(By Dr. Joseph D. Lim and Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI)
MOUTH rinses have a potential to reduce the viral load of SARS-CoV-2, the virus that causes COVID-19.
The conclusion is made by a study which reviewed scientific literature on the efficacy of mouth rinses.
The study, published in the open access journal Frontiers, was conducted by Amber Ather of the Department of Endodontics, University of Texas Health Science Center at San Antonio, Texas; Abhishek Parolia of the Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia; and Nikita B. Ruparel of the University of Texas Health Science Center.
The presence of the COVID virus in saliva and nose and throat secretions has challenged the routine practice of dentistry, they write.
To potentially reduce the transmission of COVID-19, the use of mouth rinses has been recommended before dental procedures.
The review looked at 12 scientific articles, seven of which were in laboratory studies and five in human clinical studies.
The laboratory studies used a standardized methodology to evaluate the efficacy of antimicrobial mouth rinses against the COVID virus. The human clinical 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.
COVID-19 and its rapid spread have drastically affected the dental community worldwide. This has led to a complete lockdown of dental practices in some countries.
There has been a shift toward reopening of practices and provision of routine dental care, which has led to an increase in procedures that generate aerosols, the air-borne suspended particles with a potential to contain the virus in saliva.
This is a cause for concern as saliva and nasopharyngeal secretions can carry high viral load of the COVID virus in affected individuals.
Although the main mode of COVID transmission is through respiratory droplets or close contact, transmission via aerosols is possible and has not been ruled out.
Dental organizations have responded by specifying guidelines for provision of dental care during the pandemic.
In addition to recommendations such as strict infection control practices, patient screening, and wearing personal protective equipment, the use of preprocedural mouth rinse or gargle has also been suggested by numerous organizations across the world such as Centers for Disease Control and Prevention, American Dental Association, and Australian Dental Association.
The use of preprocedural mouth rinse is based on the principle of reducing oral microbial load and hence mitigating the potential transmission of microbes via aerosol, splatter, or close contact, the study authors write.
One of the most commonly used preprocedural mouth rinses in dentistry is chlorhexidine gluconate, which has been shown to be a highly effective antimicrobial agent.
Several alternative mouth rinses such as iodine-based or essential oils-based (Listerine) or oxygenating agents (hydrogen peroxide) have also demonstrated comparable antimicrobial effectiveness.
The promising results of mouth rinses against coronaviruses made the basis for recommendations supporting the use of preprocedural mouth rinses during COVID-19 pandemic, the researchers say.
They appraised the most updated evi1dence on the efficacy of mouth rinses against the COVID virus.
The study’s conclusion: mouth rinses can reduce the presence of the COVID virus in the mouth and throat, noting that further research is still needed on the effectiveness of mouth rinses.
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Dr. Joseph D. Lim is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; and Honorary Life Member of the Thai Association of Dental Implantology. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate professor; Fellow, International Congress of Oral Implantologists; Member, American Academy of Implant Dentistry and Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com/PN
