Povidone-Iodine as a Pre-Procedural Mouthwash to Reduce the Salivary Viral Load of SARS-CoV-2: A Systematic Review of Randomized Controlled Trials

Alvaro Garcia-Sanchez; Juan-Francisco Peña-Cardelles; Esther Ordonez-Fernandez; María Montero-Alonso; Naresh Kewalramani; Angel-Orión Salgado-Peralvo; Dániel Végh; Angélica Gargano; Gabriela Parra; Lourdes-Isabela Guerra-Guajardo; Wataru Kozuma

doi:10.3390/ijerph19052877

Povidone-Iodine as a Pre-Procedural Mouthwash to Reduce the Salivary Viral Load of SARS-CoV-2: A Systematic Review of Randomized Controlled Trials

Int J Environ Res Public Health. 2022 Mar 1;19(5):2877. doi: 10.3390/ijerph19052877.

Authors

Affiliations

¹ Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA.
² Department of Health Sciences, Rey Juan Carlos University, 28040 Madrid, Spain.
³ Oral and Maxillofacial Surgery Department, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA.
⁴ Department of Prosthodontics, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA.
⁵ Division of General Dentistry, Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA.
⁶ Pediatric Service, Hospital Álvaro Cunqueiro, 36213 Vigo, Spain.
⁷ Department of Nursery and Stomatology, Rey Juan Carlos University, 28922 Madrid, Spain.
⁸ Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain.
⁹ Department of Prosthodontics, Semmelweis University, 1085 Budapest, Hungary.
¹⁰ Division of Oral Surgery and Orthodontics, Department of Dentistry and Oral Health, Medical University of Graz, 8010 Graz, Austria.
¹¹ Department of Regenerative and Reconstructive Dental Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.

Abstract

The use of pre-procedural rinses has been investigated to reduce the number of viral particles and bacteria in aerosols, potentially decreasing the risk of cross-infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during medical and dental procedures. This review aims to confirm whether there is evidence in the literature describing a reduction in salivary load of SARS-CoV-2 when povidone-iodine (PVP-I) is used as a pre-intervention mouthwash. An search of the MEDLINE, Embase, SCOPUS, and the Cochrane library databases was conducted. The criteria used followed the PRISMA^® Statement guidelines. Randomized controlled trials investigating the reduction of salivary load of SARS-CoV-2 using PVP-I were included. Ultimately, four articles were included that met the established criteria. According to the current evidence, PVP-I is effective against SARS-CoV-2 in saliva and could be implemented as a rinse before interventions to decrease the risk of cross-infection in healthcare settings.

Keywords: COVID-19; SARS-CoV-2; aerosols; cetylpiridinium chloride; chlorhexidine; colony-forming units; hydrogen peroxide; mouthrinse; mouthwashes; povidone-iodine.

Publication types

Review
Systematic Review

MeSH terms

COVID-19* / prevention & control
Humans
Mouthwashes
Povidone-Iodine* / therapeutic use
Randomized Controlled Trials as Topic
SARS-CoV-2
Viral Load

Substances

Mouthwashes
Povidone-Iodine