Effect of aloe vera as a preprocedural rinse in reducing aerosol contamination during ultrasonic scaling

Paul, Benna; Baiju, R M; Raseena, Nafeesa Beevi; Godfrey, Periera Shibu; Shanimole, Puthenpurayil Ibrahimkutty

doi:10.4103/jisp.jisp_188_19

Cited by 14 publications

(7 citation statements)

References 25 publications

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“…Studies were published between 1992 and 2020. Approximately a quarter (6/21) were split-mouth design RCTs (21-25), 13 were full-mouth design (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40), and one did not provide details of study design (41). The vast majority were parallel-arm TCTs (19/21) and two were RCTs of cross-over design.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…Of the 21 RCTs, 18 used chlorhexidine (CHX)-containing mouth rinse as either a test (21,22,24,26,(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) or as a positive control group (27). Other agents tested were novel antiseptics (four studies) (22,23,25,36), herbal essential oils, EO (two studies) (28,37), cetylpyridinium chloride, CPC (three studies) (32,35,38), povidone iodine (two studies) (30,31), chlorine dioxide (one study) (24), aloe vera (one study) (30), and herbal extract (two studies) (34,40). Controls used were saline, sterile water, distilled water, hydro alcohol, or no rinse at all.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

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Effectiveness of Pre-procedural Mouth Rinses in Reducing Aerosol Contamination During Periodontal Prophylaxis: A Systematic Review

et al. 2021

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Background: Aerosol-producing dental procedures are of concern in the spread of infections, especially during the COVID-19 pandemic. Periodontal prophylaxis is the most common aerosol-producing procedure conducted in dental practice globally. During COVID-19, many national and international organizations advocated the use of pre-procedural mouth rinsing to prevent the spread of infections from aerosol-generating procedures in the dental setting; however, many questioned the scientific basis for such recommendations.Objective: This systematic review aimed to evaluate the effectiveness of pre-procedural rinsing when preforming periodontal prophylaxis in reducing aerosol contamination in the dental setting.Methods: A comprehensive standardized search strategy was employed, informed by a defined PICO question across four electronic databases. The review of the literature was conducted using the PRISMA framework. Agreement between assessors was determined throughout. Synthesis of study characteristics and key outcomes were conducted. Cochrane's risk-of-bias tool for randomized trials (RoB 2) was employed to assess the quality/bias among studies.Results: The initial search yielded 731 citations across the four databases; 95 potentially effective studies were identified, with 56 effective studies found. Thirty randomized control trial studies were identified, 21 with a focus on effectiveness of pre-procedural mouth rinsing, involving 984 participants (aged 18–70). Agreement between assessors was high (Kappa >0.80). Various pre-procedural mouth rinses were tested, most frequently chlorhexidine (CHX) in 18 studies. The concentrations, volume, and prescribed duration of rinsing varied among studies, hampering meta-analyses. Nonetheless, all studies identified significant reductions in bacterial contamination, as measured by colony forming units (cfu). The effectiveness of CHX over other agents was evident with more than half of the studies (7/15) reporting over a 70% reduction in bacterial contamination (cfu). There were concerns over the risk of bias in most studies (76.2%); 19.0% had a high risk of bias and 4.8% were of low risk of bias.Conclusion: There is substantial evidence to support pre-procedural mouth rinsing, such as with chlorohexidine, to effectively reduce aerosol contamination when performing periodontal prophylaxis compared to mouth rinsing with water or not rinsing.

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Section: Characteristics Of the Studiesmentioning

confidence: 99%

Section: Characteristics Of the Studiesmentioning

confidence: 99%

Effectiveness of Pre-procedural Mouth Rinses in Reducing Aerosol Contamination During Periodontal Prophylaxis: A Systematic Review

et al. 2021

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“…This also reinforces the need to implement mandatory universal precautionary measures with effective infection control. The use of antimicrobial solutions are indicated to reduce the microbial load, as well as its spread [18,19]. Furthermore, special attention should be given to the fact that contamination is cumulative along the workday and the measure adopted by the Brazilian Health Surveillance Agency, which recommends 1.5 m of minimum distance between the equipment dental care, may not prevent contamination by the SARS-CoV-2 virus.…”

Section: Discussionmentioning

confidence: 99%

Individual biosafety barrier in dentistry: an alternative in times of covid-19. Preliminary study

Montalli

Garcez

Montalli

et al. 2020

RGO, Rev. Gaúch. Odontol.

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ABSTRACT The return to dental practice in pandemic times is a new challenge due to the generation and dispersion of droplets and aerosols that may contain the SARS-CoV-2 virus, the etiological agent of covid-19. In the last months some droplet and aerosol containment strategies have been circulating on the internet, however, until now there is no evidence in the literature to prove the effectiveness of such barriers. Thus, using a microbial dispersion model with the fast handpiece, the aim of this preliminary study was to compare the dispersion caused by the the dental drill (DD) alone or in association with an individual biosafety barrier (IDBD / DD), which consisted of a layer of PVC film combined to a layer of polypropylene mounted on a frame. The dental drill was activated for one minute having had the water from the reservoir been replaced with a suspension of Lactobacillus casei Shirota. Petri dishes containing MRS agar were positioned at 50, 100 and 150 cm from the headboard of the dental chair at different angles (90 and 0 degrees). At 50 cm, the mean (standard deviation) of L. casei Shirota for DD was 13,554.59 (493.48) CFU, while for IDBD / DD was 570.67 (60.54) CFU (p <0.0001), establishing a 96% reduction. Considering these preliminary results, the individual biosafety barrier proved effective in reducing dispersion from the dental drill in this study model, which suggests that this barrier may be a viable option to optimize biosafety in the dental environment.

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“…Shetty et al included 60 patients in their RCT and randomly assigned them to rinsing with distilled water, CHX, or tea tree oil before examining their efficacy in reducing the bacterial load in dental aerosols produced after a 10-min ultrasound scaling and found a significantly higher efficacy for CHX (20% reduction of CFU) than for tea tree oil (7% reduction) [ 56 ]. A recent study by Paul et al investigated the efficacy of a preprocedural mouthwash containing 94.5% aloe vera extract as compared to 0.2% CHX and 1% PVP-I and found similar efficacy of aloe vera and CHX, which both were significantly more effective than PVP-I [ 57 ].…”

Section: Preprocedural Mouthwashes For Infection Control: Bacteriamentioning

confidence: 99%

Preprocedural mouthwashes for infection control in dentistry—an update

et al. 2023

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Objectives Aerosols and splatter are routinely generated in dental practice and can be contaminated by potentially harmful bacteria or viruses such as SARS-CoV-2. Therefore, preprocedural mouthwashes containing antiseptic agents have been proposed as a potential measure for infection control in dental practice. This review article aims to summarize the clinical (and, if insufficient, preclinical) evidence on preprocedural mouthwashes containing antiseptic agents and to draw conclusions for dental practitioners. Methods Literature on preprocedural mouthwashes for reduction of bacterial or viral load in dental aerosols was searched and summarized. Results Preprocedural mouthwashes, particularly those containing chlorhexidine digluconate (CHX), cetylpyridinium chloride (CPC), or essential oils (EO), can significantly reduce the bacterial load in dental aerosols. With respect to viruses such as HSV-1, there are too little clinical data to draw any clear recommendations. On the other hand, clinical data is consolidating that CPC-containing mouthwashes can temporarily reduce the intraoral viral load and infectivity in SARS-CoV-2 positive individuals. Nevertheless, potential risks and side effects due to regular antiseptic use such as ecological effects or adaptation of bacteria need to be considered. Conclusions The use of preprocedural mouthwashes containing antiseptics can be recommended according to currently available data, but further studies are needed, particularly on the effects on other viruses besides SARS-CoV-2. When selecting a specific antiseptic, the biggest data basis currently exists for CHX, CPC, EO, or combinations thereof. Clinical relevance Preprocedural mouthwashes containing antiseptics can serve as part of a bundle of measures for protection of dental personnel despite some remaining ambiguities and in view of potential risks and side effects.

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Effect of aloe vera as a preprocedural rinse in reducing aerosol contamination during ultrasonic scaling

Cited by 14 publications

References 25 publications

Effectiveness of Pre-procedural Mouth Rinses in Reducing Aerosol Contamination During Periodontal Prophylaxis: A Systematic Review

Effectiveness of Pre-procedural Mouth Rinses in Reducing Aerosol Contamination During Periodontal Prophylaxis: A Systematic Review

Individual biosafety barrier in dentistry: an alternative in times of covid-19. Preliminary study

Preprocedural mouthwashes for infection control in dentistry—an update

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