The next time you visit the dentist during the COVID-19 pandemic, you will notice the addition of a hydrogen peroxide pre-procedural rinse. This means your dental provider will have you rinse with a mouthwash containing 1.5% hydrogen peroxide prior to treatment. Doing so is an attempt to reduce the potential spread of the virus. But, will hydrogen peroxide kill coronavirus at the dentist?
Aerosols produced during dental procedures can result in aerosolization of viruses, fungi and bacteria. These aerosols are created during treatments to restore teeth and during routine cleanings. The aerosols can travel throughout the air and linger for hours. This puts others in danger of coming in contact with them. Pre-procedural rinses are used in theory to help reduce the load of pathogens, including coronavirus in the dental office.
With so much conflicting information available, this article will provide useful information to help you understand this now common recommendation. Read on to learn about an option for a hydrogen peroxide rinse you can use at home.
Why Is Hydrogen Peroxide Used as a Dental Pre-Rinse?
As a dental hygienist, I would like to share what the ADA (American Dental Association) recommends for patients as a pre-rinse. This is a 1.5% hydrogen peroxide rinse. It is recommended to have patients swish with this solution for 30 seconds, spit out, swish again for another 30 seconds and spit out again.
It is referred to as a pre-procedural rinse, meaning a rinse done before procedures. Because aerosols are commonly created at the dental office, this is an attempt to cut down on the pathogens spread throughout the air during and after dental procedures.
Hydrogen peroxide is described by the Center for Disease Control (CDC) as being an active ingredient against microorganisms including viruses, bacteria, fungi, yeasts and spores.
Because hydrogen peroxide is an oxidizing agent, it is thought to disrupt the cell membrane of coronavirus which is susceptible to oxidation. The method of action is thought to be from the hyroxyl free radicals produced by hydrogen peroxide. In vitro, this oxidizing agent has been shown to penetrate cell membranes, attack the genetic materials including cell components and oxidize the cell’s structure.
But Does It Work? Will Hydrogen Peroxide Kill Coronavirus?
At this time, it must be noted that there is no conclusive evidence that using hydrogen peroxide as a pre-procedural rinse is effective against COVID-19. It is only theorized to be effective at reducing the viral load of dental aerosols. Further research is needed to conclude whether hydrogen peroxide is beneficial.
Even though it has been shown to be effective in vitro, there are limitations to consider. The virus lives in the nose and throat not just in the oral cavity. By rinsing only in the mouth, you are not reaching these other areas. COVID-19 can be spread from dental aerosols but also by other airway transmissions including breathing, talking and coughing or sneezing.
According to the CDC (Center for Disease Control), dental health care providers are advised to limit aerosol generating procedures. This includes the use of air/water syringes, ultrasonic scalers and high-speed dental handpieces. The use of high-speed suction is also encouraged during dental procedures. The addition of a pre-procedural rinse is for the possible extra protection it may provide to the patient and the dental professional.
The Choice Is Yours
In the dental office, pre-procedural rinses with hydrogen peroxide are likely here to stay. To what degree these rinses are effective is still to be determined. You may choose to use a hydrogen peroxide rinse outside the dental office. This is something you can do on your own if you want to obtain the possible protection it provides.
The most common rinse available for home use is Peroxyl. This is the same rinse used in dental offices for their pre-procedural rinse and is available for over the counter use as well. Peroxyl is an antiseptic mouth rinse that contains 1.5% hydrogen peroxide. Its oxygenating action flushes out debris, it’s alcohol free and has a great tasting mint flavor.
Be cautious if you are using a product other than Peroxyl that is not premixed to a standardized 1.5% solution. Rinsing with a 3% hydrogen peroxide solution as it is commonly sold in brown bottles over the counter is not recommended. At this strength, it is too concentrated and may cause damage to your oral tissues. For this reason, it is always recommended to dilute 3% hydrogen peroxide with equal parts of water (half-and-half) before using in the mouth.
Using 3% hydrogen peroxide full strength can disrupt the oral microbiome of the mouth. It can cause a condition known as “black hairy tongue” and be irritating to oral tissues. See a related article on what a healthy tongue should look like. The oral cavity needs to have a balance of good and bad bacteria to remain healthy. Oral probiotics can help to keep this precious balance in check.
According to the Dimensions of Dental Hygiene Journal, “Pre-procedural rinsing has been recommended to help reduce transmission of pathogenic microorganisms.” More research is needed on how these rinses play a part in the reduction of coronavirus. However, in theory, the use of rinses containing 1.5% hydrogen peroxide like Peroxyl suggests effectiveness against viruses such as the novel coronavirus.
Since coronavirus is thought to be vulnerable to oxidation, use of a 1.5% hydrogen peroxide pre-procedural rinse at the dentist may help reduce the spread of coronavirus. However, at this time, there are no clinical studies supporting the virucidal effects of any pre-procedural mouth rinse against coronavirus.
Please be safe and visit your dentist for regular care. There are many safety and precautionary measures being put into place at the dental office to increase your safety as a patient. It is not guaranteed that you won’t contract the virus responsible for the COVID-19 pandemic while visiting the dentist. However, you can be reassured by the fact that your dental provider is advised to follow strict protocols for your safety.
If you have any questions related to a dental visit during these times, please refer to a related article: Coronavirus and Dental Offices-How to Be Safe. Please leave any comments or concerns below and I would be happy to help.
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