Full-Mouth Disinfection Strategies in Periodontal Therapy

Full-mouth disinfection involves comprehensive, single-session mechanical and chemical debridement of all periodontal sites within a 24-hour period to disrupt subgingival biofilm, reduce microbial burden and control inflammation. Conceived in the mid-1990s, this protocol contrasts with traditional quadrant-wise treatment by completing scaling and root planing for the entire dentition in one visit, often supplemented with antiseptics such as chlorhexidine. Subsequent adaptations have incorporated erythritol air-polishing, antimicrobial photodynamic therapy, probiotics or systemic antibiotics to target residual niches. By limiting cross-contamination between treated and untreated areas and improving patient adherence through fewer appointments, full-mouth disinfection achieves more uniform reductions in probing depths, gains in clinical attachment and decreases in bleeding on probing. Its global relevance is underscored by evidence of systemic biomarker modulation and its role in patient-centred management of advanced periodontitis.

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Full-Mouth Disinfection Strategies in Periodontal Therapy publication trend

The graph below shows the total number of articles in full-mouth disinfection strategies in periodontal therapy across all publications each year (not limited to Nature Index journals).

Technical terms

Full-mouth disinfection (FMD): A one-session protocol combining mechanical debridement of all periodontal sites with antiseptic measures to eradicate subgingival biofilm.

Scaling and root planing (SRP): Mechanical removal of plaque and calculus from tooth roots and smoothing of root surfaces to discourage bacterial recolonisation.

Subgingival instrumentation: Debridement performed below the gingival margin to eliminate biofilm and calculus within periodontal pockets.

Chlorhexidine: A broad-spectrum antiseptic agent used as a rinse or gel adjunct to enhance mechanical periodontal therapy.

Pocket probing depth (PPD): The measurement from the gingival margin to the base of a periodontal pocket, indicative of disease severity.

Clinical attachment level (CAL): The position of the periodontal attachment relative to a fixed point on the tooth, reflecting the extent of tissue support loss.

References

1. Impact of Three Nonsurgical, Full-Mouth Periodontal Treatments on Total Bacterial Load and Selected Pathobionts. Antibiotics (2022).
2. Effect of quadrantwise versus full‐mouth subgingival instrumentation on clinical and microbiological parameters in periodontitis patients: A randomized clinical trial. Journal of Periodontal Research (2024).
3. Twenty Years of Full-Mouth Disinfection: The Past, the Present and the Future. The Open Dentistry Journal (2018).