Efficacy of antiseptic mouthrinses against SARS-CoV-2: A prospective randomized placebo-controlled pilot study

Fantozzi, Paolo Junior; Pampena, Emanuele; Pierangeli, Alessandra; Oliveto, Giuseppe; Sorrentino, Leonardo; Vanna, Domenico Di; Pampena, Riccardo; Lazzaro, Alessandro; Gentilini, Elio; Mastroianni, Claudio Maria; d’Ettorre, Gabriella; Polimeni, Antonella; Romeo, Umberto; Villa, Alessandro E. P.

doi:10.1016/j.amjoto.2022.103549

Cited by 11 publications

(14 citation statements)

References 26 publications

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“…Out of these, three clinical studies were eligible for quantitative analysis [27] , [28] , [29] . The reasons for exclusion after full-text screening are reported in Table 3 [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] .…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of different mouthwashes against COVID-19: A systematic review and network meta-analysis

Sbricoli,

Schiavon,

Brunello

et al. 2023

Japanese Dental Science Review

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Section: Resultsmentioning

confidence: 99%

“… Absence of a control group (as defined in the "Materials and methods" section) 4 [37] , [38] , [39] , [65] 7. Missing details on mouthwash formulation, concentration and/or application time 10 [36] , [44] , [69] , [72] , [73] , [74] , [75] , [76] , [78] , [85] 8. Language 1 [43] 9.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of different mouthwashes against COVID-19: A systematic review and network meta-analysis

Sbricoli,

Schiavon,

Brunello

et al. 2023

Japanese Dental Science Review

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“…After full-text analysis, 36 were eliminated: 6 for not being a randomized trial [ 44 , 45 , 46 , 47 ], 3 for being an in vitro study [ 48 , 49 , 50 ], 17 for not having quantitative data of viral load [ 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ], 3 for not being in the oral cavity [ 68 , 69 , 70 ], 5 for not being a mouth rinse [ 71 , 72 , 73 , 74 , 75 ], and 2 for being a summary protocol [ 76 , 77 ]. Finally, 14 articles were selected for data extraction [ 12 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ].…”

Section: Resultsmentioning

confidence: 99%

Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review

Ting,

Dahlkemper,

Schwartz

et al. 2023

Biomedicines

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(1) There are limited clinical trials to support the effectiveness of mouth rinses when used as a preprocedural rinse against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This systematic review aims to evaluate the efficacy of antiseptic mouth rinses as a preprocedural rinse in reducing SARS-CoV-2 oral viral load in-vivo. (2) Methods: A literature search was conducted through November 2022 for the following databases: PubMed, Web of Science, Cochrane Library, and Google Scholar. The evaluated outcomes were quantitative changes in viral load and the statistical significance of that change after using antiseptic mouth rinses. (3) Results: 14 randomized controlled trials (RCT) were selected for risk of bias assessment and data extraction. (4) Conclusion: Within the limits of this systematic review, preprocedural mouth rinses may significantly reduce SARS-CoV-2 in the mouth, thus, reducing the viral particles available for airborne dispersion. Preprocedural mouth rinses may be an effective strategy for reducing airborne SARS-CoV-2 dispersion in the environment. Their use may be a preventive strategy to reduce the spread of COVID-19 in selected medical and healthcare facilities, including dental clinics. Potential preprocedural mouth rinses are identified for use as an integral part of safe practice for healthcare protocols. This systematic review was registered with the National Institute for Health Research, international prospective register of systematic reviews (PROSPERO): CRD42022315177.

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“…Additionally, sampling methods might also affect the effects of mouthwashes. Previous studies have indicated that supervised saliva collection may reduce variability between samples [ 47 , 48 ]. Other studies also suggest that viral load is higher with throat gargle samples than with nasopharyngeal or oropharyngeal swabs [ 49 , 50 ], and that saline mouth and throat gargle methods are more sensitive than saliva sampling [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

Oral mouthwashes for asymptomatic to mildly symptomatic adults with COVID-19 and salivary viral load: a randomized, placebo-controlled, open-label clinical trial

Onozuka,

Takatera,

Matsuo

et al. 2024

BMC Oral Health

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Background Recent randomized clinical trials suggest that the effect of using cetylpyridinium chloride (CPC) mouthwashes on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load in COVID-19 patients has been inconsistent. Additionally, no clinical study has investigated the effectiveness of on-demand aqueous chlorine dioxide mouthwash against COVID-19. Methods We performed a randomized, placebo-controlled, open-label clinical trial to assess for any effects of using mouthwash on the salivary SARS-CoV-2 viral load among asymptomatic to mildly symptomatic adult COVID-19-positive patients. Patients were randomized to receive either 20 mL of 0.05% CPC, 10 mL of 0.01% on-demand aqueous chlorine dioxide, or 20 mL of placebo mouthwash (purified water) in a 1:1:1 ratio. The primary endpoint was the cycle threshold (Ct) values employed for SARS-CoV-2 salivary viral load estimation. We used linear mixed-effects models to assess for any effect of the mouthwashes on SARS-CoV-2 salivary viral load. Results Of a total of 96 eligible participants enrolled from November 7, 2022, to January 19, 2023, 90 were accepted for the primary analysis. The use of 0.05% CPC mouthwash was not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.640; 95% confidence interval [CI], -1.425 to 2.706; P = 0.543); 2 h (difference vs. placebo, 1.158; 95% CI, -0.797 to 3.112; P = 0.246); 4 h (difference vs. placebo, 1.283; 95% CI, -0.719 to 3.285; P = 0.209); 10 h (difference vs. placebo, 0.304; 95% CI, -1.777 to 2.385; P = 0.775); or 24 h (difference vs. placebo, 0.782; 95% CI, -1.195 to 2.759; P = 0.438). The use of 0.01% on-demand aqueous chlorine dioxide mouthwash was also not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.905; 95% CI, -1.079 to 2.888; P = 0.371); 2 h (difference vs. placebo, 0.709; 95% CI, -1.275 to 2.693; P = 0.483); 4 h (difference vs. placebo, 0.220; 95% CI, -1.787 to 2.226; P = 0.830); 10 h (difference vs. placebo, 0.198; 95% CI, -1.901 to 2.296; P = 0.854); or 24 h (difference vs. placebo, 0.784; 95% CI, -1.236 to 2.804; P = 0.447). Conclusions In asymptomatic to mildly symptomatic adults with COVID-19, compared to placebo, the use of 0.05% CPC and 0.01% on-demand aqueous chlorine dioxide mouthwash did not lead to a significant reduction in SARS-CoV-2 salivary viral load. Future studies of the efficacy of CPC and on-demand aqueous chlorine dioxide mouthwash on the viral viability of SARS-CoV-2 should be conducted using different specimen types and in multiple populations and settings.

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Efficacy of antiseptic mouthrinses against SARS-CoV-2: A prospective randomized placebo-controlled pilot study

Cited by 11 publications

References 26 publications

Efficacy of different mouthwashes against COVID-19: A systematic review and network meta-analysis

Efficacy of different mouthwashes against COVID-19: A systematic review and network meta-analysis

Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review

Oral mouthwashes for asymptomatic to mildly symptomatic adults with COVID-19 and salivary viral load: a randomized, placebo-controlled, open-label clinical trial

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