Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey.
Department of Medical Microbiology, Faculty of Medicine, Bursa Uludağ University, Turkey.
Dent Med Probl. 2022 Jul-Sep;59(3):357-363. doi: 10.17219/dmp/150831.
In the oral cavity, which plays an important role in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is possible to reduce the viral load of SARS-CoV-2 with antiseptics, thereby minimizing the transmission of the virus during dental procedures.
The aim of this study was to clinically evaluate the effect of the hypochlorous acid (HClO) and povidone-iodine (PVP-I) solutions on the oral viral load of SARS-CoV-2.
This randomized controlled trial was conducted on 75 patients hospitalized in the COVID-19 ward of a local hospital. All the patients included in the study were within the first 24 h of hospitalization and the first 5 days of coronavirus disease 2019 (COVID-19) symptoms. The viral load of mouthwash samples was measured with the cycle threshold (Ct) value of SARS-CoV-2 through a realtime reverse transcription polymerase chain reaction (RT-PCR). The patients were divided into 3 groups. The effect on the patient's SARS-CoV-2 viral load was investigated after gargling the mouths and throats for 30 s with HClO, PVP-I and isotonic saline. First, a sample was taken after gargling with isotonic saline, then another sample was taken after gargling for 30 s with a particular antiseptic to determine the viral load of SARS-CoV-2.
Comparing the before and after mouthwash samples from all 3 groups, there were no statistically significant differences in the Ct values before and after gargling (p > 0.05). However, there were statistically significant differences in the number of negative samples after the use of HClO and PVP-I, which were positive before gargling (p < 0.05).
In the light of the data obtained in this study, there is insufficient evidence that gargling with HClO or PVP-I reduces viral load. Taken together, these findings imply no role for antiseptics in the transmission of SARS-CoV-2 by the aerosol generated during dental procedures, or more generally, SARS-CoV-2 infection control.
口腔在严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）的传播中起着重要作用，使用消毒剂可以降低 SARS-CoV-2 的病毒载量，从而最大限度地减少牙科手术过程中病毒的传播。
本研究旨在临床评估次氯酸（HClO）和聚维酮碘（PVP-I）溶液对 SARS-CoV-2 口腔病毒载量的影响。
这是一项在当地医院 COVID-19 病房住院的 75 名患者中进行的随机对照试验。所有纳入研究的患者均在住院后 24 小时内和出现 COVID-19 症状的前 5 天内。通过实时逆转录聚合酶链反应（RT-PCR），用 SARS-CoV-2 的循环阈值（Ct）值测量漱口样本中的病毒载量。患者分为 3 组。用 HClO、PVP-I 和等渗盐水漱口 30 秒后，观察对患者 SARS-CoV-2 病毒载量的影响。首先，用等渗盐水漱口后采集样本，然后用特定的消毒剂漱口 30 秒后再次采集样本，以确定 SARS-CoV-2 的病毒载量。
比较三组患者漱口前后的样本，漱口前后 Ct 值无统计学差异（p＞0.05）。然而，在使用 HClO 和 PVP-I 后，漱口前阳性但漱口后转为阴性的样本数量有统计学差异（p＜0.05）。
根据本研究获得的数据，没有足够的证据表明用 HClO 或 PVP-I 漱口可以降低病毒载量。综上所述，这些发现表明，消毒剂在牙科操作过程中产生的气溶胶传播 SARS-CoV-2 或更普遍的 SARS-CoV-2 感染控制方面没有作用。
