Background: 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.