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Effectiveness of Mouthwashes on Reducing Sars-Cov-2 Viral Load in Oral Cavity: A Systematic Review and Meta-Analysis Publisher Pubmed



Ebrahimi T1, 2 ; Shamshiri AR1, 2 ; Alebouyeh M3 ; Mohebbi SZ1, 2
Authors
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Authors Affiliations
  1. 1. Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Pediatric Infections Research Centre, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: BMC Oral Health Published:2023


Abstract

Background: The risk of SARS-COV-2 transmission is relatively high during dental procedures. A study was conducted to investigate the effects of mouthwashes on SARS-COV-2 viral load reduction in the oral cavity. Methods: A systematic search was performed in PubMed, EMBASE, Scopus, Web of Science, and Cochrane library for relevant studies up to 20 July, 2022. Randomized and non-randomized clinical trial and quasi-experimental studies evaluating patients with Covid-19 infection (patients) who used mouthwashes (intervention) compared to the same patients before using the mouthwash (comparison) for reducing the SARS-COV-2 load or increasing the cycle threshold (Ct) value (outcome) were searched according to PICO components. Three independent reviewers conducted literature screening and data extraction. The Modified Downs and Black checklist was used for quality assessment. A meta-analysis was performed with a random effects model in the Revman 5.4.1software using the mean difference (MD) of cycle threshold (Ct) values. Results: Of 1653 articles, 9 with a high methodological quality were included. A meta-analysis indicated that 1% Povidone-iodine (PVP-I) was an effective mouthwash for reducing the SARS-COV-2 viral load [MD 3.61 (95% confidence interval 1.03, 6.19)]. Cetylpyridinium chloride (CPC) [MD 0.61 (95% confidence interval -1.03, 2.25)] and Chlorhexidine gluconate (CHX) [MD -0.04 95% confidence interval (-1.20, 1.12)] were not effective against SARS-COV-2. Conclusion: Using mouthwashes containing PVP-I may be recommended for reducing the SARS-COV-2 viral load in the oral cavity of patients before and during dental procedures, while the evidence is not sufficient for such effects for CPC and CHX-containing mouthwashes. © 2023, The Author(s).
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