The effect of a one‐stage full‐mouth disinfection on different intra‐oral niches Clinical and microbiological observations

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Abstract
A treatment for periodontal infections often consists of consecutive rootplanings (per quadrani, at a 1‐to 2‐week interval), without a proper disinfection of the remaining intra‐oral niches (untreated pockets, tongue, saliva, mucosa and tonsils). Such an approach, could theoretically lead to a reinfection of previously‐treated pockets. The present study aims to examine the effect of a full‐mouth disinfection on the microbiota in the above‐mentioned niches. Moreover, the clinical benefit of such an approach was investigated. 16 patients with severe periodontitis were randomly allocated to a test and a control group. The patients from the control group were scaled and rootplaned, per quadrant, at 2‐week intervals and obtained oral hygiene instructions. The patients from the test group received a full‐mouth disinfection consisting of: scaling and rootplaning of all pockets in 2 visits within 24 h, in combination with tongue brushing with 1% chlorhexidine gel for 1 min, mouth rinsing with a 0.2% chlorhexidine solution for 2 min and subgingival irrigation of all pockets (3× in 10 min) with 1%, chlorhexidine gel. Besides oral hygiene, the test group rinsed 2× daily with 0.2% chlorhexidine and sprayed the tonsils with a 0.2% chlorhexidine for 2 months. Plaque samples (pockets, tongue, mucosa and saliva) were taken at baseline and after 2 and 4 months, and changes in probing depth, attachment level and bleeding on probing were reported. The full‐mouth disinfection resulted in a statistically significant additional reduction/elimination of periodonlopathogens, especially in the subgingival pockets, but also in the other niches. These microhiological improvements were reflected in a statistically‐significant higher probing depth reduction and attachment gain in the test patients. These findings suggest that a disinfection of all intra‐oral niches within a short time span leads to significant clinical and microbiological improvements for up to 4 months.