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What are you using for the preprocedural rinse



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Here is what the 2003 CDC Guidelines for Infection Control in Dental Health-Care Settings states regarding preprocedural mouth rinses (verbatim):
 
Preprocedural Mouth Rinses
 
Antimicrobial mouth rinses used by patients before a dental procedure are intended to reduce the number of microorganisms the patient might release in the form of aerosols or spatter that subsequently can contaminate DHCP and equipment operatory surfaces. In addition, preprocedural rinsing can decrease the number of microorganisms introduced in the patient’s bloodstream during invasive dental procedures (389,390).
 
No scientific evidence indicates that preprocedural mouth rinsing prevents clinical infections among DHCP or patients, but studies have demonstrated that a preprocedural rinse with an antimicrobial product (e.g., chlorhexidine gluconate, essential oils, or povidone-iodine) can reduce the level of oral microorganisms in aerosols and spatter generated during routine dental procedures with rotary instruments (e.g., dental handpieces or ultrasonic scalers) (391–399). Preprocedural mouth rinses can be most beneficial before a procedure that requires using a prophylaxis cup or ultrasonic scaler because rubber dams cannot be used to minimize aerosol and spatter generation and, unless the provider has an assistant, high-volume evacuation is not commonly used (173).
 
The science is unclear concerning the incidence and nature of bacteremias from oral procedures, the relationship of these bacteremias to disease, and the preventive benefit of antimicrobial rinses. In limited studies, no substantial benefit has been demonstrated for mouth rinsing in terms of reducing oral microorganisms in dental-induced bacteremias (400,401). However, the American Heart Association’s recommendations regarding preventing bacterial endocarditis during dental procedures (402) provide limited support concerning preprocedural mouth rinsing with an antimicrobial as an adjunct for patients at risk for bacterial endocarditis. Insufficient data exist to recommend preprocedural mouth rinses to prevent clinical infections among patients or DHCP.
 
Source: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm
 
Though these guidelines are from 2003, they are still considered current protocol.
 
In addition, the CDC Interim Infection Prevention and Control Guidance for Dental Settings During the Coronavirus Disease 2019 (COVID-19) Pandemic states (verbatim):
 
Preprocedural mouth rinses (PPMR)
 
There is no published evidence regarding the clinical effectiveness of PPMRs to reduce SARS-CoV-2 viral loads or to prevent transmission. Although SARS-CoV-2 was not studied, PPMRs with an antimicrobial product (chlorhexidine gluconate, essential oils, povidone-iodine or cetylpyridinium chloride) may reduce the level of oral microorganisms in aerosols and spatter generated during dental procedures.
 
Source: https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html
 
It should be noted that both the ADA and ADHA came out with their pandemic guidelines before the CDC released there pandemic guidelines. Both the ADA and ADHA stated to use pre-rinses containing hydrogen peroxide. The ADHA has since updated their guidelines to align with the CDC and removed this recommendation, but the ADA has not. Here’s an article regarding the use of hydrogen peroxide as a pre-rinse during the pandemic and that situation:
 
https://www.todaysrdh.com/hydrogen-peroxide-pre-rinse-during-covid-have-we-been-misled/

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