It is well known that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads through respiratory droplets, saliva or by direct contact. Hence, controlling the viral load in the saliva and secretions from the respiratory tract becomes important to check the spread of this virus.¹

Good oral and throat hygiene is a simple and cost-effective way to prevent community transmission of the virus. Now, there is evidence showing that povidone-iodine (PVP-I), a broad-spectrum microbicidal agent, has virucidal properties and is effective against coronavirus. PVP-I has the potential to inactivate enveloped as well as nonenveloped viruses.¹

Several studies have shown the potential of PVP-I to inactivate SARS-CoV-2. PVP-I mouth rinse or gargle for 30 seconds has been reported to decrease the infectivity of SARS-CoV-2 to below detectable levels. Moreover, PVP-I has also been shown to hinder the attachment of SARS-CoV-2 to oral and nasopharyngeal tissues and decreases the viral particles in saliva and respiratory droplets.¹

In a 2020 study, Liang et al reported that PVP-I could cause rapid inactivation of SARS-CoV-2.² Another study noted that PVP-I mouthwash reduced SARS-CoV-2 viral load in coronavirus disease 2019 (COVID-19) patients.³  

Therefore, it is advised that PVP-I mouth rinse should be used as a prophylactic to reduce the transmission of COVID-19. It has been stated that the preoperative use of PVP-I mouth rinse or gargle is crucial to prevent the spread of infection during the ongoing pandemic.¹

The American Dental Association (ADA) has also approved the use of PVP-I mouthwash prior to all dental procedures during the pandemic. PVP-I solution as a mouthwash is well-tolerated and can be administered for up to 6 months in the oral cavity.¹

As COVID-19 vaccines are being rolled out across the globe, a safe and inexpensive adjunctive modality, in the form of PVP-I mouth rinse, should be used to limit virus transmission in the community. Regular use of PVP-I mouthwash can help hospitalized, non-hospitalized, symptomatic, as well as asymptomatic COVID-19 patients by reducing the viral load.

References

1. Chopra A, Sivaraman K, Radhakrishnan R, et al. Can povidone iodine gargle/mouthrinse inactivate SARS-CoV-2 and decrease the risk of nosocomial and community transmission during the COVID-19 pandemic? An evidence-based update. Jpn Dent Sci Rev. 2021;57: 39-45.
2. Liang B, Yuan X, Wei G, et al. In-vivo toxicity studies and in-vitro inactivation of SARS-CoV-2 by povidone-iodine in-situ gel forming formulations. bioRxiv [Preprint]. 2020:2020.05.18.103184.
3. Martínez Lamas L, Diz Dios P, Pérez Rodríguez MT, et al. Is povidone iodine mouthwash effective against SARS-CoV-2? First in vivo tests. Oral Dis. 2020 Jul 2;10.1111/odi.13526. [Epub ahead of print]