Full-mouth Disinfection vs. Scaling and Root Planing for the Treatment of Periodontitis: A review of the current literature

Before new treatment concepts can be used in daily practice, a critical analysis of the present scientific literature is necessary. The concept of full-mouth disinfection (FMD) was introduced as a new alternative treatment for the non-surgical therapy of inflammatory periodontal diseases, and is becoming more and more popular in dental practice. The following article provides a short survey and evaluation of the present scientific evidence about full-mouth disinfection. The concept of full-mouth disinfection includes scaling and root planing within 24 hours combined with an adjunctive chlorhexidine chemotherapy aimed to eliminate bacterial reservoirs in periodontal pockets and in all oral niches. Scaling and root planing within 24 hours but without the adjunctive chemotherapy called full-mouth scaling (FMS) is another newly introduced strategy for the treatment of periodontitis. For the present review, 9 original publications of clinical studies were analyzed, in which a total of 118 patients with chronic or aggressive periodontitis were treated. Bleeding upon probing, the reduction of probing depths, changes of attachment level, and analysis of the bacterial microflora were used as markers to compare the different treatment modalities. Based on the present review, no evidence was found that full-mouth disinfection or full-mouth scaling could improve the clinical results of periodontal treatment compared to conventional scaling and root planing. Currently there exists no evidence for a change in a paradigm in periodontal treatment from conventional non-surgical therapy to full-mouth disinfection.