Mouthwash (Part 1)
ANAFFORDABLE way to prevent coronavirus infection may be available in something that is familiar to all who have visited a dental clinic. It’s the ordinary mouthwash which may be an effective way to slow down the transmission of COVID-19. We emphasize the word “may” oral hygiene, the researchers observe. here and do not encourage the use of Their study is the first to look a mouthwash to prevent COVID-19. at known mechanisms of viral lipid As in all medications, a dentist’s membrane disruption by widely or a doctor’s advice is always wise. available dental mouthwash Otherwise, do not – repeat, do not – components that include ethanol, self-medicate. chlorhexidine, cetylpyridinium Having said that, we are featuring chloride, hydrogen peroxide and here a study that is worth mentioning povidone-iodine. as a piece of information and not – I t al s o assesses existing again, not – as a medical advice. formulations for their potential
The study was led by Professor ability to disrupt the SARS- CoV- 2 Valerie B. O’Donnell of the Systems l i pid envelope, based on the Immunity Research Institute, School concentrations of the mouthwash of Medicine, University Hospital of components. It concludes that several Wales in Cardiff; and Professor David deserve clinical evaluation. Thomas in the School of Dentistry of The study highlights t hat the same university hospital. already published research on
I t was published J une 5 other enveloped viruses, including in , a journal of the American coronaviruses, “directly supports Physiological Society. the idea that oral rinsing should be Function The researchers observe that considered as a potential way to studies increasingly demonstrate the reduce transmission of SARS-CoV-2,” importance of the throat and salivary the virus that causes COVID-19. glands as sites of virus replication “This is an under- researched and transmission in early COVID-19 area of major clinical need,” the disease. researchers point out.
SARS-CoV-2, the virus that causes They explain: common with COVID- 19, is an enveloped virus, many viruses, such as influenza and characterized by an outer lipid herpes simplex, coronaviruses are membrane derived from the host surrounded by a fatty layer, called a cell from which it buds. While it is “lipid envelope”, into which the spike highly sensitive to agents that disrupt glycoproteins required for infection lipid biomembranes, there has been are inserted. no discussion about the potential “It is widely known that interfering role of oral rinsing in preventing with the lipid envelope represents a transmission. virucidal strategy to target many
The researchers say there has coronaviruses, with a large body of been no discussion of oral antiviral work evidencing the impact of many strategies, apart from a recent agents,” Professors O’Donnell and response to an article in the Thomas say. calling for protection “We are now widely encouraged
British for healthcare workers against to use soap or 60 percent-70 percent Medical Journal infection. alcohol- based gels to inactivate
The interim guidance of the SARS- CoV- 2, based on the view World Health Organization on the that these agents damage the lipid clinical management of SARS-CoV-2 envelope,” they say. in the home is focused on the use of Mouthwashes vary widely in personal protection, including face composition. Some commercially masks, along with hand, clothing and available formulations contain surface sanitation, to reduce the risk ethanol at 14 percent-27 percent in of airborne and direct spread of the the United Kingdom, Europe and the virus. The guidance does not mention United States.
The study reviewed the scientific literature to establish whether oral treatment using ethanol-based or other types of mouthwashes could present a strategy to either dampen or reduce viral load, to potentially restrict virus transmission i n the current pandemic situation, particularly f or vulnerable individuals or healthcare workers.
It found that there is a paucity of data systematically testing the impact of lower (less toxic) ethanol concentrations on enveloped virus inactivation, with most simply reiterating the use of the higher concentrations.
It is becoming increasingly recognized that the throat is a major site of replication and shedding of virus in COVID-19 illness, and that viral load is important, Professors O’Donnell and Thomas say.
Data suggest that the potential for transmission is high early in the disease, they say. While further studies are needed to better understand the relationship between viral load and symptom severity, it is expected that higher levels of viral shedding in the throat or lungs might be associated with an increased ability to infect others.
The route of SARS-CoV-2 infection is currently considered to be via respiratory droplets, similar to SARS- CoV,35 and the virus particle is viable in aerosols for up to three hours.
Assuming that the throat is a major site of replication in the early stages (even before symptoms are