SARS-CoV-2, and disinfectants and antiseptics in dentistry

The medical profession was unaware that microbes cause infection until Louis Pasteur proposed the ‘germ theory of infection’ in the 1860s. The concept of surgical asepsis was almost non-existent until then, and this changed in 1867, when Joseph Lister, at the Glasgow Royal Infirmary, Scotland, discovered that carbolic acid spray (phenol) was very effective in preventing wounds from getting gangrenous, and antiseptics could dramatically reduce postpartum maternal mortality after childbirth. Subsequently, disinfectants and antiseptics developed a life of their own, as it were, with the introduction of now famous brands such as Lysol in 1889, and Dettol in 1933. Lysol, in particular, proved its worth during the 1918 influenza pandemic, in which it has been estimated that up to 100 million perished.

Although disinfectants have been used for over a century, their widespread use and utility, both in the clinical as well as domestic and public settings, have been brought into sharp focus by the current coronavirus pandemic (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is now known that SARS-CoV-2, as opposed to other coronaviruses, is viciously contagious, and may remain infectious on inanimate surfaces for several days.¹ Inevitably then, skin sanitization and surface disinfection have been critical steps in arresting the transmission of the virus at home, in public spaces and in the clinic. This, in turn, has led to a burgeoning industry of disinfectants/sanitizers, and their daily use worldwide. At this juncture, it is worth noting the subtle difference between antisepsis and disinfection. Antisepsis refers to microbial reduction, or kill, on live skin or mucosal surfaces, while disinfection denotes microbial reduction, or kill, on objects, surfaces and in liquids. Thus, all antiseptics are disinfectants, but all disinfectants are not antiseptics.²