoid the hint of text-recycling (“self-plagiarism”).


Ethical Approval

All procedures performed in studies involving human participants were in accordance with the institutional and/or national research committee's ethical standards and the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


Authors' Contributions

A.H., S.Kh., A.P., S.B., and R.B. designed this research. S.Kh. and A.R.S. conceived the statistical analysis plan. M.M.P., F.M., F.A.J., S.S.H., A.M., F.K., and N.A. collected the data. A.P., F.M., S.K.H. drafted the manuscript. M.D., S.G., and A.N. designed this research and expanded the study design with J.J. from Augusta University in Georgia state of United States and negotiated to collaborate with Shahid Beheshti Medical Sciences University and Hamedan Medical Sciences University. M.K., P.R. and A.E. collected the data and conceived the data analysis of all the patients in Masih Daneshvari Hospital; F.Z. collected the ten patients in Mashhad Medical Sciences University. All authors read, approved, and contributed to the manuscript preparation.




Publication History

Article published online:
21 July 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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