Hospital gives patients and staff mouthwash to prevent severe Covid

Patients and staff at a hospital in England are being given mouthwash in a trial to reduce severe Covid infection.

More than 4,000 bottles of an oral rinse will be distributed among employees at Salisbury District Hospital.

Clinicians say the measure aims to lower the risk of coronavirus spreading from the mouth and saliva to a patient’s lungs. However, the technique requires clinical trials to confirm its health benefits for patients with the disease.

The project follows research by Dr Graham Lloyd-Jones, a consultant radiologist at the hospital, who explained his theory that the virus could “leak from your saliva into the blood vessels of the mouth, especially if you have gum disease or bleeding gums”.

He said: “The lung disease of Covid-19 is in the blood vessels, not in the airways. The virus enters the nose and replicates in the mouth. A single teaspoon of saliva contains 500 million copies of the virus.”

Having been passed from saliva into blood vessels, “the virus would then be passed directly to the lungs via the bloodstream exactly to the areas where it does the most damage”, Dr Lloyd-Jones said, after his research was published in the Journal of Oral Medicine and Dental Research last year.

“There are everyday oral hygiene steps which might reduce the virus in the mouth and saliva, and lower the risk of it spreading to the lungs.”

His team said the hypothesis would explain why those with gum disease get more severe Covid, as well as highlighting the importance of good oral hygiene.

In the paper, the team of researchers from Salisbury District Hospital, the University of Birmingham, and the Mouth-Body Research Institute in Los Angeles, US, and Cape Town, South Africa, suggest that “daily oral hygiene and oral healthcare should be prioritised as such measures could be potentially lifesaving for Covid-19 patients”.

The research team stressed that additional studies were “urgently required to further investigate this new model”.

But Dr Lloyd-Jones said: “It is striking that the risk factors for severe Covid-19 are the same as the risk factors for severe gum disease.

“These include patient age, sex, ethnicity, blood group, obesity, other diseases such as diabetes and heart disease, and for those who have difficulty looking after their mouths such as those with dementia, learning difficulties or physical disabilities.

“Until clinical trials are performed to confirm the benefit of oral hygiene measures, we are advising careful attention to simple mouth care steps for anyone with Covid-19, including regular tooth brushing and use of certain mouthwashes.”

The researchers said there was evidence to show that some mouthwash products contain ingredients which completely eradicate Sars-CoV-2 in a test tube in as little as 30 seconds.

Specific mouthwashes tested by Cardiff University which contain these ingredients have now been sent for use with all Salisbury Hospital patients with Covid.

All of Salisbury Hospital’s Covid patients have received a supply of mouthwash since October 2021.

Sara Hurley, chief dental officer for England, said: “Good oral health is a key element of compassionate care.

“Every patient care pathway, in every hospital, should include routine daily mouth care. I welcome the Salisbury Hospital initiative, their recognition that mouth care matters and the wider dividends for health.”

Stacey Hunter, chief executive of Salisbury NHS Foundation Trust, said: “We are aiming for excellence in oral healthcare and whilst studies are ongoing, we are forging ahead with this pioneering initiative.

“The measures we are putting in place are based on existing evidence that shows paying attention to oral healthcare for inpatients is beneficial, shortening hospital stay and even reducing [the] death rate.”

The Independent contacted Salisbury NHS Foundation Trust for further comment on the trial but did not hear back at the time of publication.