Findings

What do systematic reviews say?

592 questions · 793 findings · 32 reviews · Periodontology

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No studies found 148 · 18.7%GRADE not reported 429 · 54.1%Very low 137 · 17.3%Low 53 · 6.7%Moderate 14 · 1.8%High 12 · 1.5%

Full-mouth scaling (FMS): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours, without antiseptic vs Full-mouth disinfection (FMD): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours plus adjunctive antiseptic (chlorhexidine) treatments (rinsing, pocket irrigation, tongue/tonsil brushing)

Attachment change · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

Full-mouth scaling (FMS): scaling/root planing (subgingival… showed no clear difference in change in clinical attachment level (CAL) compared with full-mouth disinfection (FMD): scaling/root planing (subgingival… (low certainty).

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
6 to 8 months (SoF); 3 to 4 months favoured FMD
MD -0.05 [-0.23, 0.13]
4 studies · 112 participants
Low

Full-mouth disinfection (FMD): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours plus adjunctive antiseptic (chlorhexidine) treatments (rinsing, pocket irrigation, tongue/tonsil brushing) vs Quadrant scaling and root planing (control): SRP of each quadrant in separate sessions at least one week apart

Pocket closure (sites with PPD <=4 mm) · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
Pocket closure (number/proportion of sites with PPD <=4 mm after treatment): 9 studies reported; all showed an increase in closed pockets after treatment; 8 of 9 found no between-group difference; Koshy 2005 found a…
9 studies
GRADE not reported

Consumption of xylitol chewing gum by women (mothers) vs No chewing gum

Plaque · Adults and children (predominantly adults; one study in children), with natural dentition

Xylitol sugar-free gum significantly reduced plaque quantity versus no-gum/control (SMD -0.743, 95% CI -1.148 to -0.338), with high heterogeneity (I2 = 86.0%; ungraded).

1 finding from 1 review

A Systematic Review and Meta-Analysis of the Role of Sugar-Free Chewing Gum on Plaque Quantity in the Oral Cavity. 2022 All outcomes
End of study (last reported time point; study durations 4 days to 2 years) · Community, residential care homes, and schools; predominantly adults
SMD -0.743 [-1.148, -0.338]
7 studies
GRADE not reported

Full-mouth disinfection (FMD): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours plus adjunctive antiseptic (chlorhexidine) treatments (rinsing, pocket irrigation, tongue/tonsil brushing) vs Quadrant scaling and root planing (control): SRP of each quadrant in separate sessions at least one week apart

Adverse events · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
13 studies provided adverse-event/participant-reported information; 3 reported an event after FMD or FMS; most important harm was increased body temperature. FMD/chlorhexidine-specific harms reported by Fonseca 2015…
13 studies
GRADE not reported

Full-mouth scaling (FMS): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours, without antiseptic vs Quadrant scaling and root planing (control): SRP of each quadrant in separate sessions at least one week apart

Adverse events · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
13 studies provided adverse-event/participant-reported information; 3 reported an event after FMD or FMS; most important harm was increased body temperature after treatment. Narrative, not separated by comparison and…
13 studies
GRADE not reported

Full-mouth disinfection (FMD): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours plus adjunctive antiseptic (chlorhexidine) treatments (rinsing, pocket irrigation, tongue/tonsil brushing) vs Quadrant scaling and root planing (control): SRP of each quadrant in separate sessions at least one week apart

Change in probing pocket depth (PPD) · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

Full-mouth disinfection (FMD): scaling/root planing (subgingival… showed no clear difference in change in probing pocket depth (PPD) compared with quadrant scaling and root planing (control): SRP of each quadrant in… (low certainty).

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
6 to 8 months (SoF); similar at 3 to 4 months
MD 0.11 [-0.04, 0.27]
6 studies · 214 participants
Low

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

Gingival index (GI) · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

Periodontal treatment (subgingival instrumentation, with or without… led to lower gingival index (GI) compared with no active intervention/usual care; GRADE not reported.

1 finding from 1 review

Treatment of periodontitis for glycaemic control in people with diabetes mellitus 2022 · Cochrane All outcomes
3-4 months
SMD -1.75 [-2.27, -1.24]
12 studies
GRADE not reported

Amoxicillin + metronidazole + SRP vs Supragingival scaling (plus placebo)

Adverse events due to periodontal therapy · People with periodontitis and metabolic syndrome (no CVD; primary prevention)

It is very uncertain whether scaling and root planing (SRP) plus antibiotics (amoxicillin and… changes adverse events due to periodontal therapy compared with supragingival scaling (plus placebo) (very low certainty).

1 finding from 1 review

Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes
12 months
Peto OR 0.14 [0.00, 6.90]
1 study · 165 participants
Very low

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

HbA1c (glycated haemoglobin), change · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

Periodontal treatment (subgingival instrumentation, with or without… probably leads to lower hbA1c (glycated haemoglobin), change compared with no active intervention/usual care (moderate certainty).

1 finding from 1 review

Treatment of periodontitis for glycaemic control in people with diabetes mellitus 2022 · Cochrane All outcomes
3-4 months
MD -0.43 [-0.59, -0.28]
30 studies · 2443 participants
Moderate

Full-mouth scaling (FMS): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours, without antiseptic vs Quadrant scaling and root planing (control): SRP of each quadrant in separate sessions at least one week apart

Change in probing pocket depth (PPD) · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

Full-mouth scaling (FMS): scaling/root planing (subgingival… showed no clear difference in change in probing pocket depth (PPD) compared with quadrant scaling and root planing (control): SRP of each quadrant in… (low certainty).

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
6 to 8 months (SoF); similar at 3 to 4 months
MD 0.03 [-0.14, 0.20]
5 studies · 148 participants
Low

Amoxicillin + metronidazole + SRP vs Supragingival scaling (plus placebo)

Cardiovascular events · People with periodontitis and metabolic syndrome (no CVD; primary prevention)

It is very uncertain whether scaling and root planing (SRP) plus antibiotics (amoxicillin and… changes all cardiovascular events compared with supragingival scaling (plus placebo) (very low certainty).

1 finding from 1 review

Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes
12 months
Peto OR 7.77 [1.07, 56.1]
1 study · 165 participants
Very low

Periodontal treatment: scaling and root planing (SRP) plus advice vs Community care: advice only

All CVD-related death · Patients with cardiovascular disease and chronic periodontitis

The review found no eligible studies for this question.

1 finding from 1 review

Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes
SoF row 'All CVD-related death': Outcome not reported. Results 2.1.2: Not reported.
0 studies
No studies found

Periodontal treatment: scaling and root planing (SRP) plus advice vs Community care: advice only

Cardiovascular events · Patients with cardiovascular disease and chronic periodontitis

1 finding from 1 review

Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes
6 to 25 months
All cardiovascular events (Follow-up: 6 to 25 months): One study of 303 participants assessed this outcome; however, we considered data were unreliable as participants were followed up for different lengths of time,…
1 study · 303 participants
Very low

Full-mouth disinfection (FMD): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours plus adjunctive antiseptic (chlorhexidine) treatments (rinsing, pocket irrigation, tongue/tonsil brushing) vs Quadrant scaling and root planing (control): SRP of each quadrant in separate sessions at least one week apart

Tooth loss · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

The review found no eligible studies for this question.

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
Tooth loss: None of the studies comparing FMD vs control reported tooth loss.
0 studies
No studies found

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

Quality of life indicators · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

1 finding from 1 review

Treatment of periodontitis for glycaemic control in people with diabetes mellitus 2022 · Cochrane All outcomes
3-4 months
Three studies measured QoL. Vergnes 2018: overall GOHAI adjusted MD 7.0 (95% CI 2.4 to 11.6), 79 participants (better oral health-related QoL); no clear change in general SF-36 QoL. D'Aiuto 2018 ADDQoL better in…
3 studies
GRADE not reported

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

Plaque index (PI) / oral hygiene · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

Periodontal treatment (subgingival instrumentation, with or without… led to lower plaque index (PI) / oral hygiene compared with no active intervention/usual care; GRADE not reported.

1 finding from 1 review

Treatment of periodontitis for glycaemic control in people with diabetes mellitus 2022 · Cochrane All outcomes
3-4 months
SMD -2.05 [-2.57, -1.53]
18 studies
GRADE not reported

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

Probing pocket depth (PPD/PD) · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

Periodontal treatment (subgingival instrumentation, with or without… led to lower probing pocket depth (PPD/PD) compared with no active intervention/usual care; GRADE not reported.

1 finding from 1 review

Treatment of periodontitis for glycaemic control in people with diabetes mellitus 2022 · Cochrane All outcomes
3-4 months
MD -0.56 [-0.72, -0.40]
21 studies
GRADE not reported

Amoxicillin + metronidazole + SRP vs Supragingival scaling (plus placebo)

All CVD-related death · People with periodontitis and metabolic syndrome (no CVD; primary prevention)

It is very uncertain whether scaling and root planing (SRP) plus antibiotics (amoxicillin and… changes all CVD-related death compared with supragingival scaling (plus placebo) (very low certainty).

1 finding from 1 review

Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes
12 months
Peto OR 7.48 [0.15, 376.98]
1 study · 165 participants
Very low

Gum chewing (sugar-free) vs No chewing gum

Plaque · Adults and children (predominantly adults; one study in children), with natural dentition

Sugar-free chewing gum significantly reduced plaque quantity versus no-gum/control (SMD -0.778, 95% CI -1.167 to -0.390), with high heterogeneity (I2 = 86.6%) and no GRADE rating (ungraded).

2 findings from 1 review

A Systematic Review and Meta-Analysis of the Role of Sugar-Free Chewing Gum on Plaque Quantity in the Oral Cavity. 2022 All outcomes
End of study (last reported time point; study durations 4 days to 2 years) · Community, residential care homes, and schools; predominantly adults
SMD -0.778 [-1.167, -0.390]
7 studies
GRADE not reported
A Systematic Review and Meta-Analysis of the Role of Sugar-Free Chewing Gum on Plaque Quantity in the Oral Cavity. 2022 All outcomes
End of study (last reported time point; study durations 4 days to 2 years) · Community, residential care homes, and schools; predominantly adults · Sensitivity analysis (pre-post correlation set to 0.95 for the SFG group)
SMD -1.098 [-1.539, -0.656]
7 studies
GRADE not reported

Full-mouth scaling (FMS): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours, without antiseptic vs Quadrant scaling and root planing (control): SRP of each quadrant in separate sessions at least one week apart

Change in bleeding on probing (BOP) · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

It is very uncertain whether full-mouth scaling (FMS): scaling/root planing (subgingival… changes change in bleeding on probing (BOP) compared with quadrant scaling and root planing (control): SRP of each quadrant in… (very low certainty).

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
6 to 8 months (SoF); similar at 3 to 4 months
MD 2.64 [-8.81, 14.09]
3 studies · 80 participants
Very low