Discussion
herpes virus, gingivitis, respiratory syncytial virus, rhinovirus, periodontitis
PERIODONTITIS, VIRUS, GINGIVITIS, VIRAL SHEDDING
In this study, we showed that CPC and CPC+Zn mouthwashes reduced the SARS-CoV-2 viral load in the saliva of COVID-19 inpatients. The antiviral potential of CPC reported by other studies (In a previous pilot study, our group showed that CPC mouthwash reduced the SARS-CoV-2 viral load in saliva for up to 60 min, a time interval considered sufficient for reducing the contamination risk during dental procedures in SARS-CoV-2-positive patients (The role of zinc in controlling SARS-CoV-2 requires further investigation. In vitro and clinical studies suggest that this ion has antiviral properties against herpes virus, respiratory syncytial virus, rhinovirus (An unexpected finding in the current study was a trend of viral load increase in the negative control (mouth washing with only distilled water) 60 min postrinsing, although this difference was not statistically significant in relation to the baseline. We interpreted this result as natural virus kinetics in the saliva in accordance with the circadian cycle, considering that in all the patients, the mouth washing and saliva collection were performed in the morning, immediately after the patient’s awakening. A study showed that from 4 a.m. to 12 p.m., there is high viral shedding in the saliva in comparison with the evening period (It is important to mention that the current study cannot differentiate the impact of the mouthwashes relative to the viral origin source, although presumably the bulk of viruses neutralized are found in saliva. The impact of the oral solutions on SARS-CoV-2 infectivity must also be further analyzed, although the significant viral load reductions observed mainly at T1 and in the Another question not addressed in the current study but with important clinical implications is the CPC mouthwash effect (with or without zinc) on the oral microbiome as a whole. Daily use of CPC mouthwash can induce changes in the oral microbiome, such as reductions in microbial diversity and gingivitis-related bacterial abundance, which can lead to positive clinical outcomes in patients with gingivitis and periodontitis (Despite the temporary effects of mouthwashes, the current study reinforces the findings of our pilot study and provides encouraging results regarding the use of these products as preprocedural rinses for patients infected with SARS-CoV-2 and may be used as a risk mitigation practice for asymptomatic patients. The use of mouthwashes as an adjunct to current mitigation practices, such as the use of masks, handwashing, disinfection, and social distancing efforts, should be considered. In addition, the incorporation of a preprocedural rinse prior to any dental procedures would help create a safer working environment for dental professionals by reducing their exposure to pathogens such as SARS-CoV-2 during routine dental procedures.