Can preprocedural mouthrinses reduce SARS-CoV-2 load in dental aerosols?

Med Hypotheses. 2021 Jan:146:110436. doi: 10.1016/j.mehy.2020.110436. Epub 2020 Nov 27.

Abstract

Dental professionals work closely with patients and present an increased risk of person-to-person transmission of SARS-CoV-2. Moreover, the use of ultrasonic scalers, air-water syringes, and slow and high-speed handpieces, which are common in the dental office, generate spatter and aerosol. The use of preprocedural mouthrinses has been proposed to reduce the viral load in saliva and oropharyngeal tissues, thus decreasing viral load in dental aerosol. Although some mouthrinses demonstrates an antiviral effect, there is limited evidence about the clinical efficacy of any mouthrinse in the reduction of SARS-CoV-2 in the dental aerosol. We hypothesized that mouthrinses may reduce SARS-CoV-2 viral load in the oropharynx and its fluids reducing viral load in dental aerosol. The potential use of mouthrinses is discussed, along with proposal of in vitro and clinical studies, in order to evaluate this hypothesis. If this hypothesis holds true, dental professionals and patients may benefit from the routine use of preprocedural mouthrinses.

Keywords: Aerosol; Coronavirus; Covid-19; Mouthrinses; Mouthwashes; SARS-CoV-2.

MeSH terms

  • Aerosols
  • Antiviral Agents / therapeutic use
  • COVID-19 / prevention & control
  • COVID-19 / transmission*
  • COVID-19 / virology*
  • Dental Auxiliaries
  • Dentists
  • Disease Reservoirs / virology
  • Humans
  • In Vitro Techniques
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control*
  • Models, Biological*
  • Mouthwashes / chemistry
  • Mouthwashes / therapeutic use*
  • Oropharynx / virology
  • Pandemics / prevention & control
  • Randomized Controlled Trials as Topic / methods
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / isolation & purification*
  • SARS-CoV-2 / pathogenicity
  • Saliva / virology
  • Viral Load*

Substances

  • Aerosols
  • Antiviral Agents
  • Mouthwashes