Herrera D, Serrano J, Roldán S, Sanz M. Is the Oral Cavity Relevant in SARS-CoV-2 Pandemic? Clin Oral Investig 2020; DOI: 10.1007/s00784-020-03413-2. [Epub ahead of print].

Antiseptic mouth rinses have been suggested in decreasing the severity of COVID-19 and in reducing the risk of transmission but the evidence on efficacy is indirect and weak.

Recent scientific evidences suggest a relevant role of the oral cavity in the transmission and pathogenicity of SARS-CoV-2. A literature search was performed in PubMed, up to April, 2020, focusing on SARS-CoV-2, COVID-19, oral cavity, and antimicrobial agents. Oral viral load of SARS-CoV-2 has been associated with the severity of COVID-19, and so a reduction in the oral viral load could be associated with a decrease in the severity of the condition. Similarly, a decrease in the oral viral load would diminish the amount of virus expelled and reduce the risk of transmission, since (i) during the first ten days, the virus mainly accumulates at the nasal, oral, and pharyngeal area; (ii) the number of angiotensin-converting enzyme receptor is greater in the salivary glands as compared with the lungs; and (iii) salivary droplets represent the most relevant transmission route. To reduce the oral viral load, antiseptic agents may be used, although the authors found the evidence on its efficacy to be indirect and weak. Further well-designed studies are required.