Preprocedural mouthwashes for infection control in dentistry—an update

Preprocedural mouthwashes for infection control in dentistry—an update

Objectives Aerosols and splatter are routinely generated in dental practice and can be contaminated by potentially harmful bacteria or viruses such as SARS-CoV-2. Therefore, preprocedural mouthwashes containing antiseptic agents have been proposed as a potential measure for infection control in dent...

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Bibliographic Details
Published in:Clinical oral investigations Vol. 27; no. Suppl 1; pp. 33 - 44
Main Authors: Weber, Johanna, Bonn, Eva L., Auer, David L., Kirschneck, Christian, Buchalla, Wolfgang, Scholz, Konstantin J., Cieplik, Fabian
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-06-2023
Springer Nature B.V
Subjects:
Aerosols
Antiseptics
Cetylpyridinium chloride
Chlorhexidine
Dental personnel
Dentistry
Disease control
Essential oils
Infectivity
Medicine
Mouthwashes
Review
Severe acute respiratory syndrome coronavirus 2
Side effects
Viruses
Mouthwash
SARS-CoV-2
Mouth rinse
Infection control
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Summary:Objectives Aerosols and splatter are routinely generated in dental practice and can be contaminated by potentially harmful bacteria or viruses such as SARS-CoV-2. Therefore, preprocedural mouthwashes containing antiseptic agents have been proposed as a potential measure for infection control in dental practice. This review article aims to summarize the clinical (and, if insufficient, preclinical) evidence on preprocedural mouthwashes containing antiseptic agents and to draw conclusions for dental practitioners. Methods Literature on preprocedural mouthwashes for reduction of bacterial or viral load in dental aerosols was searched and summarized. Results Preprocedural mouthwashes, particularly those containing chlorhexidine digluconate (CHX), cetylpyridinium chloride (CPC), or essential oils (EO), can significantly reduce the bacterial load in dental aerosols. With respect to viruses such as HSV-1, there are too little clinical data to draw any clear recommendations. On the other hand, clinical data is consolidating that CPC-containing mouthwashes can temporarily reduce the intraoral viral load and infectivity in SARS-CoV-2 positive individuals. Nevertheless, potential risks and side effects due to regular antiseptic use such as ecological effects or adaptation of bacteria need to be considered. Conclusions The use of preprocedural mouthwashes containing antiseptics can be recommended according to currently available data, but further studies are needed, particularly on the effects on other viruses besides SARS-CoV-2. When selecting a specific antiseptic, the biggest data basis currently exists for CHX, CPC, EO, or combinations thereof. Clinical relevance Preprocedural mouthwashes containing antiseptics can serve as part of a bundle of measures for protection of dental personnel despite some remaining ambiguities and in view of potential risks and side effects.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:1436-3771
1432-6981
1436-3771
DOI:10.1007/s00784-023-04953-z