Changes in oral microflora after full-mouth tooth extraction: a prospective cohort study

AimThe aim of the study was to evaluate the effect of full-mouth tooth extraction on the oral microflora, with emphasis on the presence and load of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis. Material and methodsAdult patients (n=30), with moderate to advanced periodontitis and scheduled for full-mouth tooth extraction, were consecutively selected. Prior to and 1 and 3months after full-mouth tooth extraction saliva, tongue, buccal and gingival mucosa and subgingival plaque/prosthesis samples were obtained. Aerobic and anaerobic culture techniques and quantitative real-time polymerase chain reaction (qPCR) were employed for the detection of oral pathogens. ResultsFull-mouth tooth extraction resulted in reduction below detection level of A.actinomycetemcomitans and P.gingivalis in 15 of 16 and 8 of 16 previously positive patients using culture techniques and qPCR, respectively. Those patients remaining qPCR positive showed a significant reduction in load of these bacteria. ConclusionFull-mouth tooth extraction significantly changes the oral microflora. These changes include reduction of A.actinomycetemcomitans and P.gingivalis, frequently to levels below detection threshold. In some patients, A.actinomycetemcomitans and P.gingivalis can persist in the edentulous oral cavity up to 3months after full-mouth tooth extraction.