Evidence map›Paper›PMID 33067640›Full record

ReviewIntensive care medicine2021

Antiseptic mouthwash, the nitrate-nitrite-nitric oxide pathway, and hospital mortality: a hypothesis generating review.

Stijn Blot

Registry-linked trialOpen access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Intensive care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06575335 (Antibacterial Efficacy of Triphala Tooth Wipes in Reduction of Streptococcus Mutans Colonies in Differently Abled Children- A Randomized Clinical Trial), which is not on this map. Cited by 29 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 3 pooled it
4.5field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06575335 nacompletednot on this mapstarted 2024, after this paper: background citation

Antibacterial Efficacy of Triphala Tooth Wipes in Reduction of Streptococcus Mutans Colonies in Differently Abled Children- A Randomized Clinical Trial

TypeinterventionalSponsorDow University of Health SciencesRan2024 to 2024Enrolled60ConditionsPlaque ControlArmsTriphala Tooth Wipe, Chlorhexidine Tooth Wipe
3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 68 citations in OpenAlex.

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  19. A comprehensive review ofFrontiers in pharmacology · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author at 1 institution in 2 countries.

Stijn BlotDepartment of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ Gent, Corneel Heymanslaan 10, 9000, Ghent, Belgium. stijn.blot@UGent.be.ORCID http://orcid.org/0000-0003-2145-0345
The University of Queensland · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Meta-analyses and several large cohort studies have demonstrated that antiseptic mouthwashes are associated with mortality in hospitalized patients. A clear pathogenic mechanism is lacking, leading to controversy and a reluctance to abandon or limit the use of antiseptic mouthwashes. Here, we generate the hypothesis that a disturbance in nitric oxide homeostasis by antiseptic mouthwashes may be responsible for the observed increase in mortality risk. Nitric oxide is essential in multiple physiological processes, and a reduction in nitric oxide bioavailability is associated with the occurrence or worsening of pathologies, such as atherosclerosis, diabetes, and sepsis. Oral facultative anaerobic bacteria are essential for the enterosalivary nitrate-nitrite-nitric oxide pathway due to their capacity to reduce nitrate to nitrite. Nitrate originates from dietary sources or from the active uptake by salivary glands of circulating nitrate, which is then excreted in the saliva. Because antiseptic mouthwashes eradicate the oral bacterial flora, this nitric oxide-generating pathway is abolished, which may result in nitric oxide-deficient conditions potentially leading to life-threatening complications such as ischaemic heart events or sepsis.

Indexed as

Anti-Infective Agents, LocalMouthwashesBlood PressureChlorhexidineHospital MortalityHumansNitratesNitric OxideNitritesAnti-Infective Agents, LocalChlorhexidineMouthwashesNitratesNitric OxideNitritesAntiseptic mouthwashChlorhexidineEnterosalivary pathwayMortalityNitrate–nitrite–NO pathwayNitric oxideOral care

Identifiers

PMID33067640
PMCPMC7567004
OpenAlexW3092746890

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.