OraWize+ : Biocidal, oxidising pre-treatment Mouthwash.
OraWize+ is a stabilised soluBon of Hypochlorous acid (HOCl) which is a naturally occurring biocide, produced by mammalian neutrophils as an essenBal part of the phagocytosis of bacteria and viruses. (1)
Hypochlorous acid (HOCl) is part of a group of molecules known as reacBve oxygen species (ROS). It’s primary method of acBon is the physical oxidisaBon of 99.9999% of known micro-organisms.
The OraWize+ molecule’s neutral charge enables it to rapidly adhere to and penetrate the microbial cell. Once within the cell, the HOCl disrupts replicaBon and protein synthesis rapidly killing the bacterium or virus.
OraWize+ is one of the most efficient biocides known and is 80-100 Bmes more anBmicrobial than sodium hypochlorite (bleach). (2,3,4)
This fundamental chemical / physical nature of this action means that neither patent sensation nor microbial resistance are issues.
OraWize+ is effecBve against all of the common oral commensals and pathogens, Gram-posiBve and Gram- negaBve, aerobic and anaerobic bacteria, fungi and spores.
OraWize+ has been shown to be effecBve against enveloped and non-enveloped viruses (5). Tests against the Feline Calcivirus, a commonly used, hard to kill, subsBtute for Norovirus, showed a 5 log reducBon in less than 60s (6).
Specific tests against SARS-CoV-2, are currently in progress.
HOCl was discovered in 1834, but it has only recently been technically possible to create a soluBon that is pure enough to be commercially viable. Orawize has a shelf life of over 12 months importantly this is not reduced even if the boale is opened and some of the soluBon is used.
The two major benefits of hypochlorous acid are its potent antimicrobial actvity and the fact that it is harmless to host Bssue.
The acBve ingredient id OraWize+ has been described as the “ideal wound care agent” (7). It has been shown to speed wound healing in abdominal surgery (8) breast implant surgery (9) and in the management of leg ulcers and burns. (10)
To further demonstrate its safety, Avenova, a product with the same formulaBon as Orawize+ is licensed for use as an eye wash by the US FDA.
OraWize+ is a completely natural biocide and it is broken down by the body to saltwater. It therefore poses no risk following ingesBon, inhalaBon or accidental eye contact.
There are no known reports of allergy to OraWize.
It is safe for use in pregnancy and breast feeding.
There are no known drug interacBons.
Orawize has professional and home applications as a:
1. Pre-treatment oxidising mouthwash:
Hypochlorous acid provides a safe, and effecBve, method of reducing oral bacterial and viral load prior to dental treatment. Studies from the Wuhan region advise using an oxidising mouthwash prior to treatment as a method of reducing the oral virus count and increasing the safety of aerosol generaBng procedures. (11). OraWize+ is a powerful oxidising agent.
2. As an irrigant during treatment:
OraWize+ has uses in periodontal, treatment where its anBbacterial acBvity is equivalent to Chlorhexidine. (12). Chlorhexidine however is not acBve against viruses so would be unsuitable as a pre-treatment rinse.
In endodonBcs it has been shown to have the same anBbacterial effect as Sodium hypochlorite (bleach) but far, far safer. (13)
Studies show that HOCl can remove biofilm from Btanium surfaces so OraWize+ also has applicaBons in the placement of implants and the management of peri-implant disease. (14)
3. Post treatment and at home.
OraWize+ is effecBve against all of the common oral pathogens.
It can be used to help oral hygiene measures aier treatment such as tooth extracBon. As it has a neutral PH and is free from alcohol, parabens, preservaBves and arBficial sweeteners, it can be used daily as part of a comprehensive oral hygiene rouBne. It can also be used to clean orthodonBc appliances, aligners or dentures.
OraWize+ provides a safe, effecBve oxidising mouthwash that can improve safety for paBents and the dental team, as well as helping paBents manage their oral hygiene.
1. Albrea AM, Ashby LV, N, Keale AJ, Winterbourn CC.
Heterogeneity of hypochlorous acid producBon in individual neutrophil phagosomes revealed by a rhodamine- based probe. J Biol Chem. 2018 Oct 5;293(40):15715-15724
2. Rossi-Fedele G., Guastalli A.R., Do?ramac? E.J., Steier L., De Figueiredo J.A.P. Influence of pH changes on chlorine containing endodonBc irrigaBng soluBons. Int. Endod. J. 2011;44:792–799.
3. Fair GM, Morris JC, Chang SL, Weil I, Burden RP (1948) The behaviour of chlorine as water disinfectant. Journal of the American Water Works Associa4on 1, 1051– 61.
4. Brazis AR, Leslie JE, Kabler PW, Woodward RL (1958) The inacBvaBon of spores of Bacillus globigiiand Bacillus anthracis by free available chlorine. Applied Microbiology 6, 338– 42.
5. Ramalingam, S., Cai, B., Wong, J. et al. AnBviral innate immune response in non-myeloid cells is augmented by chloride ions via an increase in intracellular hypochlorous acid levels. Sci Rep 8, 13630 (2018).
6. Chander, Y., Johnson, T., Goyal, S.M. and Russell, R.J. 2012. AnBviral acBvity of Ecasol against feline calicivirus, a surrogate of human norovirus. Journal of Infec4on and Public Health. 5 (6): 420-424.
7. Sakayra S, Gunay N, Karakulak M. Hypochlorous acid: an ideal wound care agent with powerful microbicidal, anBbiofilm, and wound healing properBes. Wounds. 2014;26(12):342–350
8. Fernández LG, Maahews MR, Seal L. Intraabdominal Lavage of Hypochlorous Acid: A New Paradigm for the SepBc and Open Abdomen. Wounds 2020 Jan 23. pii: WNDS20200120-1. [Epub ahead of print]
9. Haws MJ, Gingrass MK, Porter RS, Brindle CT. Surgical Breast Pocket IrrigaBon With Hypochlorous
Acid (HOCl): An In Vivo EvaluaBon of Pocket Protein Content and PotenBal HOCl AnBmicrobial Capacity. Aesthet Surg J 2018 Oct 15;38(11):1178-1184.
10. Selkon JB, Cherry GW, Wilson JM, Hughes MA. EvaluaBon of hypochlorous acid washes in the treatment of chronic venous leg ulcers.
J Wound Care. 2006 Jan;15(1):33-7.
11. Xian Peng, Xin Xu, Yuqing Li, Lei Cheng, Xuedong Zhou, Biao Ren. Transmission routes of 2019-nCoV and controls in dental pracBce InternaBonal Journal of Oral Science (2020)12:9
11.Del Rosso JQ and BhaBa N. Status Report on Topical Hypochlorous Acid: Clinical Relevance of Specific FormulaBons, PotenBal Modes of AcBon, and Study Outcomes.J Clin Aesthet Dermatol. 2018 Nov; 11(11): 36– 39.
12. Coello-Gómez A, Navarro-Suárez S, Diosdado-Cano JM, Azcárate-Velazquez F, Bargiela-Pérez P, Serrera- Figallo MA, Torres-Lagares D, GuBérrez-Pérez JL.
PostoperaBve effects on lower third molars of using mouthwashes with super-oxidized soluBon versus 0.2% chlorhexidine gel: A randomized double-blind trial.
Med Oral Patol Oral Cir Bucal. 2018 Nov 1;23(6):e716-e722.
13. Hsieh SC, Teng NC, Chu CC, Chu YT, Chen CH, Chang LY, Hsu CY, Huang CS, Hsiao GY, Yang JC. The AnBbacterial Efficacy and In Vivo Toxicity of Sodium Hypochlorite and Electrolyzed Oxidizing (EO) Water-Based EndodonBc IrrigaBng SoluBons. Materials (Basel) 2020 Jan 7;13(2).
14. Chun-Ju Chen, ChunCheng Chen, Shinn-Jyh Din. EffecBveness of Hypochlorous Acid to Reduce the Biofilms on Titanium Alloy Surfaces in Vitro Int. J. Mol. Sci. 2016, 17(7), 1161