COVID-19: A Recommendation to Examine the Effect of Mouthrinses with β-Cyclodextrin Combined with Citrox in Preventing Infection and Progression

Abstract

Considered to be a major portal of entry for infectious agents, the oral cavity is directly associated with the evolutionary process of SARS-CoV-2 in its inhalation of ambient particles in the air and in expectorations. Some new generations of mouth rinses currently on the market have ingredients that could contribute to lower the SARS-CoV-2 viral load, and thus facilitate the fight against oral transmission. If chlorhexidine, a usual component of mouth rinse, is not efficient to kill SARS-CoV-2, the use of a mouth rinses and/or with local nasal applications that contain β-cyclodextrins combined with flavonoids agents, such as Citrox, could provide valuable adjunctive treatment to reduce the viral load of saliva and nasopharyngeal microbiota, including potential SARS-CoV-2 carriage. We urge national agencies and authorities to start clinical trials to evaluate the preventive effects of βCD-Citrox therapeutic oral biofilm rinses in reducing the viral load of the infection and possibly disease progression.

Comparison of In Vitro Inactivation of SARS CoV‐2 with Hydrogen Peroxide and Povidone‐Iodine Oral Antiseptic Rinses

“…1,2 Human modes of transmission of SARS-CoV-2 from infected individuals can occur by simple procedures such as breathing, talking, coughing or sneezing. 2,3 It has been accepted that the oral cavity including oropharynx, and the nasopharynx have the highest viral loads. [2][3][4] Adding to the risk is the nature of dental care, which involves close physical contact of dental professionals with patients, and constant exposure to saliva which is known to have a high load of oral microbes including virus.…”

“…2,3 It has been accepted that the oral cavity including oropharynx, and the nasopharynx have the highest viral loads. [2][3][4] Adding to the risk is the nature of dental care, which involves close physical contact of dental professionals with patients, and constant exposure to saliva which is known to have a high load of oral microbes including virus. [2][3][4] Therefore, any dental procedure, especially prosthodontic procedures, which can aerosolize contaminated saliva (using handpieces, air-water syringes, and ultrasonic instrumentation), has the potential to significantly increase airborne transmission of the virus.…”

“…[2][3][4] Adding to the risk is the nature of dental care, which involves close physical contact of dental professionals with patients, and constant exposure to saliva which is known to have a high load of oral microbes including virus. [2][3][4] Therefore, any dental procedure, especially prosthodontic procedures, which can aerosolize contaminated saliva (using handpieces, air-water syringes, and ultrasonic instrumentation), has the potential to significantly increase airborne transmission of the virus. [5][6][7] All of this places dental professionals at a significantly higher risk for infection, and be a source for further transmission of infection.…”

“…10,11 An additional component of protection that has recently begun to receive increased attention is the use of preprocedural oral rinses. 2,3,7,12 Due to the knowledge that the oropharyngeal region is a major site of viral replication during the early asymptomatic stages of COVID-19, it has been suggested that oral antiseptic rinses that target the lipid envelope of SARS-CoV-2, has the potential to reduce viral load in the oropharynx. 12 There is increasing recognition that oral antiseptic rinses with significant viricidal activity may have a role as potential therapeutic agents to inactivate infective particles generated in the oropharyngeal region.…”

A systematic review of etiology, epidemiology, clinical manifestations, image findings, and medication of 2019 Corona Virus Disease-19 in Wuhan, China

“…[ 5 ] The physicochemical characteristics of SARS-COV-2 have not yet been clarified, and it is generally accepted that SARS-COV-2 is sensitive to ultraviolet light and heat and can be effectively killed by lipid solvents such as diethyl ether, while chlorhexidine is with poor effects. [ 13 – 16 ] SARS-COV-2 is an RNA virus that may mutate during the occurrence and development of the disease, thereby making it more difficult for epidemic prevention and control. [ 2 , 5 , 17 – 20 ]…”