Mouth Rinses with Substantivity Can Prevent COVID-19 Spread and Protect the Healthcare Workers

11 Pages Posted: 13 Jul 2020

Date Written: June 30, 2020


SARS-CoV-2, a novel coronavirus, has caused a worldwide spread of COVID-19 mainly by coughing, sneezing, droplet inhalation, and contact. Studies have found viral load in saliva to be not only consistently high but also higher than that from the oropharynx, suggesting that saliva could be a potential source of SARS‐CoV‐2 transmission. Moreover, healthcare workers face a higher risk of contracting SARS-CoV-2 infection due to their nature of work that brings them in close contact with the patients and potential exposure to saliva-contaminated droplets and aerosols generated during several clinical procedures. Pre-procedural mouth rinses are one of the effective ways of protecting healthcare workers by reducing the microbial load coming out from patients' mouths via coughing, sneezing, talking and during many clinical procedures. While mouth rinses have been extensively studied for their antibacterial and anti-plaque effects, now they are being tested for their antiviral effects, by which they can reduce the viral load in a patient that could be an asymptomatic or pre-symptomatic carrier. A mouth rinse may not offer sufficient protection to healthcare workers if it reduces the viral load only when it comes in contact with the virus in the mouth, without being able to maintain a low viral load after it is expectorated. Hence, only mouth rinses like Chlorhexidine that show persistent activity by virtue of their substantivity will be able to offer sufficient protection to healthcare workers. Substantivity enables a mouth rinse to maintain low viral loads in the mouth for a long period of time during which healthcare workers can complete their consultation and treatment procedures. Along with the use of masks, social distancing, and eyewear, an additional recommendation for the use of antiviral mouth rinses with substantivity can significantly help in the prevention of SARS-COV-2 infection spread in the community.

Note: Funding Information: This work has received no funding from any agency in the public, commercial, or not-for-profit sectors.

Declaration of Interest: Dr Rajeev Chitguppi is a consulting periodontist and an independent researcher, and also serves as the Scientific Advisor and Technical Head at ICPA Health Products Ltd.

Keywords: Mouth rinses, Substantivity, SARS-COV-2, COVID-19, Chlorhexidine, Infection, Public Health, Healthcare workers

Suggested Citation

Chitguppi, Rajeev, Mouth Rinses with Substantivity Can Prevent COVID-19 Spread and Protect the Healthcare Workers (June 30, 2020). Available at SSRN: or

Rajeev Chitguppi (Contact Author)

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