• Maximilian J Gottsauner, Ioannis Michaelides, Barbara Schmidt, Konstantin J Scholz, Wolfgang Buchalla, Matthias Widbiller, Florian Hitzenbichler, Tobias Ettl, Torsten E Reichert, Christopher Bohr, Veronika Vielsmeier, and Fabian Cieplik.
• Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany.
• Clin Oral Investig. 2020 Oct 1; 24 (10): 3707-3713.

ObjectivesSARS-CoV-2 is mainly transmitted by inhalation of droplets and aerosols. This puts healthcare professionals from specialties with close patient contact at high risk of nosocomial infections with SARS-CoV-2. In this context, preprocedural mouthrinses with hydrogen peroxide have been recommended before conducting intraoral procedures. Therefore, the aim of this study was to investigate the effects of a 1% hydrogen peroxide mouthrinse on reducing the intraoral SARS-CoV-2 load.MethodsTwelve out of 98 initially screened hospitalized SARS-CoV-2-positive patients were included in this study. Intraoral viral load was determined by RT-PCR at baseline, whereupon patients had to gargle mouth and throat with 20 mL of 1% hydrogen peroxide for 30 s. After 30 min, a second examination of intraoral viral load was performed by RT-PCR. Furthermore, virus culture was performed for specimens exhibiting viral load of at least 103 RNA copies/mL at baseline.ResultsTen out of the 12 initially included SARS-CoV-2-positive patients completed the study. The hydrogen peroxide mouthrinse led to no significant reduction of intraoral viral load. Replicating virus could only be determined from one baseline specimen.ConclusionA 1% hydrogen peroxide mouthrinse does not reduce the intraoral viral load in SARS-CoV-2-positive subjects. However, virus culture did not yield any indication on the effects of the mouthrinse on the infectivity of the detected RNA copies.Clinical RelevanceThe recommendation of a preprocedural mouthrinse with hydrogen peroxide before intraoral procedures is questionable and thus should not be supported any longer, but strict infection prevention regimens are of paramount importance.Trial RegistrationGerman Clinical Trials Register (ref. DRKS00022484).

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