Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: randomized control trial in Singapore

Seneviratne, Chaminda Jayampath; Balan, Preethi; Ko, Kwan Ki Karrie; Udawatte, Nadeeka S.; Lai, Deborah; Ng, David; Venkatachalam, Indumathi; Lim, Kheng Sit; Ling, Moi Lin; Oon, Lynette Lin Ean; Goh, Bee Tin; Sim, Xiang Ying Jean

doi:10.1007/s15010-020-01563-9

Cited by 166 publications

(268 citation statements)

References 27 publications

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“…After removing duplicates, 1,401 records were screened by reviewers (AA, AP) for title and abstract content, of which 1,372 records were excluded. Full texts of 29 articles were reviewed for eligibility assessment, and eventually 12 records (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) were included in the review based on the inclusion/exclusion criteria. The reasons for excluding 17 articles (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) are presented in Figure 1.…”

Section: Study Selectionmentioning

confidence: 99%

“…The study characteristics of the included studies are presented in Table 1. Of the 12 included articles in this review, seven were in vitro studies (11)(12)(13)(14)(15)(16)19) and five were in vivo human clinical studies (17,18,(20)(21)(22). Among the in vivo studies, one was a randomized controlled trial (22).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Of the 12 included articles in this review, seven were in vitro studies (11)(12)(13)(14)(15)(16)19) and five were in vivo human clinical studies (17,18,(20)(21)(22). Among the in vivo studies, one was a randomized controlled trial (22). All in vitro studies (11)(12)(13)(14)(15)(16)19) used a standardized methodology (endpoint dilution assay) to evaluate the efficacy of antimicrobial formulations against SARS-CoV-2.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…A log 10 reduction value of >4 indicates high virucidal activity and represents 99.99% kill efficacy (42,43). The in vivo studies were done utilizing real-time reverse transcriptionpolymerase chain reaction (rRT-PCR) assay of samples obtained from saliva or oropharyngeal gargle or nasopharyngeal swab or a combination of both nasopharyngeal and oropharyngeal swab (17,18,(20)(21)(22). The key results from the included studies are presented under the following subcategories based on the commonly used antimicrobial reagents present in mouth rinses.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The promising results of mouth rinses against coronaviruses made the basis for recommendations supporting the use of preprocedural mouth rinses during COVID-19 pandemic (10); however, most of these guidelines were not based on efficacy of mouth rinses against SARS-CoV-2 specifically (7-9). In the past few months, reports on efficacy of topical antimicrobials against SARS-CoV-2 have been published in the literature (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). The aim of this scoping review is to present and critically appraise the most updated evidence on the efficacy of mouth rinses against SARS-CoV-2.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Mouth Rinses Against SARS-CoV-2: A Scoping Review

2021

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Introduction: The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in saliva and nasopharyngeal secretions has challenged the routine practice of dentistry. Use of preprocedural mouth rinses has been recommended by several organizations to potentially reduce the transmission of SARS-CoV-2. This scoping review aimed at evaluating the available evidence on the efficacy of mouth rinses against SARS-CoV-2.Methods: A thorough literature search on electronic databases (PubMed, Scopus, and Google Scholar) was performed by two independent reviewers and data from articles addressing the aim of this article were extracted.Results: After exclusion of articles not addressing the end point in question, 12 articles were included in this scoping review. Of the 12 articles, seven were in vitro studies and five were in vivo human clinical studies. The in vitro studies used a standardized methodology (endpoint dilution assay) to evaluate the efficacy of antimicrobial mouth rinses against SARS-CoV-2. The in vivo studies were done utilizing polymerase chain reaction assay of samples obtained from saliva or nasopharyngeal swab or a combination of both nasopharyngeal and oropharyngeal swab. The reagents tested in these studies included povidone-iodine, chlorhexidine, hydrogen peroxide (H2O2), essential oils, and quaternary ammonium compounds and demonstrated varied efficacy against SARS-CoV-2.Conclusion: Based on the available evidence from in vitro studies, it can be concluded that mouth rinses have a potential to reduce SARS-CoV-2 viral load; however, effectiveness in in vivo conditions is still inconclusive. Owing to the substantial heterogeneity in reporting of the anti–SARS-CoV-2 efficacy of mouth rinses, this review highlights the need to conduct future research with robust and standardized methodologies to confirm effectiveness of mouth rinses.

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy of Mouth Rinses Against SARS-CoV-2: A Scoping Review

2021

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Physical interventions to interrupt or reduce the spread of respiratory viruses

Jefferson

Dooley

Ferroni

et al. 2023

Cochrane Database of Systematic Reviews

156

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Background Viral epidemics or pandemics of acute respiratory infections (ARIs) pose a global threat. Examples are influenza (H1N1) caused by the H1N1pdm09 virus in 2009, severe acute respiratory syndrome (SARS) in 2003, and coronavirus disease 2019 (COVID‐19) caused by SARS‐CoV‐2 in 2019. Antiviral drugs and vaccines may be insufficient to prevent their spread. This is an update of a Cochrane Review last published in 2020. We include results from studies from the current COVID‐19 pandemic. Objectives To assess the effectiveness of physical interventions to interrupt or reduce the spread of acute respiratory viruses. Search methods We searched CENTRAL, PubMed, Embase, CINAHL, and two trials registers in October 2022, with backwards and forwards citation analysis on the new studies. Selection criteria We included randomised controlled trials (RCTs) and cluster‐RCTs investigating physical interventions (screening at entry ports, isolation, quarantine, physical distancing, personal protection, hand hygiene, face masks, glasses, and gargling) to prevent respiratory virus transmission. Data collection and analysis We used standard Cochrane methodological procedures. Main results We included 11 new RCTs and cluster‐RCTs (610,872 participants) in this update, bringing the total number of RCTs to 78. Six of the new trials were conducted during the COVID‐19 pandemic; two from Mexico, and one each from Denmark, Bangladesh, England, and Norway. We identified four ongoing studies, of which one is completed, but unreported, evaluating masks concurrent with the COVID‐19 pandemic. Many studies were conducted during non‐epidemic influenza periods. Several were conducted during the 2009 H1N1 influenza pandemic, and others in epidemic influenza seasons up to 2016. Therefore, many studies were conducted in the context of lower respiratory viral circulation and transmission compared to COVID‐19. The included studies were conducted in heterogeneous settings, ranging from suburban schools to hospital wards in high‐income countries; crowded inner city settings in low‐income countries; and an immigrant neighbourhood in a high‐income country. Adherence with interventions was low in many studies. The risk of bias for the RCTs and cluster‐RCTs was mostly high or unclear. Medical/surgical masks compared to no masks We included 12 trials (10 cluster‐RCTs) comparing medical/surgical masks versus no masks to prevent the spread of viral respiratory illness (two trials with healthcare workers and 10 in the community). Wearing masks in the community probably makes little or no difference to the outcome of influenza‐like illness (ILI)/COVID‐19 like illness compared to not wearing masks (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84 to 1.09; 9 trials, 276,917 participants; moderate‐certainty evidence. Weari...

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