Pre-rinsing has become crucial as dental clinics around the nation consider what procedures to take to reopen after the pandemic. Numerous studies have shown that pre-rinsing can eliminate oral microorganisms before they are included in dental aerosols. In addition to bacteria, viruses, and fungi must also be destroyed by a pre-rinse. Activated chlorine dioxide (used in OraCare) is one of the few substances that can accomplish this safely. Let's examine activated chlorine dioxide in more detail.
Activated Chlorine Dioxide (ClO2)
Although it is more recent in dentistry, activated chlorine dioxide has been used for nearly 200 years to aid in disinfection in other industries. ClO2's adaptability as a disinfectant is ideal for any industry, including textiles, medicine, wastewater treatment, public health, food safety, and domestic usage. Because it is efficient against spore-forming bacteria, it has even been used to treat anthrax. Gaseous chlorine dioxide is a potent oxidant. It efficiently eliminates harmful microorganisms like bacteria, fungus, and viruses. Additionally, it stops and gets rid of biofilm. It can be strong enough to sterilize medical equipment while also being gentle enough to be administered intravenously to combat oral bacteria. ClO2 can be triggered in tiny or large amounts and at different intensities.
It's crucial to understand that when the power increases, a material with a high oxidation potential reacts with more compounds. Chlorine dioxide has a strong oxidation power, but it is also low enough to prevent it from interacting with things that we do not want it to. Chlorine dioxide is a highly selective oxidant. This is why it is so perfect at eliminating oral bacteria while having no negative effects on our cells. Ozone and peroxide, however, are less selective in what they break down.
Chlorine dioxide also has the advantage of being more efficient than some higher power oxidants (ozone and peroxide) at disinfecting a given volume of water or saliva. The rationale behind this is that a molecule like ozone, for instance, will interact with a lot of other salivary components and become exhausted before it has a chance to interact with the pathogen. This is why lower power ozone is preferable to chlorine dioxide in many situations, including water treatment. The bacteria and volatile sulfur compounds are the only organic molecules that the chlorine dioxide reacts with; other organic compounds that don't need to be treated are ignored. Therefore, even though a substance with a high potential strength would theoretically kill at lower doses, in practice it needs higher concentrations than chlorine dioxide to complete the job.
ClO2 is ideally suited for utilization due in part to its strong oxidation capacities. In comparison to peroxide or ozone, it can oxidize 2.5 times more molecules. The oxidation capacity of chlorine dioxide is 5e, which means it can receive 5 electrons from the molecule it is oxidizing. Chlorine dioxide has an oxidation capability that is 2.5 times larger than that of hydrogen peroxide and ozone since they are only able to receive two electrons from the molecule they are oxidizing. Simply put, it removes more than twice as many electrons. But there are two steps involved in how this occurs. The first effect of the reaction is the reduction of sodium chlorite from chlorine dioxide. The sodium chlorite is then converted to sodium chloride, which is everyday table salt and water. The material has a chlorine molecule all the way to the end. This explains why trihalomethanes and other hazardous chlorinated compounds are not produced by chlorine dioxide.
Some people mistake chlorine dioxide for chlorine bleach. They differ not just in structure but also in behavior; therefore, it is not chlorine bleach. Compared to regular chlorine bleach, chlorine dioxide is an extremely selective oxidant. The cell wall of bacteria is pierced during chlorine dioxide eradication. Chlorine dioxide reacts with bacterial cells, disrupting a number of cellular functions. Amino acids and RNA in the cell are immediately reacting with chlorine dioxide. It is unclear whether chlorine dioxide damages the internal cell acids or the cell structure, but it does stop the creation of proteins. By altering membrane proteins and lipids as well as by preventing inhalation, chlorine dioxide has an impact on cell membranes. ClO2 is at least as effective as chlorine as a bactericide, but oftentimes it is greater. In particular, its superiority as a virucide sets it apart from the competition.
Chlorine Dioxide and Viruses
In contrast to bacteria, viruses are destroyed by a reaction between chlorine dioxide and peptone, a water-soluble product of the hydrolysis of proteins into amino acids. Viruses are destroyed by chlorine dioxide by stopping the synthesis of proteins. "Neither chlorine nor ozone are more effective against viruses than chlorine dioxide." It functions well across a wide pH range due to its radical nature. Living cell walls appear to be more permeable to gaseous chlorine dioxide radicals, making it simpler for essential chemicals to enter. Even medical equipment and electronic devices utilized in the treatment of patients on the front lines of the fight against Ebola in West Africa were sterilized by the US military using chlorine dioxide. Additionally, it has a history of use and success against the influenza A virus.
Know the Difference (Activated vs. Stabilized ClO2)
There is one last, crucial thing to address before we wrap this up. This means that the terms "stabilized" or "naturally activated" chlorine dioxide are used to describe products. This is not accurate, and you do not receive all of the advantages of chlorine dioxide. In actuality, the substance referred to as "stabilized chlorine dioxide" or "naturally activated" is sodium chlorite (a salt). You need to combine an acid and a basic salt solution to create genuine chlorine dioxide, which is a gas. Gaseous chlorine dioxide is released as a result. Because of this, OraCare is available in a two-bottle system and needs to be mixed thoroughly before each use.
While sodium chlorite still offers some advantages, they pale in comparison to those of activated chlorine dioxide, particularly the fact that it does not eradicate viruses.
Chlorine Dioxide and Dentistry
Finally, it is being used more frequently in dentistry. It's utilized for a lot more things than just replacing chlorhexidine, like implants, periodontal disease, bad breath, dry mouth, pre-rinsing, and post-op. Dental professionals have reached a new level as a result of its capacity to eliminate bacteria as effectively as chlorhexidine without causing any negative side effects and other advantages. As a pre-rinse every day in office, activated chlorine dioxide can protect us and meet all of our professional needs, especially in light of the current rise in virus-related anxiety. OraCare products contain activated chlorine dioxide, which is combined with xylitol. Only dentist offices sell OraCare Health Rinse.
Dentistry has changed since 1954, so should your rinse. There is an alternative. For more information visit OraCareProducts.com or call 1-855-255-6722.
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Kristin Goodfellow RDH
Kristin is Chief Clinical Officer of OraCare, a practicing Registered Dental Hygienist