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Infective exacerbations in patients with chronic obstructive pulmonary disease (COPD) are associated with increased mortality. Therefore, effective management of COPD should include prevention and reduction of exacerbations. The oral cavity is an important reservoir for the respiratory pathogens and these pathogens can be aspirated into the lower respiratory tract, increasing the risk of respiratory infection. Periodontal therapy may reduce these pathogens colonized on the surfaces of teeth and thus may reduce the frequency of COPD exacerbations. The authors aim to assess the effect of initial periodontal therapy on exacerbation frequency in COPD patients.The authors conducted a prospective, controlled group trial of initial periodontal treatment in 40 patients with COPD with chronic periodontitis (CP) and a history of ≥1 infective exacerbation in the previous year. Number of exacerbations in the previous year was recorded. Patients were divided into two groups; the test group (n = 20) included patients who had initial periodontal treatment, and the control group (n = 20) included patients who did not have periodontal therapy. Number of exacerbations during the following 12 months was noted. Periodontal parameters were measured at baseline and 6 and 12 months.The test group showed a significant reduction in the exacerbation frequency during the follow-up period (P = 0.01). Although median exacerbations declined from 3 to 2 in the test group, they increased from 2 to 3 in the control group.Initial periodontal therapy in patients with COPD with CP may decrease the exacerbation frequency.