University Study: Molecular Iodine Rinse Completely Effective in 30 sec against SARS CoV-2

Aim: The aim of the present study was to evaluate and compare the efficacy and cytotoxicity of four different mouthwashes containing 1.5% hydrogen peroxide, 0.2% povidone, 0.12% chlorhexidine and 100 ppm molecular iodine for their ability to inactivate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

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Canadian Dental Hygienist Association Covid 19 Update December 3, 2020. Hydrogen peroxide produces no virucidal effect.

Research has shown that, while a povidone-iodine antiseptic rinse did inactivate COVID-19, a hydrogen peroxide antiseptic rinse had ineffective virucidal results. A systematic review published in the Journal of Hospital Infection supported the findings that using a pre-procedural rinse of hydrogen peroxide produces no virucidal effects. A recent document from Public Health Ontario states that hydrogen peroxide should no longer be recommended as a pre-procedural mouthrinse.

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Ontario Public Health RAPID REVIEW Recommends not to use Hydrogen Peroxide as a Pre-Procedural Rinse

Hydrogen peroxide should no longer be recommended as a pre-operative mouth rinse due to lack of efficacy versus SARS-CoV-2.

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Chemical Considerations Related to The Dilution of Commercial 10% Povidone-Iodine For Use In The COVID-19 Pandemic. Department of Chemistry, Columbia University,

The simple on-site dilution of 10% PVP-I with water or saline solution to produce solutions in the 0.25%-2.0% range should be viewed with caution and undertaken only with the full appreciation of the risks

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Potential Role of Oral Rinses Targeting the Viral Lipid Envelope in SARS-CoV-2 Infection

Strategies to reduce the number of infective virus particles in mucous membranes through promoting their removal or inactivation could contribute to reducing risk of transmission. Thus, assuming that the throat is a major site of replication in early stages (even before symptoms are apparent), the oral washing using agents that could damage or destroy the lipid envelope has the potential to reduce viral load in the oropharynx

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Evaluation of Post-surgical Bacteremia with Use of Povidone-Iodine and Chlorhexidine During Mandibular Third Molar Surgery Journal of Maxillofacial Oral Surgery (Oct–Dec 2017)

Povidone-iodine significantly reduces the incidence of bacteremia and number of organisms compared to chlorhexidine and sterile water. Pre-procedural use of mouth rinse and subgingival irrigation with an antiseptic mouth rinse resulted in reduction of blood born aerobic and anaerobic bacteria.

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In vitro bactericidal and virucidal efficacy of povidone-iodine gargle/ mouthwash against respiratory and oral tract pathogens. Eggers M, Koburger-Janssen T, Eickmann M, Zorn J. 2018. Infect Dis Ther. 7(2):249-259

Results PVP-I gargle/mouthwash diluted 1:30 (equivalent to a concentration of 0.23% PVP-I) showed effective bactericidal activity against Klebsiella pneumoniae and Streptococcus pneumoniae and rapidly inactivated SARS-CoV, MERS-CoV, influenza virus A (H1N1) and rotavirus after 15 s of exposure. Conclusion PVP-I 7% gargle/mouthwash showed rapid bactericidal activity and virucidal efficacy in vitro at a concentration of 0.23% PVP-I and may provide a protective oropharyngeal hygiene measure for individuals at high risk of exposure to oral and respiratory pathogens.

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Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents - Journal of Hospital Infection

Hydrogen Peroxide at 0.5% took 1 minute for a >4.0 log10 reduction of viral infectivity of Human Coronavirus Strain 229E Povidone iodine at as low as 1% took only 15 seconds to achieve a > 4 log10 reduction of MERS Coronavirus

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Dental Care and Oral Health under the Clouds of COVID-19 - Eastman Institute of Oral Health, University of Rochester - International & American Associations for Dental Research 2020

The CDC (2020) has published an interim infection prevention and control guidance for dental settings during the COVID-19 response ... For aerosol-generating procedures, patients should be instructed to use 1% povidone-iodine or 1.5% hydrogen peroxide mouth rinses for 1 min before the procedure

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Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine - Journal of Dental Research, 2020, Vol. 99(5) 481–487

Oral Examination. Preoperative antimicrobial mouth rinse could reduce the number of microbes in the oral cavity.

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Approaches to the management of patients in oral and maxillofacial surgery during COVID-19 pandemic - Journal of Cranio-Maxillo-Facial Surgery, March 31, 2020

Definitely, a hospital environment with inadequate viral transmission protection can be a relevant route for the spread of COVID-19. Therefore, each and every measure should be taken to decrease the risk of disease transmission. These measures can even include adapting the composition of mouth rinses. SARS-CoV-2 seems to be sensitive to oxidation. As a consequence, it has been recommended that 1% hydrogen peroxide or 0.2% povidone iodine should be used

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Transmission routes of 2019-nCoV and controls in dental practice. International Journal of Oral Science March 3, 2020

A preoperational antimicrobial mouthrinse is generally believed to reduce the number of oral microbes. However, ...chlorhexidine, which is commonly used as mouthrinse in dental practice, may not be effective to kill 2019-nCoV. Since 2019-nCoV is vulnerable to oxidation, preprocedural mouthrinse containing oxidative agents such as 1% hydrogen peroxide or 0.2% povidone is recommended, for the purpose of reducing the salivary load of oral microbes, including potential 2019-nCoV carriage

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Journal of Endodontics recommends iodine pre-procedural rinse JOE Volume 46, Number 5, May 2020

Preprocedural mouth rinse: previous studies have shown that SARS-CoV and MERS-CoV were highly susceptible to povidone mouth rinse. Therefore, preprocedural mouth rinse with 0.2% povidone-iodine might reduce the load of corona viruses in saliva. Another alternative would be to use 0.5-1% hydrogen peroxide mouth rinse, as it has non specific virucidal activity against corona viruses.

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