TY - JOUR
T1 - Reduction of SARS-CoV-2 salivary viral load with pre-procedural mouth rinses
T2 - a randomised, controlled, clinical trial
AU - Farmaha, Jaspreet Kaur
AU - James, Jeffrey Nelson
AU - Frazier, Kyle
AU - Sahajpal, Nikhil Shri
AU - Mondal, Ashis K.
AU - Bloomquist, Doan Tam
AU - Kolhe, Ravindra
AU - Looney, Stephen W.
AU - Bloomquist, Ryan
N1 - Funding Information:
This study was sponsored by an intramural grant from Centre for Excellence in Research, Scholarship, and Innovation (CERSI) at the Dental College of Georgia (DCG). The funding organisations had no role in the study design, data collection and analysis, decision to publish, or preparation of the article.
Publisher Copyright:
© 2023, The Author(s), under exclusive licence to the British Dental Association.
PY - 2023/4/28
Y1 - 2023/4/28
N2 - Introduction The purpose of this study was to test the short-term efficacy of four commercial mouthwashes versus water in reducing SARS-CoV-2 viral load in the oral cavity over clinically relevant time points. Methods In total, 32 subjects that were proven SARS-CoV-2-positive via polymerase chain reaction (PCR)-based diagnostic test were recruited and randomised into five parallel arms. Cycle threshold (Ct) values were compared in saliva samples between the groups, as well as within the groups at baseline (pre-rinse), zero hours, one hour and two hours post-rinse, using SARS-CoV-2 reverse transcription-PCR analysis. Results We observed a significant increase in Ct values in saliva samples collected immediately after rinsing with all the four mouthwashes - 0.12% chlorhexidine gluconate, 1.5% hydrogen peroxide, 1% povidone iodine, or Listerine - compared to water. A sustained increase in Ct values for up to two hours was only observed in the Listerine and chlorohexidine gluconate groups. We were not able to sufficiently power this clinical trial, so the results remain notional but encouraging and supportive of findings in other emerging mouthwash studies on COVID-19, warranting additional investigations. Conclusions Our evidence suggests that in a clinical setting, prophylactic rinses with Listerine or chlorhexidine gluconate can potentially reduce SARS-CoV-2 viral load in the oral cavity for up to two hours. While limited in statistical power due to the difficulty in obtaining this data, we advocate for pre-procedural mouthwashing, like handwashing, as an economical and safe additional precaution to help mitigate the transmission of SARS-CoV-2 from a potentially infected patient to providers.
AB - Introduction The purpose of this study was to test the short-term efficacy of four commercial mouthwashes versus water in reducing SARS-CoV-2 viral load in the oral cavity over clinically relevant time points. Methods In total, 32 subjects that were proven SARS-CoV-2-positive via polymerase chain reaction (PCR)-based diagnostic test were recruited and randomised into five parallel arms. Cycle threshold (Ct) values were compared in saliva samples between the groups, as well as within the groups at baseline (pre-rinse), zero hours, one hour and two hours post-rinse, using SARS-CoV-2 reverse transcription-PCR analysis. Results We observed a significant increase in Ct values in saliva samples collected immediately after rinsing with all the four mouthwashes - 0.12% chlorhexidine gluconate, 1.5% hydrogen peroxide, 1% povidone iodine, or Listerine - compared to water. A sustained increase in Ct values for up to two hours was only observed in the Listerine and chlorohexidine gluconate groups. We were not able to sufficiently power this clinical trial, so the results remain notional but encouraging and supportive of findings in other emerging mouthwash studies on COVID-19, warranting additional investigations. Conclusions Our evidence suggests that in a clinical setting, prophylactic rinses with Listerine or chlorhexidine gluconate can potentially reduce SARS-CoV-2 viral load in the oral cavity for up to two hours. While limited in statistical power due to the difficulty in obtaining this data, we advocate for pre-procedural mouthwashing, like handwashing, as an economical and safe additional precaution to help mitigate the transmission of SARS-CoV-2 from a potentially infected patient to providers.
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U2 - 10.1038/s41415-023-5741-9
DO - 10.1038/s41415-023-5741-9
M3 - Article
C2 - 37117367
AN - SCOPUS:85156253857
SN - 0007-0610
VL - 234
SP - 593
EP - 600
JO - British Dental Journal
JF - British Dental Journal
IS - 8
ER -