X-PUR Opti-Rinse Plus as an Effective Pre-Procedural Mouthrinse

EXECUTIVE SUMMARY of an article in preparation for publication

Prepared by: Dennis Cvitkovitch PhD, Professor, Faculty of Dentistry, University of Toronto.

X-PUR Opti-Rinse Plus is a preventative, non-prescription mouthrinse. It provides therapeutic benefits and should be recognized for its potential use in-office as an effective Pre-Procedural Mouthrinse (PPMR), and recommended by today’s dental professional for oral self-care.

With the onset of COVID-19, the suspension of dental treatments and the subsequent return to delivering all dental care, most oral health authorities across Canada have recommended or suggested the use of various PPMRs. In dentistry, PPMRs have been used for many years to help reduce the aerosolized microbial load during dental treatments. The proximity of dental professionals to the patient during dental care, the generation of aerosols, and the recent documentation of SARS-CoV-2 in saliva have discussed the oral cavity as a potential reservoir for COVID-19 transmission. With the current pandemic, dental professionals have a critical role to play in minimizing the impact of airborne transmission due to the aerosol generating procedures employed.

The Institute for Antiviral Research at Utah State University performed testing of X-PUR Opti-Rinse Plus against the SARS-CoV-2 virus. Results confirmed that X-PUR Opti-Rinse Plus 0.2% and X-PUR Opti-Rinse Plus 0.05% were both cytotoxic to SARS-CoV-2 viral cells, and exhibited viricidal activity, reducing the virus below the limit of detection after a 1-minute contact time (LRV>1.9, >90%), equivalent to a 98.74% reduction. This demonstrates the ability of X-PUR Opti-Rinse Plus to work as an effective PPMR.

Further research conducted at the Faculty of Dentistry at the University of Toronto with X-PUR Opti-Rinse Plus 0.2% and the X-PUR Opti-Rinse Plus 0.05% compared favorably to a prescription rinse containing .12% chlorhexidine for their ability to kill and/or inhibit several oral pathogens, including:

• Porphyromonas gingivalis, a proteolytic anaerobe associated with periodontal disease, that mainly affects adults by causing destruction of alveolar bone resulting in eventual tooth loss. This bacterium has also been shown to colonize distal organs including the heart [1, 2] and brain [3], potentially causing systemic disorders including heart and Alzheimer’s disease;
• Streptococcus mutans, the most common bacteria associated with the initiation of caries, predominant in childhood caries [4];
• Streptococcus sobrinus, an additional risk factor exacerbating caries activity [4];
• Lactobacillus casei, predominant in childhood caries [5], and;
• Candida albicans, positively associated with early childhood caries [6,7], a comorbidity of hyposalivation [8], predominant in longterm care residents with prostheses, and a risk factor for pneumonia [9]

After exposure to the full strength rinses for one minute, all three rinses demonstrated: a 3-log reduction (i.e. 99.9% killing) was detected against P. gingivalis; in C. albicans, there was at least a 4 log reduction (>99.99% killing); L. casei was killed with >99.999% efficiency; S. mutans showed at least 99% of the tested cells were killed; for S. sobrinus, no colonies were detected with any of the rinses for the exposure time detected (>99.999% killing).

In the natural environment of dental plaque, bacteria grow as a biofilm attached to the tooth surface. When the three rinses were tested against biofilm-grown cells, the most prominent effect was observed with P. gingivalis and X-PUR Opti-Rinse Plus 0.2% treatment, with a 50% reduction in biofilm biomass after 10 minutes of exposure. With X-PUR Opti-Rinse Plus 0.05%, there was a 40% reduction in biofilms, while the chlorhexidine rinse was only able to reduce biofilms by 10%. X-PUR Opti-Rinse Plus (0.05% & 0.2%) are proven mouthrinses for optimal outcomes. The most recent testing data on the X-PUR Opti-Rinse Plus efficacy against SARS-CoV-2, will ease the deliberation of what PPMR to utilize as an important safety measure in preventing viral transmission for many health professionals. Considering the bactericidal and fungicidal capacities as well, the benefits to oral health, and thus systemic health, are numerous.

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