key: cord-0811672-0p8nctpy
authors: Gercina, Anne Caroline; de Souza Amorim, Klinger; Pagaduan, Rochelle; de Almeida Souza, Liane Maciel; Groppo, Francisco Carlos
title: What is the best mouthrinse against Coronaviruses?
date: 2020-08-13
journal: Oral Surg
DOI: 10.1111/ors.12549
sha: aeac6452b2adc8114d79c0dc6441a0c54dfd401c
doc_id: 811672
cord_uid: 0p8nctpy

The person‐to‐person transmission of SARS‐CoV‐2 may occur directly or indirectly through saliva, and a preoperational use of antimicrobial mouthwash is considered to reduce the number of oral microbes. (1) Chlorhexidine mouthwash has been a common antiseptic agent used in dentistry, both preoperative and postoperative use reducing post‐surgical infectious complications.

This article is protected by copyright. All rights reserved Dear Editor,

The person-to-person transmission of SARS-CoV-2 may occur directly or indirectly through saliva, and a preoperational use of antimicrobial mouthwash is considered to reduce the number of oral microbes. 1 Chlorhexidine mouthwash has been a common antiseptic agent used in dentistry, both preoperative and postoperative use reducing post-surgical infectious complications. 2 Since chlorhexidine compounds are also effective against lipid-enveloped viruses, it has been examined as a possible alternative antiseptic effective against the novel coronavirus. 3 Peng et al. (2020) 1 suggested that chlorhexidine may not be effective to kill 2019-nCoV, and since 2019-nCoV is vulnerable to oxidation, preprocedural mouthrinse containing 1% hydrogen peroxide or 0.2% povidone is recommended. Anterior studies evaluated the use of chlorhexidine against Human Coronavirus 229E (HCOV), and it proved ineffective. 4, 5 However, these studies evaluated chlorhexidine concentrations below 0.12% (table 1) .

Notwithstanding, it was observed that concentrations of chlorhexidine 0.05%, with ethanol and cetrimide added to the mouthwash, demonstrated effective results against HCOV. 4 

This article is protected by copyright. All rights reserved Even assuming that 1% of hydrogen peroxide is the best alternative to prevent transmission during oral procedures, its use on postoperative does not seem to be necessary. Rinsing with 1% of hydrogen peroxide should not be done as a treatment for COVID-19. The purpose of rinsing 1% hydrogen peroxide is to protect the professional from avoiding transmission during the procedure from patients already infected by SARS-CoV-2. 1 Besides, the frequent use of hydrogen peroxide can be harmful to the tissue and its effectiveness in reducing postoperative infectious complications has not been proven. 8 Although povidone has been used as an antiseptic in preventing infections, it is not a primary choice for mouthwash because of its possibility of pigmentate restorations, tooth darkening, and allergenic potential 9 . Povidone is not recommended either in pregnant or for patients with active thyroid disease or undergoing radioactive iodine therapy. 

Transmission routes of 2019-nCoV and controls in dental practice

Arteagoitia Calvo I. Does Chlorhexidine Prevent Alveolar Osteitis After Third Molar Extractions? Systematic Review and Meta-Accepted Article This article is protected by copyright

Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva

Human Coronaviruses: Insights into Environmental Resistance and Its Influence on the Development of New Antiseptic Strategies

Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents

Is 0.5% Hydrogen Peroxide Effective against SARS-CoV-2?

Comparison of In Vitro Inactivation of SARS CoV-2 with Hydrogen Peroxide and Povidone-Iodine Oral Antiseptic Rinses

Mouthwashes with hydrogen peroxide are carcinogenic, but are freely indicated on the internet: Warn your patients!

TRPA1 and TRPV1 contribute to iodine antiseptics-associated pain and allergy

Accepted Article