Do hydrogen peroxide mouthwashes have a virucidal effect? A systematic review

Ortega, K.L.; Rech, B.O.; El Haje, G.L.C.; Gallo, C.B.; Pérez-Sayáns, M.; Braz-Silva, P.H.

BACKGROUND: The presence of SARS-CoV-2 in saliva has alerted health professionals to the possibility of contamination by aerosols generated in a number of procedures. The indication of pre-operative mouthwash containing 1% hydrogen peroxide for reducing the viral load of SARS-CoV-2 in saliva prior to oral procedures has been significantly disseminated through several citations and influenced various dental associations in the elaboration of dental care protocols during this pandemic period, including patients admitted to hospital wards and intensive care units. AIM: The objective of this work was to perform a systematic review to answer the following question: does hydrogen peroxide mouthwash (at any concentration) have a virucidal effect? METHODS: The Cochrane, LILACS, PubMed, Scopus and EMBASE databases were searched by using the following key-words like: “hydrogen peroxide”, “mouthwash”, “mouth rinse”, “rinse”, “oral rinse”, “mouth bath”, “mouth wash” and “mouth washes”.Reviews, letters to the editor, personal opinions, book chapters, case reports, congress abstracts, studies with animals and studies on mouthwash containing other compounds other than hydrogen peroxide were excluded. FINDINGS: During the initial search1,342 articles were identified on the five electronic databases. After excluding some duplicates, 976 articles remained. Only studies assessing the virucidal effect of hydrogen peroxide mouthwash were selected, regardless of publication date. After reading titles and abstracts, no article met the eligibility criteria. CONCLUSION: There is no scientific evidence supporting the indication of hydrogen peroxide mouthwash for control of the viral load regarding SARS-CoV-2 or any other viruses in saliva.