Returning to practice in the wake of coronavirus places unique challenges on the dental industry.
The introduction of a fallow period following aerosol-generating procedures represents a new challenge to practices.
However, a £3m investment in a ‘game changing’ technical innovation by the review programme participants in the EU biocides regulatory process (aka BPR/Article 95) is delivering new advances in clinical infection control.
Their work has resulted in the stabilisation of Hypochlorous acid (HOCl) and marketed by CleanCert Innovations results in a ground-breaking range of disinfectant products.
In this article, we explain the science behind one of the safest, most efficacious infection control chemicals yet discovered.
Hypochlorous acid (HOCl) is also known as electrolysed oxidising water, electrochemically activated water and super-oxidised water.
Academics, scientists and clinicians around the world recognise HOCl as one of the most potent disinfectants available.
The performance of HOCl in efficacy and safety tests is quantifiably superior to older technologies like hypochlorite and Hydrogen peroxide (H202). And thanks to the ground-breaking technology that stabilises HOCl, the benefits for the dental industry are now being widely recognised.
The chemistry behind Hypochlorous (HOCl)
Hypochlorousappears naturally in the human immune defence system.
Defence cells such as neutrophils transform chlorine into a variety of reactive oxidants such as HOCl through a complex intracellular cascade.
Once a neutrophil identifies a bacterium or virus, it produces 1.6 million molecules of HOCl per minute, which rapidly destroys the pathogen.
This natural process has been replicated and refined and by electrolytically splitting a carefully formulated biocompatible solution that is free from preservatives, pH neutral — and stabilised with a 12-month shelf life.
HOCl is a weak acid that breaks down into its inert constituent parts under certain conditions. This unique property makes HOCl :
- non-cytotoxic so it won’t harm human cells;
- non-mutagenic so it won’t damage human DNA; and
- safe against damage to the human reproductive system.
By comparison, some disinfectants such as Quaternary Ammonium Compounds (QACs) work by disrupting intermolecular interactions. Unfortunately, this MOA (mode of action) normally doesn’t differentiate between human and microbial cells, so the process can cause human cell (mitochondrial) dysfunction over time, in concentrated form. Moreover, this MOA can lead to the development of microbial resistance.
Hypochlorous acid has no charge, while hypochlorite which dissociates to the OCl– ion, has a negative charge.
Viruses and bacteria have a negatively charged surface, which means pathogens actively repel the molecules in bleach.
By comparison, the uncharged Hypochlorous acid molecule swiftly attacks the bacterial cell wall, which significantly increases the kill speed.
The impact of this is significant for anybody working in dentistry: the kill speed for viruses is 1 minute as measured by BS EN 14476. By comparison, most other disinfectants need 5 minutes to kill viruses, thus resulting in an 80% time saving.
Reactive Oxygen Species (ROS)
HOCl is part of a small group of molecules known as Reactive Oxygen Species (ROA). The oxidative characteristic in ROS effectively kills dangerous microbes and is the most ingenious part of nature’s evolution.
However, the natural characteristic in HOCl should not be confused with the destructive variant called ‘endogenous’ ROS, that includes Hydrogen Peroxide (H2O2).
In the intracellular production of HOCl, the cascade produces by-products including oxygen-free radicals.
The body has developed mechanisms to moderate and eliminate these potentially harmful chemicals.
With the artificial production of HOCl, these additional free radicals are removed — leaving the beneficial ROS (HOCl) to perform its potent antibacterial and antiviral role.
Oxidative Reductive Potential (ORP)
The oxidation reductive potential is the outcome for a scientific calculation used to measure how effectively a chemical can acquire, donate or share electrons.
The higher the ORP, the more effective the chemical:
- The ORP in water is 1.
- The ORP in CleanCert’s products is 850.
CleanCert’s products are pH 7 (neutral), which is the ideal condition for the creation of pure, stabilised HOCl. It is important to note not all products containing HOCl are pH neutral and may contain higher % of hypochlorite.
1000ppm chlorine disinfectant products contain around 95% hypochlorite/5% HOCl in solution.
However, a pure HOCl solution is 80-100 times more effective than bleach.
So more disinfecting power exists in a pure HOCl solution at 150ppm than the equivalent 1000ppm bleach solution.
The result is a safer yet more effective disinfectant.
If post pandemic, you now need to use disinfectant with increased regularity around your dental practice, then surely you want to ensure you use the safest, least toxic product available, so as to avoid accidental toxic damage (cytotoxicity)?
HOCl has been short listed by the European Commission on Annex 1, which is a list of the least harmless products on the market and includes vegetable oil. Indeed our range of disinfectants have been approved for use on food- can you say that about your other disinfectants?
Is HOCl the magic bullet for dentists?
There’s no doubt that the evidence makes a compelling case for pure HOCl found in CleanCert’s range of products.
HOCl delivers extreme levels of efficacy while remaining safer for dental patients and staff than toxic alternatives.
It’s widely used to inactivate bacteria and dissolve biofilms in a number of intraoral dental applications, before, during and after dental treatment.
CleanCert products also save dentists crucial time, especially in the changeover cycle between patients.
All products are pre-mixed, ready to use. There’s no need to lose time pre-diluting toxic alternatives.
Moreover, CleanCert’s flagship biofilm remover and waterline cleaner is the only waterline treatment that shocks biofilm and eliminates free floating bacteria using a single product.
About the author
Simon Davies is the Managing Director of CleanCert Innovations, that works with a consortium recognised as global leaders in hypochlorous technology.
Their manufacturing partners have compiled the active substance dossiers for the approval of Hypochlorous under the Biocidal Products Regulations EU 528/2012 and are listed on Article 95 as such. They have commissioned the science to see the molecule through the process including the necessary efficacy and toxicity studies at a cost of over £3million.
Cleancert and its consortium are now collaborating to develop medical devices based around their ground-breaking HOCl technology.
Recommended Further reading:
- Technical Evaluation Report- Hypochlorous – USDA Aug ‘15
2. Evidence for Antimicrobial Efficacy and Applications in Healthcare Environments
3. Hypochlorous acid: an ideal wound care agent with powerful microbicidal, antibiofilm, and wound healing properties. Wounds. 2014;26(12):342–350.
Sakayra S, Gunay N, Karakulak M
If you’d like to learn more about how CleanCert Innovations is easing the pressure on dental practices, please call our customer helpline on:
08443 511115 or Email: Technical@CleanCert.co.uk
Where to purchase OptiZil
If you are a business looking to use OptiZil for disinfecting workplaces and practices, you can purchase the product in 1L and 5L containers here:
Retail price policy
CleanCert operates a strict retail price policy and discourages the practice of stockists increasing prices in times of high demand.