Periodontal disease is an acquired disease in most individuals. There is an aspect of periodontal disease that a few people develop that is related to genetic factors and is more troublesome for these people because their resistance is not as good. Antibiotics are an added component of treatment in conjunction with debridement type intervention. Antibiotics are also needed for patients at risk of medical complications with heart disease and prosthetic joints and organ transplants.
Generally we must be cautious about using antibiotics since there is an epidemic of over use in the United States. The big problem is that bacteria can react to antibiotics and become resistant and grow more virulent strains that antibiotics are no longer effective against.
Recently combinations of antibiotics have been shown to be more effective in certain circumstances so protocols for multidrug use is beginning to emerge.
Oral antibiotics tend to affect the whole body and are less commonly prescribed than topical gel. Here are some specific details about several different types of oral antibiotics:
Tetracycline antibiotics – Antibiotics which include tetracycline hydrochloride, doxycycline, and minocycline are the primary drugs used in periodontal treatment. They have antibacterial properties, reduce inflammation and block collagenase (a protein which destroys the connective tissue).
Macrolide antibiotics – This group of antibiotics has proven effective at reducing inflammation, and can also reduce bacterial growth associated with periodontitis.
Metronidazole – This antibiotic is generally used in combination with amoxicillin or tetracycline to combat inflammation and bacterial growth in severe or chronic periodontitis.
Topical Gels and Strips
The biggest advantage of the direct delivery of antibiotics to the surfaces of the gums is that the whole body is not affected. Topical gels and direct delivery methods tend to be preferred over their oral counterparts and are extremely effective when used after scaling and root planing procedures. Here are some of the most commonly used direct delivery antibiotics:
Atridox® – This doxycycline gel conforms to the contours of gum surfaces and solidifies over them. Over several days, this gel gradually releases the antibiotic medication.
PerioChip® – This chip is placed into the actual gum pocket after root planing procedure. PerioChip® slowly releases Chlorhexidine, a powerful antibacterial antiseptic. PerioChip® reduces pocket depth in most cases in periodontitis sufferers.
Actisite® – This thin strip is similar to dental floss and contains tetracycline hydrochloride. The thread is place temporarily directly between the tooth and gum to kill bacteria and reduce the depth of gum pockets. Several threads are sometimes placed for around 10 days to enhance the antibiotic effect.
Elyzol® – This metronidazole antibiotic comes in gel and strip form. It is unique because it is able to destroy parasites as well as oral bacteria.
Arestin® – This Minocycline antibiotic comes in mini capsules which are delivered into the gums after scaling and root planning.
Noticeable periodontal improvements are usually seen after systemic or oral antibiotic treatment. Your Periodontist or dentist will incorporate and recommend the necessary antibiotic treatments as necessary for the healing of your periodontal condition.
If you have any questions about periodontal disease or antibiotic treatments, please ask your dentist.