Electrolyzed water has been found to effectively disinfect contaminated surfaces, dental materials, and equipment in the dental setting, and may have potential use in the COVID-19 pandemic dental setting according to a systematic review of 63 studies.
- Electrolyzed water has been studied for its potential to control the spread of microorganisms in dental settings. - Several studies have investigated the efficacy of electrolyzed water in disinfecting dental equipment and materials, such as denture cleaning devices, alginate impressions, and dental unit water lines. - Some studies have also explored the potential of electrolyzed water in controlling the spread of COVID-19 in dental offices and among healthcare professionals. - Overall, the findings suggest that electrolyzed water has promising disinfectant properties and may be a useful tool in infection control in dental settings and beyond.
This is from BMC Oral Health in 2022 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733258/.
The top five keywords for this article are: - Electrolyzed water - COVID-19 - Microbiology - Dental setting - Systematic review
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BMC Oral Health. 2022; 22: 579.
Emilio A. Cafferata5,6 and Rolando Vernal1
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Associated Data
Supplementary Materials
Data Availability Statement
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Abstract
Background
Electrolyzed water has brought recent attention due to its antimicrobial properties. Indeed, electrolyzed water has been proposed to sterilize dental materials and instruments without compromising their structural integrity. In addition, electrolyzed water has been proposed as a mouthwash to control bacterial and viral oral infections without detrimental effects on the oral mucosa. However, no current consensus or evidence synthesis could indicate its potentially favorable use in the dental setting, particularly during the COVID-19 context. Therefore, this systematic review aimed to elucidate whether electrolyzed water could improve microbiologic control in the COVID-19 pandemic dental setting.
Methods
MEDLINE via Pubmed, EMBASE, Cochrane’s CENTRAL, Scopus, LILACS, and Web of Science databases were searched up to September 2021 to identify experimental studies utilizing electrolyzed water for eliminating microorganisms in a dental setting. Besides, a manual and a grey literature search were performed. The data selection and extraction were performed individually and in duplicate. The Risk of Bias (RoB) was assessed with the Nature Publication Quality Improvement Project (NPQIP) score sheet. The study protocol was registered at PROSPERO CRD42020206986.
Results
From a total of 299 articles, 63 studies met the inclusion criteria. The included studies assessed several types of electrolyzed waters, which showed a high disinfection potential when used to deal with different oral conditions. Electrolyzed water demonstrated a broad antimicrobial spectrum and was highly efficient in the dental office disinfection against viruses, fungi, and bacteria, being compatible with most dental materials. In addition, electrolyzed water could protect against SARS-CoV-2 infection and contamination in the dental office. Regarding the RoB, only 35.18% of entries were answered as ‘Yes’, thus achieving less than half of the reporting sheet.
Conclusion
Electrolyzed water effectively disinfects contaminated surfaces, dental materials, and equipment. Therefore, their use is recommendable in the SARS-CoV-2 pandemic dental setting.
Supplementary Information
The online version contains supplementary material available at 10.1186/s12903-022-02528-0.
Keywords: Electrolyzed water, COVID-19, Microbiology, Dental setting, Systematic review
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Background
The worldwide impact of coronavirus disease 2019 (COVID-19) is affecting a still increasing number of people daily. The uncontrolled widespread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection led to the global expansion of COVID-19 in over 200 countries, with stunning contagion and mortality rates [1]. Recently, the coronavirus’ genomic mutations and resulting variants have increased its virulence and infective potential, facilitating zoonotic and human transmission [2, 3].
The main transmission route of the virus is via the release of saliva droplets or aerosols by COVID-19-infected people by coughing, sneezing, talking, or touching contaminated surfaces without adequately washing hands. Accordingly, significant loads of SARS-CoV-2 RNA have been detected in saliva [4], salivary glands [5], and oral epithelial cells [6]. Indeed, the SARS-CoV-2 virus can colonize the oral mucosa by the differential expression of angiotensin-converting enzyme II (ACE2), the SARS-CoV-2 main receptor and cell-invasion route [6]. Therefore, considering the importance of the oral cavity as the primary source of viral transmission of COVID-19, the conditions of clinical dental care should be a focus of attention. Certainly, the length of dental procedures and the proximity between patients and operators within the dental setting put dentists and their patients at high risk of COVID-19 [7]. Moreover, the constant use of water-cooled high-speed rotary hand-pieces or ultrasonic scalers during most dental procedures generates and further spreads virion-loaded aerosols [8, 9]. Indeed, these aerosols can contaminate surfaces, dental instruments, impression casts, and dental unit-waterlines, among others, increasing the risk for cross-contamination [8, 9].
Several disinfectants and cleaning solutions are currently available for microbiologic control at the dental office, including viruses. However, most of them are not entirely innocuous for humans, dental instruments, materials, and the environment and are not fully effective in controlling the virus dissemination [10, 11]. From this basis, the use of electrolyzed water has brought recent attention due to its bactericidal and virucidal activities and less detrimental effects on biological tissues, skin, and mucosa [12]. Its antimicrobial properties have allowed it to sterilize instruments, dentures, and even impressions, without compromising their delicate structural integrity [13]. Furthermore, it has been hypothesized that its use as a mouthwash could be innocuous for the oral mucosa [14]. Thus, it could effectively reduce the SARS-CoV-2 viral load in patients’ saliva before aerosol-generating procedures. However, nowadays, there is no current consensus or evidence synthesis that could indicate its potentially favorable use in the dental setting. Therefore, this systematic review aimed to elucidate whether electrolyzed water could improve the microbiologic control in the COVID-19 pandemic dental setting.
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Methods
Study protocol
The protocol for this systematic review was constructed in agreement with the recommendations made by the PRISMA 2020 checklist [15] and following the quality standards recommended by the AMSTAR-2 critical appraisal tool [16]. All the authors revised, discussed, and approved the protocol for the data selection and extraction, risk of bias assessment, and data analysis a priori. Protocol registration can be found at PROSPERO CRD42020206986.
Eligibility criteria
To answer the research question: Does electrolyzed water improve microbiologic control in the dental setting? Publications that met the following PICO format and inclusion criteria were included.
- P: Oral microorganisms including viruses, bacteria, and fungi cultivated in vitro, inoculated in an animal model, or sampled from the oral cavity.
- I: Electrolyzed water produced by electrolysis of regular or distilled water with any concentration of sodium chloride.
- C: No intervention or other disinfectant solution used in the dental setting.
- O: Colonies count, plaque reduction, infection potential, and viral RNA copies.
Due to the relative novelty of the revised topic in the dental setting, randomized clinical trials were scarce. Thus, all experimental studies were considered, including randomized or non-randomized controlled trials, animal studies with a control group, and in vitro studies. Case reports, editorial letters, and incomplete studies were excluded. Language, year, and publication status were not considered as exclusion criteria. The search retrieved articles published up to September 2021, and eligible publications in languages different from English, Spanish, French, or Portuguese were translated.
Information sources and search strategy
One author (EAC) performed the electronic search in MEDLINE via Pubmed, EMBASE, Scopus, Web of Science, Cochrane’s CENTRAL, and LILACS databases, using individually adapted search strategies (Supplementary Material 1). In addition, OpenGrey and PQDT-ProQuest databases were searched for grey literature. Moreover, a manual search including recently published records from 2021 was performed in the journals from which initial studies were selected: International Journal of Oral Biology, International Journal of Clinical Preventive Dentistry, Journal of the Korean Academy of Pediatric Dentistry, Journal of Dental Rehabilitation and Applied Science, Oral Health and Dental Management, Tropical Journal of Pharmaceutical Research, Annals of Pathology and Laboratory Medicine, International Journal of Applied Pharmaceutics, Brazilian Dental Journal, International Journal of Applied Dental Sciences, Journal of Oral Research and Review, Biomedical Research, Journal of Oral Science, The Journal of the Japanese Society for Dental Materials and Devices, BioMed Research International, Jundishapur Journal of Microbiology, Dental Materials Journal, Journal of the Japanese Prosthodontics Society, The Japanese Journal of Conservative Dentistry, The Journal of the Kyushu Dental Society, Japanese Journal of Oral Biology, Journal of Dental Health, Journal of Clinical Periodontology, Journal of Virological Methods, Japanese Journal of Dental Materials, and Journal of Microbiology. Besides, contact with corresponding authors was made via e-mail if some potentially eligible detected article was unavailable. Finally, the references of the retrieved studies were also revised for additional studies.
Data selection and extraction
Two authors (AC and VC) performed the data selection and extraction independently. After duplicate removal, titles and abstracts were assessed for their potential inclusion. Then, full-text articles were analyzed against the inclusion criteria for their final inclusion. When disagreements occurred, inclusion was discussed with a third author (RV) until consensus. Excluded articles and their respective reasons for exclusion were recorded (Supplementary Material 2). Afterward, the following data were extracted from the included studies: Authors, year, and study setting (for reference), type of study, microorganism (source, concentration, and inoculation via), type of hydrolyzed water (concentration and preparation), duration of intervention, dental setting and comparator, effect over microorganism (time frame), and funding source, if available. Disagreements were solved by discussion, and all the extracted data were further revised by two authors (EAC and RV) to ensure the extraction of all the relevant data. In the case of missing data, the manuscripts’ corresponding authors were asked for additional information.
Outcome measures
In order to evaluate the potential use of electrolyzed water for microbiologic control in the dental setting, the primary outcome measure was the inhibition of bacterial growth by means of remaining colony forming units (CFU) or viral replication by means of remaining viral RNA copies.
Risk of bias assessment
The risk of bias (RoB) was assessed independently and in duplicate by two reviewers (AC and EAC), previously calibrated in RoB assessment rounds, and the disagreements were resolved by consensus. The in vivo and in vitro studies were assessed using a modified version of the Nature Publication Quality Improvement Project (NPQIP) score sheet.
Data synthesis
Due to the substantial heterogeneity between studies, a qualitative synthesis of results was performed.
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Results
Data selection
The initial electronic search yielded 299 articles across the revised databases. Additionally, the complementary manual search resulted in 32 additional records. After duplicates were removed, 290 articles were screened. Then, revising titles and abstracts excluded 218 records, resulting in the assessment of 72 potential articles, including nine articles translated from Japanese, Korean, and Turkish. Finally, the full-text assessment resulted in the inclusion of 63 studies (Fig. 1). The main reasons for excluding full-text articles were: not being primary studies, using another disinfectant different from electrolyzed water, being incomplete, not being executed in the dental setting, and not evaluating oral microorganisms. All the included studies were in vitro except for five studies [17–21] which were randomized clinical trials.
Fig. 1
PRISMA Flow chart of data selection process
Disinfection potential of electrolyzed water for oral diseases
Different varieties of electrolyzed water have been proven to be potentially helpful in treating oral diseases. In the case of caries, patients rinsing with ‘electrolyzed hydrogen water’ showed significantly diminished counts of Streptococci CFU in comparison with rinsing with tap water, leading to the authors’ concluding that oral rinse with electrolyzed water could be supportive in diminishing the levels of caries-associated bacteria such as Streptococcus mutants [17]. Otherwise, in periodontal diseases, electrolyzed water has been tested in three randomized clinical trials. For instance, in periodontally healthy individuals, irrigation with ‘aqua oxidizing water’ after discontinuing oral hygiene was effective for plaque control and preventing gingivitis [19]. Likewise, the use of ‘acid water’ rinse inhibited the development and formation of bacterial plaque, similar to chlorhexidine in human dentine [21]. Apart from that, ‘superoxidized water’ irrigation along with scaling and root planning was effective for treating periodontitis-affected patients, showing diminished probing pocket depth and gingival bleeding 30 days after treatment [20].
Apart from that, the canal-disinfection potential of electrolyzed water has particularly been considered in endodontics. Indeed, a randomized clinical trial showed no differences between the use of ‘oxidative potential water’ in comparison with 1% NaOCl, in terms of their effectiveness in reducing the bacterial load in canals of necrotic pulpectomized primary teeth [18]. In particular, the antimicrobial properties of electrolyzed water against Enterococcus faecalis in canals of extracted teeth have been tested in seven studies [20, 22–27], being effective in reducing E. faecalis levels as an endodontic irrigant, in a similar manner to sodium hypochlorite solution (Table 1).
Table 1
Electrolyzed water used in the human dental setting
Publication | Type of study | Objective | Subject/Population | Intervention | Comparison | Outcome measures | Main results | Authors’ conclusions | |
1 | Kim J., et al. 2017 [17] | RCT | To evaluate the effectiveness of electrolyzed hydrogen water against oral Streptococci biolfims. | 6 healthy adults with at least 20 teeth. | Oral rinse with electrolyzed Hydrogen water (H-water): dissolved hydrogen, 1.5 ppm; oxidation-reduction potential, − 600 mV ~ − 700 mV. Patients rinsed 3 times dayly with the test intervention for 2 weeks, then after pausing for 1 week, proceeded with tap water oral rinses for two weeks. | Tap water oral rinse | Mean ± SD of Streptococci CFU in saliva | After one week, four of the six participants showed significantly lower streptococcal CFU after gargling with H-water than after gargling with tap water (*p < 0.05, **p < 0.01). For all 18 trials data, The CFU values were also significantly lower when oral rinse was performed with H-water (p < 0.005). | Oral rinse with electrolyzed water would be helpful in diminishing oral Streptococci related to caries. |
2 | Valdez-Gonzales C., et al. 2013 [18] | RCT | To evaluate the effectiveness of OPW in reducing bacterial loading as an irrigating solution in necrotic pulpectomized primary teeth. | 40 child patients between 3 to 8 years with at least 1 necrotic teeth needing canal treatment. | Canal irrigation with oxidative potential water (OPW):+ 1100 mV, pH and ORP greater than 2.7. | Canal irrigation with 1% NaOCl | Number of CFU/mL on teeth with canal before and after irrigation. | In the pre-irrigation samples corresponding to the OPW group, a median of 1.65 × 109 CFU/mL (range, 9 × 108–2.1 × 109) with a mean of 1.63 × 109 ± 4.18 × 108 CFU/mL was obtained. In the same experimental group for post-irrigation samples, a median of 0 CFU/mL (range 0–5 × 108), with a mean of 5 × 107 ± 1.53 × 108 CFU/mL, was obtained. The difference between the bacterial load after irrigation with OPW was statistically significant (P < 0.0001). Comparative analysis showed no statistically significant difference between 1% NaOCl and OPW (P = 0.1519). | Electrolyzed water could be a feasible alternative for irrigating after pulpectomy of necrotic primary teeth. |
3 | Gulabivala K., et al. 2004 [22] | In vitro | To test the effectiveness of electrochemically activated aqueous solutions in the debridement of E. faecalis biofilms in root canals of extracted teeth. | 198 extracted human single-rooted teeth. | Canal irrigation with electrochemically activated water: Neutral anolyte (NA) (pH 6.5), acidic anolyte (AA) (pH 3.0), or catholyte (C) (pH 11.5). | Solutions with and without ultrasonication. PBS, NaOCl (3%) | Remaining CFU/mL | The NA, NA (U), C alternated with NA and the AA (U) groups all had significantly (α = 0.05) lower CFU counts compared with PBS controls. | There was a significant difference between the C/NA groups with and without ultrasonication but not between other combinations. NA (U) and AA (U) were the most effective test solutions but NaOCl (3%) gave by far the highest bacterial kills. |
4 | Marais JT, Williams WP. 2001 [23] | In vitro | To evaluate the antimicrobial effectiveness of ECA on a selected group of anaerobic bacteria in root canals of extracted human teeth. | 60 caries-free, single-rooted, adult maxillary anterior human teeth were collected from the extraction clinic, intracanal Irrigated for 5 min with one of the four different irrigation solutions. | Electro-chemically activated water (ECA): pH 7.0 or pH 9.0. | Distilled water, Sodium hypochlorite (3.5% concentration). | Mean (SD) of CFU/mL of P. intermedia, P. gingivalis, E. faecalis, and A. actinomycetemcomitans. | ECA groups showed fewer numbers of colony formation 693 (253), 525 (418) respectively. This reduction however, did not approach the negative (zero) values as recorded for NaOCl and in fact are closer to those values obtained for the control group (group A). | The use of ECA caused a reduction in the number of anaerobic bacteria within the root canal system, but this was not statistically significant (P > 0.05) when compared to sodium hypochlorite. |
5 | Zan R., et al. 2016 [24] | In vitro | To evaluate and compare the antibacterial efficacy of SPO on E. faecalis biofilms in human root canals at different irrigation times. | 126 extracted human mandibular premolar teeth with a single canal. | Canal irrigation with super-oxidized water (SPO) for different periods of time. | Canal irrigation with 0.9% NaCL, 5.25% NaOCl for 2 minutes. | CFU/mL E. faecalis. | There were statistically significant differences between negative control and all groups (P < 0.05). Although positive control showed no statistically significant difference when compared with SPO groups. | Super-oxidized water had a highly antibacterial effect against E. faecalis biofilms in root canals. Moreover, super-oxidized water indicated a remarkable and similar bactericidal effect to that of traditional NaOCl against E. faecalis biofilms. |
6 | Hope CK., et al. 2010 [25] | In vitro | To elucidate the importance of the biofilm modality of growth of E. faecalis with respect to its recalcitrance during endodontic irrigation. | 8 extracted human single teeth. | Super-oxidised water (SOXH2O), pH 5–6.5, components: Sodium chloride (0.42%w/v), hypochlorous acid (0.022%w/v) and sodium chlorate (0.002%w/v). | 1% NaOCl and PBS. | Mean log CFU/mL of E. faecalis. | Remaining mean log CFU of E.faecalis from SOXH2 irrigated teeth was greater than 1% NaOCl (4.66 vs 3.36), without statistical significance (P = 0.177). | Biofilms of E. faecalis were susceptible to concentrations of irrigant that proved ineffective in the tooth model. |
7 | Ezure M., et al. 1996 [translated from Japanese] [19] | RCT | To evaluate the effect of oral hygiene with Water-spray-type Oral Washing Unit and Aqua Oxidizing Water on experimental gingivitis. | 15 males with clinically healthy gingiva discontinuing or not oral cleaning. | Oral irrigation with aqua oxidizing water (AOW) three times a day during 30 s. | Discontinuation of all oral cleaning, and oral washing with sterile distilled water. | The change of the plaque index (P1I), the gingival index (GI), and gingival crevicular fluid (GCF volume), bacteria flora, halitosis for 1 and 2 weeks. | Changes in P1I showed significant reduction in the negative control group and test group in comparision with the controls (p < 0.05, p < 0.01). The time course of changes in GCF volume showed significant changes compared to the negative control group and the test group(p < 0.05, p < 0.01). Based on the results above, a plaque-controlling effect due to the use of the AOW was recognized, and an effect on bacterial flora due to use of AOW as the oral washing agent was observed. | The use of aqua oxidizing water for irrigation is useful in exerting a plaque-controlling effect and a gingivitis-preventing effect. |
8 | Ruqshan Anjum MG., et al. 2015 [26] | In vitro | To determine the antimicrobial efficacy of chlorhexidine, Oxum, Ozonated water in root canals infected by E. faecalis. | 40 extracted single-rooted human teeth. | Canal irrigation with super oxidized water, (Neutral pH), components: Hypochlorous acid, Sodium hypochlorite, Chlorine dioxide, Ozone, Hydrogen peroxide, and Sodium chloride. | 2% chlorhexidine, Ozonated water and NaCl. | CFU/mL of E. faecalis. | CFU of E. faecalis decreased in the pre-test when treated with CHX followed by super-oxidized water, ozonated water and saline. | Chlorhexidine significantly reduced the number of E. faecalis followed by super-oxidized water and ozonated water. |
9 | Chaudhari H., et al. 2019 [20] | RCT | To compare the superoxide solution with povidone-iodine by means of clinical parameters and microbiologically by CFU. | 20 sites with chronic periodontitis (PD ≥ 5 mm) (ten sites per group). All patients received SRP. | Superoxide solution. | Povidone-iodine. | Mean/SD of Probing pocket depth (PPD) and sulcus bleeding index (SBI). CFU/mL. | The mean PPD at baseline and 30 days was observed to be 1.716 ± 0.351 and 0.683 ± 0.274, respectively, for EWA and 1.700 ± 0.380 and 1.0 ± 0.00, respectively, for control. The mean gingival sulcus bleeding scores at baseline and 30 days were observed to be 1.726 ± 0.351 and 0.603 ± 0.274, respectively, for EW and 1.700 ± 0.380 and 1.25 ± 0.00, respectively, for control. There was a statistically significant reduction in CFU in EW after 1 month as compared to control. | Superoxidized water irrigation as an adjunct to SRP proved to be effective in the treatment of periodontitis, without any side effects. |
10 | Ito K., et al.; 1996 [21] | RCT | To compare the effects of Acid Water with placebo treatment on the ultrastructure of early plaque formed on dentine specimens attached to retainers in the human oral cavity. | 24 dentine specimens from 12 freshly extracted healthy human teeth placed in retainers. The retainers were placed in 6 healthy participants. | Acid water (AW): pH < 2.7, ORP > 1100 mV, active oxygen and Chlorine. | 2% chlorhexidine, saline. | Morphology and developmental condition of plaque deposits. Thickness of plaque formed in mm. | On AW treatment, the plaque consist of coccoid forms and and short rods, the plaque is not well developed. The thickness of plaque accumulation was moderate (8.80 mm). On CHX treatment, plaque developed was fairly and was composed mainly cocci, very few short rods and filaments were hardly evident. There wasn’t statistically significant difference between AW and CHX (p < 0.001). | Washing with AW has almost the same potential for inhibition of plaque formation as washing with CHX without producing any side-effects. Therefore, there is a possible use for AW as an anti-plaque. |
11 | Lata S., et al. 2016 [27] | In vitro | To compare and evaluate the antimicrobial effectiveness of ECA, 1% hypochlorite, and 3% hypochlorite when tested against the standard strain of E. faecalis. | 48 extracted human permanent maxillary central incisors of patients between the age group 40 to 60 years irrigated with different solutions for 5 minutes. | Electro-chemically Activated (ECA) water. | 1% an 3% sodium hypochlorite, distilled water. | Mean (μL)/SD CFU and Mean (nm)/SD CFU of E. faecalis, before and after irrigation. | Differences between CFU values between groups was found to be not statistically significant. There was a statistically significant difference between the optical density values among sodium hypochlorite, and EW. | The antibacterial efficacy of ECA water was found to be comparable with sodium hypochlorite solution against E. faecalis. |
12 | Hope CK., et al. 2010 [25] | In vitro | To validate an extracted tooth model of endodontic irrigation. | Twelve extracted, single rooted teeth. | Super-oxidised water (SOXH2O). | PBS, 1% NaOCl, 2% CHX. | The number of viable bacteria recovered, mean (Log10 CFU) E. faecalis. | The number of viable bacteria recovered from the teeth following irrigation with the PBS control was 3.329 (log10 cfu), whilst the antimicrobial irrigants 1% NaOCl, 2% CHX and SOXH2O yielded 0.552, 1.441 and 1.577 (log10 cfu) respectively. However, only the difference between PBS and 1% NaOCl was statistically significant. | The extracted tooth model is a useful method for evaluating the effectiveness of antimicrobial endodontic irrigants. In these preliminary experiments, the most effective irrigant was 1% NaOCl. |
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Innocuity of electrolyzed water in vitro and for human application
The innocuity of electrolyzed water has been tested using in vitro models and randomized clinical trials [17–21]. Indeed, daily oral rinse, irrigation, or application of ‘electrolyzed water’ reported no adverse effects on patients [17–21], while having an outstanding plaque-controlling effect. Besides, canal irrigation of necrotic primary teeth on child patients with ‘oxidative potential water’ reported no side effects, thus considering it a harmless alternative for irrigation after pulpectomies [18]. Moreover, electrolyzed water was not cytotoxic to cultured human bone marrow-derived mesenchymal stem cells [28].
Oral microorganisms growth inhibition by electrolyzed waters
The antibacterial properties of electrolyzed water were tested in 32 in vitro studies [17, 22, 29–58] (Table 2). In the case of caries-associated bacteria, the exposition to electrolyzed water was effective in diminishing bacteria CFU counts, inhibiting colonies or biofilm formation, mostly by S. mutants and, in some cases, S. sobrinus, S. mitis, S. sanguis, and S. salivarius [29, 38, 43, 45, 50, 51, 54, 58]. Moreover, the inoculation of electrolyzed water was able to inhibit periodontopathogens such as Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, and Treponema denticola [22, 29, 32, 35, 38, 41, 42, 45, 49, 50, 54, 56], by significantly reducing the percentage of viable bacteria or their CFU number after treatment. In addition, pathogens commonly found on infected canals, such as E. faecalis and Porphyromonas endodontalis, were also sensitive to electrolyzed water, showing significantly reduced CFU numbers and viability in a time-dependent manner [29, 31, 37, 39, 43, 52, 55]. Additionally, electrolyzed water also showed antifungal activity by inhibiting the growth and diminishing the mean CFU counts of Candida albicans cultures in nine studies [29, 31, 34–36, 47, 52, 59, 60] (Table 3). Last but not least, electrolyzed water showed viricidal effects against human hepatitis B virus, human immunodeficiency virus, poliovirus type 1, and herpes simplex virus type 1, by reducing their infectivity potential in a time-dependent manner [47, 61, 62] (Table 4).
Table 2
Electrolyzed water used against cultured oral bacteria
Publication | Setting | Type of study | Type of question | Subject/Population | Type of water | Manufacture | Comparison | Dependant variable(s) | Main results | Authors’ conclusions | |
1 | Okamura T., et al. 2019 [29] | Nihon University, Tokyo, Japan | In vitro | To assess antimicrobial and noxious effects of acid/alkaline electrolyzed FW compared with NaOCl | S. mutans, E. faecalis, C. albicans, and P. gingivalis. | Acid electrolyzed functional water. Acid: ACC 30 ppm; pH 2.7; ORP > 1100 mV) and alkaline: ACC 0 ppm; pH 11.5; ORP ≈ 800 mV | FW were provided by Miura Denshi (Nikaho, Japan). | NaOCl 6%. | Mean ± SD CFU/mL and Mean ± SD viable cell number. | Colony numbers of S. mutans, P. gingivalis, and E. faecalis were significantly reduced after treatment with acid FW. Alkaline FW showed strong bactericidal effects only for P. gingivalis. Further treatment for longer periods yielded a time-dependent decrease in viability; no colony was present after 20 min of treatment. | Acid FW is safe and has a bactericidal effect equivalent to that of NaOCl. Because of its efficient bactericidal, and less noxious, effects on human cells, acid FW may be a useful irrigant for effective root canal treatment. |
2 | Kim J., et al.; 2017 [17] | School of Dentistry, Kyungpook National University, Daegu. South Korea | 1. In vitro 2. RCT | To evaluate the effect of H-water on oral Streptococci. | S. mutans and S. sobrinus | Electrolyzed Hydrogen water (H-water): dissolved hydrogen, 1.5 ppm; ORP, −600 mV ~ −700 mV. | Nanotec (nano H®, South Korea) | Tap water. | Absorbance at 590 nm. | Bacteria incubated with H-water did not form any colonies. | Oral rinse with H-water would be helpful in treating dental biofilm-dependent diseases with ease and efficiency. |
3 | Gunaydin M., et al.; 2014 [31] | Ondokuzmayis University, Turkey | In vitro | To investigate the in-vitro activity of superoxidized water against an extended group of microorganisms including bacteria and fungi causing hospital-acquired infections. | Six ATCC strains: A. baumannii, E. coli, E. faecalis, K. pneumoniae, P. aeruginosa, S. aureus, eight multidrug-resistant bacteria isolated from different clinical samples: A. baumannii, E. coli, vancomycin resistant E. faecium, K. pneumoniae, P. aeruginosa, methicillin-resistant S. aureus, B. subtilis, and Myroides spp. | Super-oxidized water: pH 6, 80 ppm chlorine | Medilox® (Soosan E & C, Korea) device uses salt, water and electricity and electrolyzes water. | Different concentrations and contact times of SOW. | Absence/presence of growth of ATCC strain, multidrug-resistant bacteria. | Medilox® was effective against all standard strains and all clinical isolates tested at a dilution of 1/1 and exposure time of 1 minute. | SOW produced by Medilox® disinfectant generator using water, salt, and electricity provides highly efficient disinfection. |
4 | Okajima M., et al. 2011 [32] | Meiji Pharmaceutical University, Tokyo, Japan | In vitro | To evaluate the bactericidal action of ERI on periodontopathic bacteria. | P.gingivalis, A. actinomycetemcomitans | Electrolyzed ion-reduced water (ERI): pH of 12.0–12.4, ORP − 344 mV, corresponding to a 0.3% NaCl solution | ERI generator (A. I. System Product Corp.) | ERI solution containing 1% Sodium carboxymethyl cellulose (CMC-Na), 0.3% NaCl solution. | CFU/mL; viable cell count of P. gingivalis and A. actinomycetemcomitans. | More than 99 and 100% of each bacteria species were killed after exposure to ERI or ERI-1% CMC-Na for 15 and 30 sec, respectively. The bactericidal action of ERI was concentration-dependent. | Results suggest that the antibacterial activity of ERI on two types of bacteria is due to the synergistic effect of a very high negative oxidation reduction potential (−344 mV) and hydroxyl radicals (OH –). This may prove extremely useful to the prevention and treatment of periodontal diseases through daily oral care, such as rinsing the mouth out with ERI and/or brushing the teeth with ERI-1% CMC-Na. |
5 | Jnanadev KR., et al. 2011 [33] | China Agricultural University, Beijing, Republic of China | In vitro | To investigate the efficacy of AEW and BEW in killing S. aureus imbedded in biofilm and removing established S. aureus biofilm | S. aureus | Basic electrolyzed water (BEW): pH 10.8 and 11.6, acidic electrolyzed water (AEW): pH 3.5 and 2.5 | AEW and BEW were generated simultaneously from the electrolysis of a 0.1% NaCl solution in a commercial EW generator (Sai Ai Environmental Protection and Technology Development Company Ltd., Guangzhou, China). | Distilled water, NAOH and HCl, BEW generated from the electrolysis of different salt solutions (BEW1, BEW2). | % of Total number of living and dead cells (absorbance at 450 nm), % of number of living cells (absorbance at 550 nm). | As the pH of BEW rose, the removal efficacy of BEW increased. BEW at pH 10.8 reduced 42% of the biofilm mass after a 2 min treatment, whereas BEW at pH 11.6 reduced 78% of the biofilm biomass. AEW1 reduced 89% biofilm viability, whereas AEW2 only reduced 13% biofilm viability. AEW at pH 2.5 and 2% HCl solution dropped biofilm viability to 5 and 4% after a 2 min treatment, respectively. | AEW could be used as a bactericide for S. aureus imbedded in biofilm and that BEW could be applied as a removing agent for established S. aureus biofilm. |
6 | Gomi K., et al. 2010 [34] | Tsurumi University, Yokohama, Japan | In vitro | To evaluate the disinfection effects of functional water in comparison with sodium hypochlorite solution and hydrogen peroxide solution. | Sheep prolapsed cellulose blood as inorganic substance group and saline as organic substance group, human dental pulp cells | Alkaline (pH 12.3), Strong acid (pH 2.8; 10 ppm Chlorine) and Hypochlorous (pH 6.0; 50 ppm Chlorine) electrolysis water (AEW, SAEW, or HAW) | AEW (Aoi Engineering), SAEW (Aoi Engineering), or HAW (Technomak) | Physiologic saline (PS), 3% sodium hypochlorite solution (SHS), 3% hydrogen peroxide solution (HPS). | The number of living cells (absorbance at 490 nm). CFU/mL of E. faecalis. | SAEW showed a weaker microbicidal activity compared to HAW in the absence of organic substance, and complete inhibition of colony-forming bacteria did not occur in the presence of organic substance. The microbicidal effect was not observed with AEW and PS. | Functional waters SAEW and HAW have good microbicidal effect in the presence of organic substance, with disinfection activity similar to that of SHS. |
7 | Yamada K., et al. 2010 [35] | Tokyo Dental College, 1–2-2 Masago Mihama-ku, Chiba, Japan | In vitro | To investigate the efficacy of super-oxidised water containing a high concentration of O (O-water) in destroying cariogenic and periodontopathic bacteria. | S. sobrinus, P. gingivalis, P. intermedia, A. actinomycetemcomitans, and F. nucleatum. | Super-oxidised water at low, medium or high concentration | O-water was generated in the AOE-750 (Oxy Japan Corporation, Tokyo, Japan). Three concentrations of O−water—low (pH 3.0), medium (pH 2.5, O− concentration: ca. 3.2 x low) and high (pH 2.0, O− concentration: 10x low)—were prepared. | Distilled water, hydrochloric acid solution. | CFU/mL of cariogenic and periodontophatic bacteria. | Super-oxidised water showed bactericidal activity against all cariogenic and periodontopathic bacteria tested in this study. The antibacterial effect at 37° C was higher than that at room temperature. | O-water exerts an antibacterial effect on cariogenic and periodontopathic bacteria, suggesting its potential as a disinfectant in the prevention of bacterial contamination of dental equipment |
8 | Ileri C., et al. 2006 [translated from Turkish] [36] | High Technology Institute, Gebze, Turkey | In vitro | To investigate the effects of EAAW on standard strains of pathogenic microorganisms at different time periods and at different concentrations. | S. aureus and P. aeruginosa | Electro-activated acidic water (EAAW) at different concentrations | EAAW was produced by direct current passed through the water by using a power source. | Sterile deionized water. | Log CFU/mL of S.aureus and P. aeruginosa. | A decrease of approximately 6.5–8.2 Log CFU/mL was detected at 2-100% concentrations of EAAW at the 10th second, depending on the microorganisms. | EAAW can be used in surface disinfection even at low (at least 2%) dilutions. |
9 | Gulabivala K. 2004 [22] | Seoul National University, Seoul, Korea | In vitro | To evaluate the antibacterial effect of electrolyzed tap water (Puriwater) on five major periodontopathogens cultured in vitro. | A. actinomycetemcomitans, F. nucleatum, P. gingivalis, P. intermedia, and T. denticola. | Puri-water: pH 8.4. | Tap water was subjected to electrolysis (30 V of DC/300 mA) for 2 min at ambient temperature using an electrolysis apparatus equipped with platinum electrodes (SciacuaTM, Puri Co., Korea). | Tap water. | CFU/mL or OD660 | Puri-water reduced the bacterial counts to 12.6–15.4% for A. actinomycetemcomitans, F. nucleatum, P. intermedia, and P. gingivalis. Growth of T. denticola was not observed during 7-day incubation after exposure. | Electrolyzed tap water markedly inhibited the growth of cultured periodontopathogens. |
10 | Vorobjeva NV., et al. 2004 [37] | Lomonosov Moscow State University | In vitro | To evaluate the bactericidal effect of EO water on common hospital bacterial strains in vitro. | P.aeruginosa, E. faecalis, S. aureus, E. coli, Bacillus cereus (vegetative cells and spores), Citrobacter freundii, Flavobacter sp., Proteus vulgaris, Alcaligenes faecalis, and Aeromonas liquefaciens. | Electrolyzed Oxidizing Water (EO):.84 ± 0.01, 1125 ± 3 mV, 43 ± 0.3 ppm Chlorine, and 4.0 ± 0.02 mS/cm | EO water was obtained from ROX-20TA electrolyzer, Hoshizaki Electric Company (Aichi, Japan) at 19.8 A and 10 V. | Deionized water. | Mean Log CFU/ mL. | The counts of the majority of the bacterial strains in the treatment samples were reduced to zero after 0.5 min of treatment, whereas the population of B. cereus was 3.76 log CFU/mL. After 5 min,the counts of the vegetative cells and spores of B. cereus were zero. | EO water renders a strong bactericidal action to both Gram-positive and Gram-negative bacteria as well as to the vegetative cells and spores of bacilli. |
11 | Shimada K., et al. 2000 [38] | Nihon University Japan | In vitro | To compare the bactericidal effects on cariogenic and periodontopathogenic bacteria of EW. | S. mutans, S. sobrinus, S. mitis, S. salivarius, S. sanguis, A. biscosus, A. naeslundii, F. nucleatum, P. gingivalis, P. nigrescens, P. loeschii, P.melaninogenica, and A. actinomycetemcomitans. | Acid oxidizing water (AOW), neutral oxidizing water (NtOW), acid oxidizing water with a low chlorine ppm | AOW was prepared using an Aquachid NDX- 60KMW electrolysis apparatus, (Omco O.M.C. Co., Saitama, Japan), NtOW using an Aquachid NDX- 60KH (Omco O.M.C. Co.), and AOW-LC using a Minestar 201 (Minestar Co., Tokyo, Japan). | Povidoneiodine (PI) 0.35, 0.2% chlorhexidine (CHX), Listerine (LST), 70% ethyl alcohol (Et), PBS. | CFU/mL | Bacteria incubated with NtOW, AOW, AOW-LC, LST, PI or Et did not form any colonies. | The three types of oxidizing water examined are approximately as potent at inhibiting bacterial plaque formation as conventional chemical plaque control agents. |
12 | Horiba N., et al. 1999 [39] | AICHI-GAKUIN University, Nagoya, Japan | In vitro | To examine Electrolized Neutral Water (ENW) bactericidial effect against bacteria isolate from infected root canals. | Methicillin-resistant S.epidermidis, isolated from a human nasal cavity; B. subtilis. 15 strains isolated and identified from infected root canals: S. aureus, S. sanguis, L. acidophilus, S. intermedia, P. niger, P.anaerobius, V. parvula, L. rogosae, A. israelii, E. lentum, B. bifidum, P. acnes, P. endodontalis, P. melaninogenica, and F. nucleatum. | Electrolized Neutral Water (ENW) | Ameni Clean (National Co/Matsushita Seico Co, Osaka) was used to produce ENW. | Sterilized distilled water. | CFU/mL | ENW was bactericidal against 12 strains: S aureus, MRSE, S sanguis, P niger, Ps anaerobius, L acidophilus, L. rogosae, A israelii, E lentum, B bifidum, P. endodontalis, and F. nucleatum. In addition, the ENW reduced the bacterial numbers of the other 6 strains. However, ENW showed little effectiveness against B subtilis. | ENW exhibits a bacteriostatic/bactericidal action against isolates obtained from infected root canals |
13 | Tanaka H., et al. 1996 [40] | Nagasaki University School of Medicine, Nagasaki, Japan | In vitro | To evaluate the antimicrobial activity of superoxidized water against Gram-positive and Gram-negative bacteria. | Methicillin-sensitive S.aureus, methicillin-resistant S.aureus, S. epidermidis, S. marcescens, E. coli, P. aeruginosa, and B. cepacia. | Superoxidized water: pH 2.3–2.7, ORP 1000-l 100 mV, 30 ppm chlorine. | Superoxidized water was prepared by electrolysis of tap water using the Super Oxseed alpha 1000 (Janix, Inc., Kanagawa, Japan). | 0.1% chlorhexidine, 0.02% povidone iodine, 80% ethanol and sterile distilled water. | CFU/ mL | Superoxidized water reduced the viable count below the limit of detection within 10 s of contact as did 80% ethanol and 0.02% povidone iodine. Superoxidized water killed B. cepacia faster than 0.02% povidone iodine. The bactericidal activity of superoxidized water was superior to that of 0.1% chlorhexidine and 0.02% povidone iodine. | Superoxidized water has powerful bactericidal activity and is a low cost but powerful disinfectant. |
14 | Ogawa T., et al. 1998 [translated from Japanese] [42] | The Nippon Dental University, Japan | In vitro | To evaluate the bactericidal effect of soft alkaline solution water on periodontopathic bacteria. | A. actinomycetemcomitans, P. gingivalis, P. intermedia, and E.coli | Soft alkaline solution water: ORP 800 mV, pH 8–06, 60 ppm Chlorine | OXILIZER generator: OXM01 (Miura Electronics Corporation, Tokio) | Hard oxidized water: 1050 mV, pH 2.46, Chlorine concentration 30 ppm. | CFU/mL after contact time (1,5, and 10 min). | Soft alcaline water and strong acid water had a bactericidal effect against all bacteria, after 5 and 10 minutes (p < 0,05), and beyond 10 minutes (p < 0,01). | Soft alcaline water is as effective as strong acid water, having no problem with the presence of saliva. Strong acid water could be more effective in the oral environment. |
15 | Ogiwara K., et al. 1996 [translated from Japanese] [41] | Nippon Dental University, Japan | In vitro | To evaluate the bactericidal effect of AAW (Aqua alkalic water) to periodontopatic bacteria. | S. aureus, E. coli, A. actinomycetemcomitans, P. gingivalis, P. intermedia, and F. nucleatum | Aqua alkalic water (AAW), Aqua oxidized water (AOW), | OXILIZER water generator (OXILIZER Co., Tokyo, Japan). | Saline solution. | CFU/mL | Aa, Pg, Pi were killed in one minute (Aa; 108 to 104 CFU/ml, Pg; 108 to 103 CFU/ml, Pi; less than 108 to 103 CFU/ml) from original 100% AAW, while it took more than one minute to kill Fn, and Sa and Ec which survived after ten minutes. | The disinfectant effect of AAW could be useful for the treatment of periodontal diseases. |
16 | Hsieh SC., et al. 2020 [43] | Taipei Medical University, Taiwan | In vitro | To investigate the antibacterial property and cytotoxicity of EO water containing HOCl, relative to NaOCl. | Zebrafish embryo, S. mutans and E. faecalis | Electrolyzed Oxidizing (EO), ORP 1100 mV, 330–350 Chlorine | The ANK-Neutral Anolyte GH-40 (Envirolyte Industries International Ltd., Tallinn, Estonia) was used to produce EO water by mixing water with an over-saturated solution of sodium chloride under 110 V. | 1.5% Sodium Hypochlorite, E3 medium. | CFU/mL | All the HOCl or NaOCl treatment groups showed over a 5 log 10 cfu/mL reduction in E. faecalis and S. mutans population, indicating > 99.9% antibacterial efficacy. | Both EO waters containing 0.0125 and 0.0250% HOCl revealed a remarkable but similar bactericidal effect (> 99.9%) to that of conventional NaOCl against E. faecalis and S. mutans. |
17 | Salisbury AM., Percival SL. 2019 [44] | 5D Health Protection Group Ltd., Centre of Excellence for Biofilm Science (CEBS), Liverpool, UK | In vitro | To assess the antimicrobial and anti-biofilm efficacy of a new formulation of electrolysed water against microorganisms associated with complicated chronic wounds. | CDC Biofilm Bioreactor Model S. aureus and P. aeruginosa | Electrolysed water at concentrations of 100, 75, 50 and 25% | Water was produced by passing an electric current through deionised water, with the 2 main constituents being Sodium hypochlorite and Hypochlorous acid. | 0.85% sodium chloride solution. | Mean Log10 densitiy CFU/mL. | No colonies of either S. aureus or P. aeruginosa were detected following antimicrobial treatment with all dilutions of the electrolysed water (p < 0.0001). | The assessment of the electrolysed water as an antimicrobial and antibiofilm agent showed exceptionally fast-acting efficacy. The use of electrolysed water as a method of controlling bioburden and biofilm in complicated chronic wounds could significantly aid wound closure. |
18 | Kim, S.B. 2016 [45] | Korea Institute of Industrial Technology, Ansan, Republic of Korea | In vitro | To propose a low-level hypochlorous acid solution of electrolyzed water as an alternative to mouthwash by monitoring oral bacteria though a bactericidal activity experiment | P. gingivalls, P. intermedius, P. nigrescens, F. nucleatum, S. mutans, S. sobrinus, S. godonii, S. oralis, S. salivarius | Low-level HOCL acid solution (electrolyzed water): pH 5–7, 3–5 mg/L Chlorine | Water was produced through a macroporous structure at Pt films electrode and an electrolysis device. | Non-treated saline solution served. | Bactericidal activity (%) for 1 min. | The low-level hypochlorous acid solution exhibited ≥99.9% bactericidal activity for all strains tested. | Low-level hypochlorous acid solution for the range of bacteria tested exhibits greater bactericidal activity for four anaerobic bacteria responsible for periodontitis and five facultative anaerobic bacteria associated with cavity development. |
19 | Davis JM., et al. 2007 [46] | Marquette University, Milwaukee, Wisconsin, USA | In vitro | To compare the antimicrobial action of Dermacyn, BioPure MTAD, 2% CHX (Ultradent, West Jordan, UT), and 5.25% NaOCl against E. faecalis. | E. faecalis | Super-oxidized water | Dermacyn (Oculus Innovative Sciences, Petaluma, CA, USA). | BioPure MTAD, 2% CHX, and 5.25% NaOCl, sterile distilled water. | Mean zones of microbial inhibition on aerobical and aerobical conditions. | Dermacyn and the control showed zones of microbial inhibition that were not different from each other (p > 0.05). | Dermacyn showed no ability to prevent the growth of E. faecalis. |
20 | Landa-Solis C., et al. 2005 [47] | Instituto Nacional de Rehabilitación, Secretarıía de Salud, Mexico, DF, Mexico | In vitro | To evaluate the disinfectant activity of Microcyn against various microbes including pathogenic vegetative bacteria in vitro. | E. coli, S. aureus, P. aeruginosa, S. typhi, | Super-oxidized waters (SOWs) | Microcyn (SOW) is made up by purified water which passes through anode and cathode chambers that are separated from a middle salt (NaCl) chamber by ionic membranes in a REDOX equipment (Oculus Innovative Sciences, California, USA). | Sterile, deionized water. | Log10 surviving Bacillus spores. | An exposure time of 30 s was enough to completely inactivate all pathogens tested in thetreatment samples (99.9999% reduction). Thus, a log10 reduction factor of 8 in the level of all pathogens occurred in the treatment samples. | Microcyn is an effective disinfectant for which sporocide activity and appropriate applications are now being validated. |
21 | Yoo, Y.S., et al. 2015 [49] | Dankook University, Cheonan, Republic of Korea | In vitro | To analyze and compare the antimicrobial activity of electrolyzed water using various electrodes on biofilms of oral microbes | Biofilms of oral microbes (pooled saliva of 10 healthy donors) and planktonic oral microbes. (To form biofilm of P. gingivalis and T. forsythia, the protein of F. nucleatum was extracted) | Electrolyzed Water using copper (EWC), silver (EWS) and platinum (EWP) electrode | Tap water was subjected to electrolysis for 5 min with 24 V of DC 400 mA using copper, silver or platinum electrode in an whole tank undivided anode chamber and cathode chamber. | Tap water. | CFU/mL, OD 590 nm and live/dead staining of S. mutans, F. nucleatum, P. gingivalis, T. forsythia. | Electrolyzed water using platinum electrode (EWP) exhibited antimicrobial activity against S. mutans, P. gingivalis and T. forsythia. The electrolyzed water using copper electrode (EWC) and silver electrode (EWS) did not affect oral microbes. EWP showed strong antimicrobial activity against the biofilm of oral microbes. | Electrolyzed water generated using a palladium electrode may have potential value as a gargle solution for prevention of oral diseases induce by pathogens and denture-related stomatitis. |
22 | Cho I.W., et al. 2017 [50] | College of Dentistry, Dankook University, Korea | In vitro | To investigate antimicrobial activity of recent developed EW generator for oral bacteria | A. actinomycetemcomitans, S. mutans, F. nucleatum, and P. gingivalis. | Hydrogen enriched electrolyzed water | Tap water was subjected to electrolysis for 3 min with 24 V of DC using eBio-Cleaner (ebiotech, Seoul) . | Tap water and Listerine®. | CFU/mL, LIVE/DEAD staining of cariogenic and periodontopathogenic bacteria. | eBio cleaner water showed significantly antimicrobial activity against S. mutans compared to tap water. The levels of F. nucleatum, P. gingivalis, and A.a were reduced by eBio-cleaner water. eBio-cleaner water reduced the levels of P. gingivalis and A.a by several hundred-fold compared to tap water. | The electrolyzed water generated by eBio cleaner reduced the growth of periodontopathogens and S. mutans. The EW generated by eBio-cleaner showed disruptive and antimicrobial effect on the salivary biofilm. |
23 | Lee K. 2016 [51] | Dankook University, Korea | In vitro | To investigate the antimicrobial effects of NEW on cariogenic bacteria and their biofilm, and to compare the antimicrobial activity of NEW and commercial gargle solution | S. mutans and S. sobrinus (To form biofilm, saliva was used). | Two types of Neutral Electrolyzed Water containing 0.05 and 0.15% sodium chloride | EW was generated from an electrolyzing distilled water containing 0.05 and 0.15% sodium chloride in an undivided anode chamber and cathode chamber. | Distilled water and commercial gargle solutions (alcohol-containing gargle for adults and a fluoride-containing gargle for children). | CFU and OD 590 nm of cariogenic bacteria. | The EW showed significant antimicrobial activity against S. mutans and S. sobrinus. Furthermore, the EW has more antimicrobial activity compared to the gargle solution for children. The EW and the alcohol-containing gargle significantly disrupted the biofilm. Furthermore, the count of S. mutans and S. sobrinus in the biofilm was decreased by both the EW and the alcohol-containing gargle. Interestingly, the EW disrupted more the biofilm and killed more the cariogenic bacteria in the biofilm than the alcohol-containing gargle. | The NEW is effective in removing cariogenic biofilm as thoroughly as the commercial gargle solutions and showed antimicrobial activity against S. mutans and S. sobrinus. |
24 | Gupta M., et al. 2017 [52] | Department of Microbiology, IMS, BHU, Varanasi, U.P., India | In vitro | To observe the effect of SOW in different dilutions against several pathogenic bacteria | S. aureus, E. coli, P. aeruginosa, A. baumannii, E. faecalis, and K. pneumoniae. | Superoxidised water (SOW), pH 5.0–6.5, ORP > 950 mv | SOW (Sterisol) generated by Steri-Gen® disinfectant generating system, prepared by passing the normal saline over titanium coated electrode at 9 amp | 5 and 10 times dilutions of SOW. | Growth inhibition or no growth inhibition. | Undiluted SOW and 5, 10 times dilution of SOW inhibited the growth of bacteria. | Undiluted SOW prevent the occurrence of nosocomial infections. Also, the efficacy of SOW was observed in different dilutions against various microbes. |
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FW Functional water, ACC Actual chlorine concentration, ORP Oxidation reduction potential, S. mutans Streptococcus mutans, E. faecalis Enterococcus faecalis, C. albicans Candida albicans, P. gingivalis Porphyromonas gingivalis, S. sobrinus Streptococcus sobrinus, A. baumannii Acinetobacter baumannii, E. coli Escherichia coli, K. pneumoniae Klebsiella pneumoniae, P. aeruginosa Pseudomonas aeruginosa, S.aureus Staphylococcus aureus, E. faecium Enterococcus faecium, B. subtilis Bacillus subtilis, SOW Super oxidized water, A. actinomycetemcomitans Aggregatibacter actinomycetemcomitans, BEW Basic electrolyzed water, AEW Acidic electrolyzed water, SAEW Strong acid electrolyzed water, HAW Hypochlorous acid water, PS Physiologic saline, SHS 3% sodium hypochlorite solution, HPS 3% hydrogen peroxide solution, F. nucleatum Fusobacterium nucleatum, EAAW Electro-activated acidic water, P. intermedia Prevotella intermedia, T. denticola Treponema denticola, S. mitis Streptococcus mitis, S. salivarius Streptococcus salivarius, S.sanguis Streptococcus sanguis, A. viscosus Actinomyces viscosus, A. naeslundii Actinomyces naeslundii, P. nigrescens Prevotella nigrescens, P. loeschii Prevotella loeschii, P.melaninogenica Prevotella melaninogenica, S. epidermidis Staphylococcus epidermidis, Bacillus subtilis B. subtillis, L. acidophilus Lactobacillus acidophilus, P. niger Peptococcus niger, P. anaerobius Peptostreptococcus anaerobius, V. parvula Veillonella parvula, A. israelli Actinomyces israelii, E. lentum Eubacterium lentum, B. bifidum, P. acnes Propionibacterium acnes, P. endodontalis Porphyromonas endodontalis, S. marcescens Serratia marcescens, B. cepacia Burkholderia cepacia, S. gordonii Streptococcus gordonii, S. oralis Streptococcus oralis, S. typhi Salmonella typhi
Table 3
Electrolyzed water used against oral fungi
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Table 4
Electrolyzed water used against viruses