Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: randomized control trial in Singapore.

Singapore Oral Microbiomics Initiative, National Dental Research Institute Singapore (NDRIS), National Dental Centre Singapore, SingHealth, Singapore, Singapore. jaya.seneviratne@ndcs.com.sg. Duke NUS Medical School, Oral Health ACP, Singapore, Singapore. jaya.seneviratne@ndcs.com.sg. Singapore Oral Microbiomics Initiative, National Dental Research Institute Singapore (NDRIS), National Dental Centre Singapore, SingHealth, Singapore, Singapore. Duke NUS Medical School, Oral Health ACP, Singapore, Singapore. Department of Microbiology, Singapore General Hospital, SingHealth, Singapore, Singapore. Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore. Department of Urology, Singapore General Hospital, Singapore, Singapore. Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore, Singapore. Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore. jean.sim.x.y@singhealth.com.sg.

Infection. 2021;(2):305-311

Abstract

PURPOSE One of the key approaches to minimize the risk of COVID-19 transmission would be to reduce the titres of SARS-CoV-2 in the saliva of infected COVID-19 patients. This is particularly important in high-risk procedures like dental treatment. The present randomized control trial evaluated the efficacy of three commercial mouth-rinse viz. povidone-iodine (PI), chlorhexidine gluconate (CHX) and cetylpyridinium chloride (CPC), in reducing the salivary SARS-CoV-2 viral load in COVID-19 patients compared with water. METHODS A total of 36 SARS-CoV-2-positive patients were recruited, of which 16 patients were randomly assigned to four groups-PI group (n = 4), CHX group (n = 6), CPC group (n = 4) and water as control group (n = 2). Saliva samples were collected from all patients at baseline and at 5 min, 3 h and 6 h post-application of mouth-rinses/water. The samples were subjected to SARS-CoV-2 RT-PCR analysis. RESULTS Comparison of salivary Ct values of patients within each group of PI, CHX, CPC and water at 5 min, 3 h and 6 h time points did not show any significant differences. However, when the Ct value fold change of each of the mouth-rinse group patients were compared with the fold change of water group patients at the respective time points, a significant increase was observed in the CPC group patients at 5 min and 6 h and in the PI group patients at 6 h. CONCLUSION The effect of decreasing salivary load with CPC and PI mouth-rinsing was observed to be sustained at 6 h time point. Within the limitation of the current study, as number of the samples analyzed, the use of CPC and PI formulated that commercial mouth-rinses may be useful as a pre-procedural rinse to help reduce the transmission of COVID-19. ISRCTN (ISRCTN95933274), 09/09/20, retrospectively registered.

Methodological quality

Publication Type : Randomized Controlled Trial

Metadata