Twenty Years of Full-Mouth Disinfection: The Past, the Present and the Future

Ange Désiré Pockpa1, 3, Assem Soueidan1, 2, 4, *, Pauline Louis4, Nadin Thérèse Coulibaly3, Zahi Badran2, 4, 5, Xavier Struillou2, 4
1 Clinical Investigation Unit 11 Odontology, CHU Nantes, Nantes, France
2 Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France
3 Department of Periodontology, Faculty of Dental Surgery, University of Felix Houphouët Boigny, Abidjan, Ivory Coast
4 Department of Periodontology, Faculty of Dental Surgery, University of Nantes, Nantes, France
5 Faculty of Dentistry, McGill University, Montreal, QC, Canada

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 482
Abstract HTML Views: 137
PDF Downloads: 92
ePub Downloads: 39
Total Views/Downloads: 750
Unique Statistics:

Full-Text HTML Views: 302
Abstract HTML Views: 105
PDF Downloads: 77
ePub Downloads: 36
Total Views/Downloads: 520

Creative Commons License
© 2018 Pockpa et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to the author at the Department of Periodontology, Dental College, Clinical Investigation Unit 11 Odontology, 1 place Alexis –Ricordeau, 44200, CHU Nantes, France; Tel: +33-(0)2-40412923; Portable: +33-(0)6-19112579; E-mail:



Conventional periodontal treatment, performed quadrant by quadrant in multiple visits, was re-evaluated in the early 1990s when the full-mouth disinfection concept was introduced. Over the years, several modifications to the full-mouth disinfection approach have been suggested.


The purpose of this article is to review the evolution of full-mouth disinfection during the past 20 years, to specify its indications and to consider the prospects for this approach.

Materials and Methods:

An electronic and manual search of the literature, ending in December 2016, was performed by two independent researchers. Only pivotal studies and randomized controlled clinical trials published in the English language that evaluated a new approach to full-mouth disinfection were selected.


According to the studies included in our analysis (21 articles), several modified full-mouth disinfection protocols have been designed including: full-mouth treatment without chlorhexidine, the extension of hygiene methods and an increase in the duration of post-treatment chlorhexidine use, the replacement of chlorhexidine with other antiseptics, supplementation with antibiotics or probiotics, full-mouth antimicrobial photodynamic therapy and one-stage full-mouth disinfection combined with a periodontal dressing.


Since 1995, several modifications have been suggested to improve the effectiveness of full-mouth disinfection. The majority of the studies demonstrate that the results obtained with full-mouth disinfection and its variants are equivalent to each other and to those obtained with the conventional quadrant method. Currently, the selection of this technique remains empirical and depends on the preferences of the practitioner and the patient. In the future, a patient-centered approach should be the best indication for the use of this technique.

Keywords: Periodontal disease, Periodontal treatment, Scaling and root planing, Full-mouth disinfection, Chlorhexidine, Antibiotics or probiotics.