{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:07:52Z","timestamp":1785434872838,"version":"3.56.0"},"posted":{"date-parts":[[2026,5,22]]},"group-title":"Dentistry and Oral Medicine","reference-count":51,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The University of California Office of the President Emergency COVID- 19 Research Funding through California Breast Cancer Research Program","award":["R00RG2901"],"award-info":[{"award-number":["R00RG2901"]}]},{"award":["T32DE007306"],"award-info":[{"award-number":["T32DE007306"]}],"id":[{"id":"https:\/\/ror.org\/004a2wv92","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"crossref"}]},{"award":["U01DE025507-S1"],"award-info":[{"award-number":["U01DE025507-S1"]}],"id":[{"id":"https:\/\/ror.org\/004a2wv92","id-type":"ROR","asserted-by":"publisher"}]},{"name":"UCSF Clinical and Translational Science Institute","award":["TL1 TR001872"],"award-info":[{"award-number":["TL1 TR001872"]}]},{"name":"Rowpar Pharmaceutical Inc.","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Procter & Gamble, USA","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,6,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The COVID-19 pandemic has caused significant global mortality. Despite declining infection rates, new variants of SARS-CoV-2 continue to emerge, necessitating new prevention strategies.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study aimed to evaluate the effect of four over-the-counter (OTC) antiseptic mouthwash\/gargling solutions in the U.S., compared with a distilled water control, on SARS-CoV-2 viral load across multiple oral and oropharyngeal sample types.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This pilot single-center randomized controlled clinical trial enrolled adults in the San Francisco Bay Area, California, who tested positive for COVID-19. Participants were randomized to distilled water, chlorine dioxide, hydrogen peroxide, cetylpyridinium chloride, and essential oils. Participants were instructed to rinse and gargle four times daily for four weeks using standardized instructions to ensure protocol adherence. Samples were collected on Days 1, 7, and 28 and analyzed using reverse transcription\u2013quantitative polymerase chain reaction (RT-qPCR). The primary outcome was the change in SARS-CoV-2 viral load from baseline to Day 28, assessed using cycle threshold (Ct) values. Secondary outcomes included self-reported clinical symptoms and hospitalization.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Forty-nine participants completed the study. No mouthwash demonstrated a statistically significant reduction in SARS-CoV-2 viral load over time. Cetylpyridinium chloride showed a transient increase in Ct values on Day 7 that was not sustained on Day 28. At baseline, throat swab samples had the lowest Ct values across all sample types. Due to limited subgroup sample sizes for secondary outcome measures, no statistical or moderator analyses were conducted.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Further large-scale randomized trials are needed before recommending antiseptic mouthwashes for SARS-CoV-2 prevention or management.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Trial Registration<\/jats:title>\n                  <jats:p>\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04409873\">NCT04409873<\/jats:ext-link>\n                  <\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.05.20.26353686","type":"posted-content","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:35:23Z","timestamp":1779496523000},"source":"Crossref","is-referenced-by-count":0,"title":["Effect of Antiseptic Mouthwash\/Gargling Solutions on SARS-CoV-2 Viral Load: A Randomized Clinical Trial"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8271-9902","authenticated-orcid":false,"given":"Sepideh","family":"Banava","sequence":"first","affiliation":[{"name":"Division of Oral Epidemiology & Dental Public Health, Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, USA"},{"name":"Center to Address Disparities in Children\u2019s Oral Health (known as CAN DO), University of California, San Francisco, California, USA"},{"name":"Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0899-9061","authenticated-orcid":false,"given":"Allan","family":"Radaic","sequence":"additional","affiliation":[{"name":"University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pachiyappan","family":"Kamarajan","sequence":"additional","affiliation":[{"name":"University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9902-0997","authenticated-orcid":false,"given":"Nancy F.","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Oral Epidemiology & Dental Public Health, Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, USA"},{"name":"Center to Address Disparities in Children\u2019s Oral Health (known as CAN DO), University of California, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne L.","family":"Hernandez-Kapila","sequence":"additional","affiliation":[{"name":"University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3147-0884","authenticated-orcid":false,"given":"Stuart A.","family":"Gansky","sequence":"additional","affiliation":[{"name":"Division of Oral Epidemiology & Dental Public Health, Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, USA"},{"name":"Center to Address Disparities in Children\u2019s Oral Health (known as CAN DO), University of California, San Francisco, California, USA"},{"name":"Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, USA"},{"name":"University of California Los Angeles, Los Angeles, California, USA"},{"name":"Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026061311352901000_2026.05.20.26353686v2.1","unstructured":"World Health Organization. Number of COVID-19 deaths reported to WHO. Updated 2024. Accessed April 30, 2025. https:\/\/data.who.int\/dashboards\/covid19\/deaths"},{"key":"2026061311352901000_2026.05.20.26353686v2.2","unstructured":"Centers for Disease Control and Prevention. COVID Data Tracker. Updated 2024. Accessed February 10, 2025. https:\/\/covid.cdc.gov\/covid-data-tracker"},{"key":"2026061311352901000_2026.05.20.26353686v2.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.2648"},{"key":"2026061311352901000_2026.05.20.26353686v2.4","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines9101195"},{"key":"2026061311352901000_2026.05.20.26353686v2.5","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-022-00841-7"},{"key":"2026061311352901000_2026.05.20.26353686v2.6","doi-asserted-by":"publisher","DOI":"10.1177\/0022034520914246"},{"key":"2026061311352901000_2026.05.20.26353686v2.7","doi-asserted-by":"publisher","DOI":"10.1177\/0022034520918518"},{"key":"2026061311352901000_2026.05.20.26353686v2.8","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.26316"},{"key":"2026061311352901000_2026.05.20.26353686v2.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2020.06.213"},{"key":"2026061311352901000_2026.05.20.26353686v2.10","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.34147"},{"key":"2026061311352901000_2026.05.20.26353686v2.11","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-021-01582-4"},{"key":"2026061311352901000_2026.05.20.26353686v2.12","doi-asserted-by":"publisher","DOI":"10.26355\/eurrev_202205_28760"},{"key":"2026061311352901000_2026.05.20.26353686v2.13","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6915e6"},{"key":"2026061311352901000_2026.05.20.26353686v2.14","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2024.8432"},{"key":"2026061311352901000_2026.05.20.26353686v2.15","unstructured":"Centers for Disease Control and Prevention (CDC). Guidelines for infection control in dental health-care settings\u20142003. Accessed May 1, 2025. https:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/rr5217a1.htm"},{"key":"2026061311352901000_2026.05.20.26353686v2.16","doi-asserted-by":"publisher","DOI":"10.1038\/s41368-020-0075-9"},{"key":"2026061311352901000_2026.05.20.26353686v2.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2019.06.024"},{"key":"2026061311352901000_2026.05.20.26353686v2.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2020.110436"},{"key":"2026061311352901000_2026.05.20.26353686v2.19","unstructured":"Centers for Disease Control and Prevention. Guideline for disinfection and sterilization in healthcare facilities. Updated 2008. Accessed May 1, 2025. https:\/\/www.cdc.gov\/infection-control\/hcp\/disinfection-sterilization\/chemical-disinfectants.html"},{"key":"2026061311352901000_2026.05.20.26353686v2.20","unstructured":"American Dental Association. Summary of ADA guidance during the COVID-19 crisis. Updated 2020. Accessed May 1, 2025. https:\/\/www.ada.org\/about\/press-releases\/2020-archives\/summary-of-ada-guidance-during-the-covid-19-crisis"},{"key":"2026061311352901000_2026.05.20.26353686v2.21","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa471"},{"key":"2026061311352901000_2026.05.20.26353686v2.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2024.02.023"},{"key":"2026061311352901000_2026.05.20.26353686v2.23","doi-asserted-by":"publisher","DOI":"10.1111\/odi.14044"},{"key":"2026061311352901000_2026.05.20.26353686v2.24","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-020-01563-9"},{"key":"2026061311352901000_2026.05.20.26353686v2.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"2026061311352901000_2026.05.20.26353686v2.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"2026061311352901000_2026.05.20.26353686v2.27","doi-asserted-by":"publisher","DOI":"10.1111\/jopr.13209"},{"key":"2026061311352901000_2026.05.20.26353686v2.28","doi-asserted-by":"publisher","DOI":"10.1021\/acsomega.1c00166"},{"key":"2026061311352901000_2026.05.20.26353686v2.29","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.648660"},{"key":"2026061311352901000_2026.05.20.26353686v2.30","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-024-04246-1"},{"key":"2026061311352901000_2026.05.20.26353686v2.31","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-03461-y"},{"key":"2026061311352901000_2026.05.20.26353686v2.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.sdentj.2022.01.006"},{"key":"2026061311352901000_2026.05.20.26353686v2.33","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13746"},{"key":"2026061311352901000_2026.05.20.26353686v2.34","doi-asserted-by":"publisher","DOI":"10.1177\/00220345221102310"},{"key":"2026061311352901000_2026.05.20.26353686v2.35","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.15080"},{"key":"2026061311352901000_2026.05.20.26353686v2.36","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.28412"},{"key":"2026061311352901000_2026.05.20.26353686v2.37","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-39308-x"},{"key":"2026061311352901000_2026.05.20.26353686v2.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.04.005"},{"key":"2026061311352901000_2026.05.20.26353686v2.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.05.071"},{"key":"2026061311352901000_2026.05.20.26353686v2.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.06.059"},{"key":"2026061311352901000_2026.05.20.26353686v2.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2020.09.027"},{"key":"2026061311352901000_2026.05.20.26353686v2.42","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2016359"},{"key":"2026061311352901000_2026.05.20.26353686v2.43","unstructured":"Centers for Disease Control and Prevention. Symptoms of COVID-19. Updated 2025. Accessed May 1, 2025. https:\/\/www.cdc.gov\/covid\/signs-symptoms\/index.html"},{"key":"2026061311352901000_2026.05.20.26353686v2.44","doi-asserted-by":"publisher","DOI":"10.4103\/ijnmr.ijnmr_38_23"},{"key":"2026061311352901000_2026.05.20.26353686v2.45","doi-asserted-by":"publisher","DOI":"10.1016\/j.jebdp.2022.101777"},{"key":"2026061311352901000_2026.05.20.26353686v2.46","doi-asserted-by":"publisher","DOI":"10.1016\/j.identj.2023.08.010"},{"key":"2026061311352901000_2026.05.20.26353686v2.47","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-020-03613-w"},{"key":"2026061311352901000_2026.05.20.26353686v2.48","doi-asserted-by":"publisher","DOI":"10.4317\/jced.57406"},{"key":"2026061311352901000_2026.05.20.26353686v2.49","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-45195-z"},{"key":"2026061311352901000_2026.05.20.26353686v2.50","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-023-01218-y"},{"key":"2026061311352901000_2026.05.20.26353686v2.51","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000028925"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.64898\/2026.05.20.26353686","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T18:35:43Z","timestamp":1781375743000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.64898\/2026.05.20.26353686"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":51,"URL":"https:\/\/doi.org\/10.64898\/2026.05.20.26353686","relation":{},"subject":[],"published":{"date-parts":[[2026,5,22]]},"subtype":"preprint"}}