Abstract
Introduction Virus particles in respiratory droplets and aerosols generated during medical/dental procedures are a potential source of SARS-CoV-2 cross infection. In the dental setting, oral decontamination could be an important adjunct to personal protective equipment and is recommended by a number of national COVID-19 guidance documents for dental settings.
Aim To assess the in vitrovirucidal activity of an oral povidone iodine (PVP-I) product against SARS-CoV-2.
Material and methods BETADINE gargle and mouthwash (1% PVP-I) was tested against SARS-CoV-2 virus under both clean and dirty conditions using a suspension assay based on EN14476 methodology. Virucidal activity of the product, undiluted and at 1:2 dilution, was tested at contact times of 15, 30 and 60 seconds. Viral titres were calculated using the Spearman-Kärber method and reported as median tissue culture infectious dose (TCID50/ml).
Results The undiluted product achieved >5 log10 reduction in viral titres compared to the control at 15, 30 and 60 seconds under both clean and dirty conditions. At a twofold dilution (0.5% PVP-I), the test product demonstrated >4 log10 kill at 15 seconds and >5 log10 kill at 30 and 60 seconds in both clean and dirty conditions.
Conclusion PVP-I gargle and mouthwash product, undiluted and at 1:2 dilution, demonstrated potent and rapid virucidal activity (≥4 log10 reduction of viral titre) in 15 seconds against SARS-CoV-2 in vitro. The PVP-I gargle and mouthwash product is widely available and could be readily integrated into infection control measures during dental treatment including pre-procedural oral decontamination.
Key points
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Close contact and potential for aerosol generation increase risk of SARS-CoV-2 exposure during medical and dental procedures.
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Pre-procedural mouth rinses are recommended as an additional measure to reduce cross-infection risk in dental settings.
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PVP-I (1%) gargle and mouthwash showed 99.99% kill rate of SARS-CoV-2 in vitro within 15 seconds of contact in clean and dirty conditions.
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The use of PVP-I-containing pre-procedural mouth rinse to reduce oral viral load could be recommended in addition to other protective measures.
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Acknowledgements
This study and editorial support for the publication of this manuscript was funded by Mundipharma Singapore Holding Pte Limited. The results of this study were reported in abbreviated form in a letter to the editor published in the British Dental Journal: P. Hassandarvish, V. Tiong, A. B. Sazaly et al., Povidone iodine gargle and mouthwash, British Dental Journal, 2020, volume 228, page 900.
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PH and VT are both joint first authors. All the authors contributed to the design and analysis of the experiments, and the development of the manuscript. The experiments were performed by PH and VT under the guidance of SA, who was the principal investigator for the study.
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Hassandarvish, P., Tiong, V., Mohamed, N. et al. In vitro virucidal activity of povidone iodine gargle and mouthwash against SARS-CoV-2: implications for dental practice. Br Dent J (2020). https://doi.org/10.1038/s41415-020-2402-0
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DOI: https://doi.org/10.1038/s41415-020-2402-0
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