. 2022 Jun 28;2022(6):CD004622. doi: 10.1002/14651858.CD004622.pub4

Summary of findings 1. Full‐mouth scaling compared to control for periodontitis in adults.

FMS compared to control for periodontitis in adults
Population: adults with periodontitis Setting: university dental departments  Intervention: FMS Comparison: control
Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	Number of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with control	Risk with FMS
Tooth loss	None of the studies comparing FMS vs control reported tooth loss.
Change in PPD: whole mouth, single‐ and multi‐rooted teeth Follow‐up: 6–8 months	The mean change in PPD was 0.27 mm to 1.80 mm	MD 0.03 mm higher (0.14 lower to 0.20 higher)	—	148 (5 RCTs)	⊕⊕⊝⊝ Low^a	Similar results at 3–4 months. Subgroup analyses of 6‐ to 8‐month data were undertaken for: single and multi‐rooted teeth separately, and teeth with initial moderate (5–6 mm) or high (> 6 mm) levels of PPD. See Table 2; Table 3; Table 4. There was no consistent evidence of a benefit for FMS.
Change in CAL: whole mouth, single‐ and multi‐rooted teeth Follow‐up: 6–8 months	The mean change in CAL was 0.19 mm to 1.10 mm	MD 0.1 mm higher (0.05 lower to 0.26 higher)	—	148 (5 RCTs)	⊕⊕⊝⊝ Low^a
Change in BOP: whole mouth, single‐ and multi‐rooted teeth Follow‐up: 6–8 months	The mean change in BOP was 23% to 58%	MD 2.64% higher (8.81 lower to 14.09 higher)	—	80 (3 RCTs)	⊕⊝⊝⊝ Very low^b,c,d
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). BOP: bleeding on probing; CAL: clinical attachment level; CI: confidence interval; FMS: full‐mouth scaling; MD: mean difference; mm: millimetres; PPD: probing pocket depth; RCT: randomised controlled trial
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.

^aDowngraded two levels for risk of bias (three trials at high risk of detection bias and one at unknown risk of bias). ^bDowngraded one level for inconsistency ‐ some concern about unexplained heterogeneity. ^cDowngraded two levels for risk of bias (two trials at high risk of detection bias). ^dDowngraded one level for design limitations and imprecision.