7 Best Mouthwashes for COVID-19 according to Evidence (2022)

The COVID-19 Delta variant replicates to achieve high viral loads in the throat. Therefore, appropriate mouthwashes will likely reduce the viral load in the throat and thereby reducing the risk of severe disease due to the viral load in the lungs.

Credit: covid19criticalcare.com

One of the key approaches to minimize the risk of severe COVID-19 and also transmission would be to reduce the viral load of COVID-19 virus in the saliva and throat. 

Mouthwash is part of the FLCCC I-MASK+ Protocol

Best Mouthwashes for COVID-19 according to evidence 2022

There are lots of great mouthwashes out there, and this list is by no means complete. We’ve included therapeutic mouthwashes with proven anti-COVID-19 ingredient, you can buy over the counter.

1. Betadine (Povidone Iodine) Gargle - Mouthwash with 1% povidone iodine

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The antiseptic povidone-iodine has immediate virucidal effects against COVID-19 virus. There are 10 published studies on povidone-iodine for COVID-19 (c19pvpi.com).

Povidone-iodine is no. 4 in this COVID-19 drug league table:

Instruction: Gargle twice a day or after having been out for prevention, and three times a day for early treatment of COVID-19.

• CONTAINS one 8 oz bottle (24 uses) of Betadine Antiseptic Sore Throat Gargle for the temporary relief of occasional sore throat
• TREAT AND RELIEVE SORE THROAT SYMPTOMS the moment you feel a sore throat coming on
• FAST ACTING GARGLE From Betadine, the brand that has been trusted by healthcare professionals for over 50 years.
• 0.5% POVIDONE-IODINE ANTISEPTIC GARGLE
• MINT FLAVOR, ALCOHOL FREE FORMULATION

“Iodine is essential to not only fighting off an infection it is necessary for proper immune system functioning. There is no bacteria, virus, parasite or fungus that is known to be resistant to iodine.”

- Dr. David Brownstein

Update Dec 13, 2021: Retrospective 266 COVID-19 ICU patients in India, showing significantly lower mortality with Povidone Iodine oral gargling and topical nasal use (Jamir et al., Cureus, doi:10.7759/cureus.20394 - Peer Reviewed)

2. Scope Mouthwash

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A lab study demonstrated that CPC (CetylPyridinium Chloride) was highly effective against a human coronavirus (BioRxiv 2020, BioRxiv 2020). CPC mouthwash is also part of the FLCCC I-MASK+ protocol for the prevention and treatment of COVID-19.

Instruction: twice a day or after having been out for prevention, and three times a day for early treatment of COVID-19.

• Ingredients: Cetylpyridinium Chloride (CPC), Water, Alcohol (15 Wt%), Glycerin, Flavor, Polysorbate 80, Sodium Saccharin, Sodium Benzoate, Benzoic Acid, Blue 1, Yellow 5
• Kills 99% of bad breath germs in lab tests
• Crest clean meets Scope freshness
• Cosmetic mouthwash
• Made in the USA with U.S. and imported ingredients
• Original Mint Flavor

3. Crest Pro Health Intense Mouthwash with CPC (Cetylpyridinium Chloride)

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A lab study demonstrated that CPC (CetylPyridinium Chloride) was highly effective against a human coronavirus (BioRxiv 2020, BioRxiv 2020). CPC mouthwash is also part of the FLCCC I-MASK+ protocol for the prevention and treatment of COVID-19.

Instruction: twice a day or after having been out for prevention, and three times a day for early treatment of COVID-19.

• Active Ingredients: Cetylpyridinium Chloride 0.05% Inactive Ingredients Water, Alcohol (15 Wt%), Propylene Glycol, Flavor, Poloxamer 407, Sucralose, Benzoic Acid, Sodium Benzoate, Blue 1, Yellow 6
• 99% Germ Kill with no medicinal taste
• Cooling sensation
• Keeps teeth clean longer
• Freshens breath
• Fights plaque & gingivitis

4. Colgate Zero with CPC

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The biggest red flag on an ingredient list for mouthwash is alcohol, according to board-certified dentist Michaela Tozzi, DMD, since it can irritate the gums and oral tissue. Plus, it temporarily depletes saliva flow, which acts as the mouth's immune system. Colgate Zero is alcohol free and contains the anti-viral CPC.

Instruction: Gargle twice a day or after having been out for prevention, and three times a day for early treatment of COVID-19.

• Active Ingredient: Cetylpyridinium Chloride
• Kills 99% of plaque germs
• 0% alcohol
• 0% dyes
• 0% artificial flavors
• 0% artificial sweeteners

5. Colgate Peroxyl

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Chinese health authorities recommended the use of povidone–iodine (PI) and hydrogen peroxide-based mouth-rinses as a pre-procedural preventive measure, while the American Dental Association has advocated the use of 1% hydrogen peroxide mouth-rinse before dental examination.

However, the April 2020 version of the ADA Interim Guidance recommended:

Since SARS-CoV-2 may be vulnerable to oxidation, use 1.5% hydrogen peroxide (commercially available in the US) or 0.2% povidone iodine as a pre-procedural mouth-rinse (Int J Oral Sci. 2020). 

Instruction: Gargle twice a day or after having been out for prevention, and three times a day for early treatment of COVID-19.

• Active ingredient: Hydrogen peroxide 1.5%.
• #6 best seller in Amazon Best Seller Mouthwash category. Review rating 4.7 out of 5 with more than 17,000 reviews.
• Mouth rinses cleanses and promotes healing of minor oral wounds
• Helps promote healing of: oral sores, irritations, mouth burns
• Oxygenating action removes oral debris to facilitate healing
• Soothes minor gum inflammation from dental procedures, dentures and orthodontic appliances
• Antiseptic mouthwash, alcohol free formula

6. Iotech ioRinse Mouthwash

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There is a new generation of recently patented iodine-based antiseptics that overcome the negative side effects of PVP-1. A new aqueous formulation with 100 times more I2 than contained in PVP-1 is now available, and the nonbiocidal content has been reduced from 31,600 ppm to a few hundred ppm. This new formulation increases its effectiveness, safety, and shelf life, while also reducing staining, toxicity, bad taste, and potential irritancy. It is now available in mouth-rinses, concentrates, nasal sprays, and hand sanitizers offered by IoTech International (IoTech International).

7. Dynarex PVP 10% Povidone Iodine Disinfecting Solution

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Most studies use the 1% povidone iodine mouthwash. If 1% povidone iodine is not available, you could use the more widely available 10% povidone iodine. However, the 10% Povidone Iodine must be diluted by one tenth, to 1% strength before use as a mouth wash, otherwise it is too strong and irritating. 

10% Povidone Iodine is available OTC (Over the Counter) without a prescription at any drug store for a few dollars. 

Notes: 

• Dilute by adding 2 tablespoons (30 ml) of the 10% Povidone Iodine into a full glass of water (250-300 ml). This will make the product diluted enough to use as a mouth rinse, or gargle, (approximately 1.0 to 1.2 %).
• 2 tablespoons = 30ml povidone iodine
• 1 glass water = 250-300 ml

Key Takeaways

With so many options, you might wish to choose the one which is the most easily available to you. You might even wish to use the alternating strategy where you alternate between two different mouthwashes with different active ingredients in order to optimise the effectiveness.

That said, mouthwash alone cannot be used as a stand-alone strategy to prevent or treat COVID-19. You must still adhere to your local guidelines such as vaccination, face mask, hand sanitisation, quarantine, social distancing and etc.

Related Updates and Studies:

The use of a mouthwash and a dentifrice containing antimicrobial phthalocyanine derivative on the reduction of clinical symptoms of COVID-19: A randomized triple-blinded clinical trial (Dec 2021)

The results demonstrated that the regular use of mouthwash and dentifrice containing APD (antimicrobial phthalocyanine derivative) had a positive impact on the clinical symptoms reported by COVID-19 patients.

Beneficial effects of a mouthwash containing an antiviral phthalocyanine derivative on the length of hospital stay for COVID-19 (Mar 2021)

The use of APD (Anionic Phthalocyanine Derivative) in a mouthwash as an adjuvant the hospital COVID-19 treatment presented no contraindication and reduced the hospital stay period.

Note: The phthalocyanine mouthwash is on the market in Brazil under the brand DentalClean Detox Pro.