Efficiency Of Mouthwashes And Nasal Sprays In Early Treatment And Control Of Coronavirus Infection

This paper aims to discuss the efficiency of mouthwashes and nasal spray in the early treatment and control of Coronavirus infection based on the existing literature. Pathophysiology of Covid-19 also discussed along with a critical review, comparison of existing research, benefits and limitations of the researches, and finding of the researches. Various precautions such as face masks, other PPEs, and social distancing have introduced to prevent the risk of Covid-19; however, it poses a higher risk to health professionals and hospitalised patients due to its contagious nature, and the risk of transmission increases for both patient and health professional during the health intervention. Saliva is the major factors of Covid-19 transmission virus; some professionals including dentists have a higher risk of Covid-19 as they work closely with patients while generation of aerosol in dental process. Oral health plays an important role as the oral cavity leads to various illness and infection (Gandhi et al., 2021). Thus, nasal spray and mouth rises can be used to prevent the infections.

Covid-19 has been defined as a respiratory illness that affects the lung, upper airways, and nasal cavity. It is detected by the Saliva test as it plays important role in the transmission of disease; hence, health professionals such as oral care providers have a higher risk of infection. According to Fini (2020), Covid-19 can transmit through saliva; thus, Covid-19 in the lower and upper respiratory tract reaches the oral cavity along with liquid droplets, and it can enter the mouth; hence, it is necessary to take precautions regarding early treatment and prevention of virus. Mouthwash and nasal sprays can be used to protect oral healthcare providers and patients from the risk of transmission.

According to Guenezan et al. (2021), Covid-19 can spread person to person by the contaminated surfaces, items, and droplets; however, Povidone-iodine (PI) solutions with a low concentration of 0.5% can be used to inactive the Covid in vitro within 15 seconds, and application of PI can reduce risk of infection who have non-severe Covid symptoms. In this study, adult outpatient participants were included those who have been tested positive for Covid and randomly assigned to the control and intervention groups. The intervention group has been given 25 ml PI solution for mouthwashes and gargles followed by 2.5ml nasal pulverization. The study follows basic rules and ethics as participants have been trained for the use of PI. Participants were unpleasant with the use of PI. Finding from the study revealed that nasal intervention of PI and mouthwash reduces the carriage of infection in people with mild Covid symptoms. This study included small numbers of participants and has a single-centred design; hence further studies are required to confirm the efficacy of PI concentration (Guenezan et al et al., 2021).  Pathophysiology Of Covid-19 Example Paper

Another study by Anderson et al. (2020), revealed that PI concentration can reduce the risk of transmission and can be used in different products such as hand sanitisers and mouth wash. This study tested the products that contain PVP-I at the animal biosafety level, and products have been tested against the ability to kill Covid-19 infection. A kill time assay has performed on the different products including hand sanitisers, throat spray, and mouth wash, and the effectiveness of PI products against Covid-19 has been tested at the exposure time of the 30s. Early prevention and control strategies for Covid-19 include the control of transmission by using; hence, PI solutions and products that contain PI concentration can be used to eliminate the risk of infection (Anderson et al., 2020). Chopra et al. (2021), have also focused on PI, and iodine gargles to reduce the risk of transmission. There are no clinical studies that confirm the effectiveness of oral rinse; however, many studies are ongoing to confirm the efficacy of PI against the Covid-19 virus.

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Precautions Against Covid-19 Transmission

Casale et al. (2020), reviewed existing studies to find out the effectiveness of nasal irrigation and oral rinse to control and prevent infection. Mouth and nose are the entry portals for Covid infection; hence interventions such as nasal irrigation and mouth wash can be the best possible strategies to reduce and prevent Covid-19 infection. It has been also found that oral rinse with the Listerine antiseptic and mouthwash that contain alcohol can prevent viral contamination in oral fluid for at least 30 minutes after oral rise. It has been also found that the risk of contamination from person to person depends on the oral fluids; hence, alcohol solution and Listerine can be used to control and prevent the infection transmission. Evidence upheld the adequacy job of antimicrobial rinses against the wrapped infections including the human coronavirus. It has been found that Chlorhexidine could cause staining of tooth surfaces, reclamations, and the tongue, modification in taste, irritation, and mucosal harm with everyday use (Casale et al., 2020).

A cohort study by Huang & Huang (2021), focuses on the efficacy of chlorhexidine to prevent the risk of transmission. Since the vaccine has taken a long period of development; professionals have recommended following the prevention guidelines including the use of PI, Listerine, and chlorhexidine concentration in mouth wash, nasal irrigation and hand wash. Along with the social distancing and face mask, chlorhexidine solution was also considered a preventive measure. The use of chlorhexidine gluconate is effective to prevent Covid-19 infection. The study of Huang & Huang (2021), was performed at the four community hospitals in California. The patients who have been admitted to Covid-19 wards due to the infection, participated in the study by the randomized assigned method. Since the oral rinse would not reach the posterior oropharynx effectively, a chlorhexidine spray has also been added to the oral rinse. The patients were educated to use the chlorhexidine (approximately 1.5 ml), and instructed to vocalize for 5s during the intervention. Chlorhexidine is also used for preoperative preparation of skin to prevent postoperative infection, dental plaque, and ventilator-associated pneumonia prevention. Furthermore, chlorhexidine has cationic nature that can kill enveloped viruses; hence, it can be used to prevent or kill the Covid-19 infection as it is an enveloped virus (Huang & Huang, 2021).

Hydrogen peroxide H2O2 has also been identified as an effective weapon for infection prevention, reducing hospitalization, and complications of Covid-19 (Caruso et al., 2020). Kampf et al. (2020), found the effectiveness of H2O2 as an antiseptic agent that can be used to prevent Covid infection. This study was also used by Caruso et al. (2020), to evaluate the role of hydrogen peroxide in reducing Covid-19 based hospitalization and complications of infection. The antiseptic viability of H2O2 3% against SARS-CoV-2 on oral and nasal mucosa can be sensibly estimated. The general movement of the contamination from the upper to the lower respiratory tract can be diminished by the H2O2. Thus, an off-mark use of H2O2 is advised 3% and 1.5 % by oral and nasal washing individually, performed following the beginning of the primary side effects and the possible analysis of Covid and during the sickness at home quarantine or by inpatients not needing required care. It is also recommended to gargle 3 times a day for disinfection of oral activity and nasal washes with nebuliser, this activity can be done twice a day. H2O2 is considered to be safe for the mucous membranes of nasal spray, and it is common in otolaryngology (Caruso et al., 2020).

Efficiency Of Mouthwashes And Nasal Sprays In Early Treatment Of Covid-19

Di Domenico et al. (2021), found that a low concentration of H2O2 can be used for several purposes; for example, decontamination of surfaces, and N95 respirators for reuse. Furthermore, H2O2 is an antiseptic cleaning agent that can also be used for whitening of tooth. It gives various advantages as an antiseptic agent with low cost. Caruso et al. (2020), found that mouthwash using H2O2 and nasal spray are effective in preventing Covid infection. Oral manifestations developed in Covid-19 include ulcerative lesions on the tongue, palate, lip and cheek. In Covid-19 the lesion on the tongue is inflammatory that can appear on the sides, and top of the tongue, and increase the severity of the illness; hence, antiseptic agents can be used to decrease the severity of symptoms; for example, H2O2. Various studies have conducted on antiseptic agents such as H2O2, PI, and Listerine, and their ability to dimmish the infection; however, these studies remain inconclusive due to the small sample size (Di Domenico et al., 2021).

Oral rinse, mouth wash and a nasal spray of antiseptic agents are the effective interventions to control the transmission of infection. Kelly, Íomhair & McKenna (2020), found that dilute formulation of ethanol and H2O2 are effective agents for enveloped virus prevention. The use of alcohol in hand rubs has also proven effective in preventing the transmission of viruses as alcohol kills the growth of bacteria or viruses, similarly, ethanol is also used with H2O2 in nasal sprays and mouthwash products that can kill the viruses. According to Siddharta et al., (2017), mouthwash is an effective approach that can inactive SARS-CoV and other influenza viruses; hence, healthcare associations and pharmaceutical organizations have started researching the efficacy of this agent in reducing the risk of infection and started to develop the product such as hand sanitisers, mouthwashes, and nasal sprays. This practice can be seen at a broad level in Asian countries; however, is not followed in some Western countries; for example, it is not available in the UK, while government of Japan have suggested the people to gargle or mouthwash with the PI solution to prevent upper respiratory tract infections (Kelly, Íomhair & McKenna, 2020).

The lipid membrane can be disrupted by the hydrogen peroxide agent that produces oxygen free radicals; hence it can inactive enveloped viruses such as Covid-19 by producing oxygen-free radicals. It is important to note that the concentration of the agent should be lower than 0.5%, while a high concentration above 0.5% can damage the tissues. Findings from the above studies have revealed that regular mouthwash and nasal interventions are necessary to prevent the risk of infection, and healthcare professionals that provide oral care and hospitalised patients must be must follow these recommendations. While the transmission of Covid-19 has appeared to be via respiratory, droplets saliva, and throat; it is necessary to focus on the use of mouthwash and nasal sprays to inactive the virus (Kelly, Íomhair & McKenna, 2020).

Conclusion

Based on the above analysis it can be concluded that Covid-19 has spread by human transmission through mouth saliva, respiratory droplets, and throat; hence, prevention and early treatment of the virus should focus on the mouth and nasal intervention. Findings from the above analysis revealed that disinfection agents such as povidone-iodine, PI, PVP-I, Listerine, chlorhexidine, and H2O2 can be used in the early prevention and early treatment of Covid-19 infection. The above disinfection agents have been found to be effective and cost-efficient. H2O2 and other agents are widely used for the treatment and prevention of infection.

References

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Guenezan, J., Garcia, M., Strasters, D., Jousselin, C., Lévêque, N., Frasca, D., & Mimoz, O. (2021). Povidone iodine mouthwash, gargle, and nasal spray to reduce nasopharyngeal viral load in patients with COVID-19: a randomized clinical trial. JAMA Otolaryngology–Head & Neck Surgery, 147(4), 400-401. doi:10.1001/jamaoto.2020.5490

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