Is hydrogen peroxide an effective mouthwash for reducing the viral load of SARS-CoV-2 in dental clinics?

Emma Burgos-Ramos; Itziar R Urbieta; Diana Rodríguez

doi:10.1016/j.sdentj.2022.01.005

Is hydrogen peroxide an effective mouthwash for reducing the viral load of SARS-CoV-2 in dental clinics?

Saudi Dent J. 2022 Mar;34(3):237-242. doi: 10.1016/j.sdentj.2022.01.005. Epub 2022 Jan 29.

Authors

Emma Burgos-Ramos¹, Itziar R Urbieta², Diana Rodríguez³

Affiliations

¹ Biochemistry Area, Faculty of Environmental Sciences and Biochemistry, University of Castilla-La Mancha, Avenida Carlos III s/n, 45071 Toledo, Spain.
² Department of Environmental Sciences, Faculty of Environmental Sciences and Biochemistry, University of Castilla-La Mancha, Avenida Carlos III s/n, 45071 Toledo, Spain.
³ Department of Physical Chemistry, Faculty of Environmental Sciences and Biochemistry, University of Castilla-La Mancha, Avenida Carlos III s/n, 45071 Toledo, Spain.

Abstract

Background: Previous studies have demonstrated that SARS-CoV-2 is mainly transmitted by inhalation of aerosols and can remain viable in the air for hours. Viruses can spread in dental settings and put professionals and patients at high risk of infection due to proximity and aerosol-generating procedures, and poor air ventilation.

Objectives: The aim of this study was to investigate the effects of a 1% hydrogen peroxide (H₂O₂) mouth rinse on reducing the intraoral SARS-CoV-2 load.

Methods: Portable air cleaners with HEPA filters exposed for 3 months were analysed to test for virus presence in a waiting room (where patients wore a face mask but did not undergo mouth rinsing) and three treatment rooms (where patients wore no mask but carried out mouth rinsing). As CO₂ is co-exhaled with aerosols containing SARS-CoV-2 by COVID-19 infected people, we also measured CO₂ as a proxy of infection risk indoors. Specific primer and probe RT-PCR were applied to detect viral genomes of the SARS-CoV-2 virus in the filters. Specifically, we amplified the nucleocapsid gene (Nuclv) of SARS-CoV-2.

Results: CO₂ levels ranged from 860 to 907 ppm, thus indicating low ventilation and the risk of COVID-19 transmission. However, we only found viral load in filters from the waiting room and not from the treatment rooms. The results revealed the efficiency of 1-minute mouth rinsing with 1% H₂O₂ since patients rinsed their mouths immediately after removing their mask in the treatment rooms.

Conclusions: Our findings suggest that dental clinics would be safer and more COVID-19 free by implementing mouth rinsing 1 min with 1% H₂O₂ immediately after the patients arrive at the clinic.

Keywords: Airborne SARS-CoV-2; CO2, carbon dioxide; COVID-19 free room; COVID-19, Coronavirus Disease 2019; H2O2, hydrogen peroxide; HEPA filter; HEPA, High-Efficiency Particulate Air; Hydrogen peroxide mouthwash; Oral health; PACs, Portable air cleaners; Portable air cleaner; RT-PCR, Real Time- reverse transcriptase-Polymerase Chain Reaction; SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus-2.