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L W Petersen

Narrator Notes for Presentation

L W Petersen

HYPOCHLOROUS ACID (HOCL) IN DENTISTRY

Narrator Notes for The American Association of Oral and Maxillofacial Surgeons Slide Presentation (September 2021)

[Introduction – Refer to Narrator Notes in slideshow presentation]

[Refer to Slide 3 on “Introduction to HOCl in dental settings.”]

Hypochlorous acid (HOCl) is a powerful disinfectant that kills viruses, bacteria, and fungi. HOCl can be used for bacterial and viral control in various settings, including office spaces, waiting rooms, childcare centers, and hospitals. Unlike other chemical disinfectants, HOCl is safe enough to be used in medical settings, for root canal irrigation, as an antibacterial mouthwash, to prevent wound infection, and to clean and disinfect medical instruments. 

[Refer to Slide 5 on FDA and EPA approvals.]

HOCl is approved by the FDA for use in wound care, eye drops, and skin care products. The EPA has registered its use for hospitals, medical suites and instruments, and daycare centers. Most importantly, the EPA has recognized it as a registered disinfectant that can be used against emerging pathogens, including coronaviruses, the family of viruses that includes SARS-CoV-2. Importantly, HOCl is entirely non-toxic and is safe for contact and inhalation. It can also be applied to surfaces and diffused in generous amounts in the presence of people.

[Refer to Slide 7 on “Various HOCl Settings and Applications.”]

The use of HOCl in medical and dental applications underscores its preeminent safety profile. Furthermore, its compatibility with medical and dental equipment allows it to integrate into dental office disinfecting seamlessly. HOCl can be applied to disinfect soft and hard surfaces and does not require wiping after application. HOCl does not irritate skin, eyes, or airways, so it can safely be used on surfaces that come in contact with patients and staff. 

[Describe the following in your own words.]

  • HOCl rinses were shown to remove multiple bacteria, especially in periodontopathic bacteria, effectively. This supports its use in the control of subgingival biofilm in periodontal patients.
  • Smear layer deproteinization was performed with HOCl on the dentin surface before adhesive application. 
  • Smear layer deproteinization significantly improved micro tensile bond strength.
  • HOCl could enhance the quality of dentin for bonding to one-step self-etch adhesives.
  • Smear layer deproteinization enhances dentin bonding.
  • Staphylococcus aureus can form biofilm on medical devices and food equipment, which is hard to eradicate. 
  • Electrolyzed water (HOCl) could effectively remove established biofilm 
  • Electrolyzed acid water is applicable to disinfect acrylic denture bases with excellent anti-bacterial activities in a significantly shorter treatment than conventional denture cleaning.

[Refer to Slide 11 on “Root Canals.”]

HOCl is discussed on dental forums for use in root canals (endodontic irrigation), but there are few peer-reviewed publications on this topic. 

One specific HOCl-based root canal irrigation product for this purpose is Endowize©. 

Endowize© is widely used, considered effective, and non-toxic (other irrigation products are hydrogen peroxide and NaOCl).

[Switch to “share screen” mode and click through the following links.]

[Switch back to the presentation, Slide 12 on “HOCl in Dental Practices”]

Likely due to the safety profile, HOCl is better known in the dental community as a surface disinfectant in response to COVID. Several news links discuss enhanced safety and use in dental practices for surface disinfection purposes.  

[Switch to “share screen” mode and click through the following links.]

[SUMMARY]

[Q&A SESSION]

[Closing remarks – See narrator notes included on slide 12]

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