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ANTIMICROBIAL THERAPY



Periodontal disease is a chronic condition caused by specific types of bacteria. The bacteria can grow and form clusters or colonies on the tongue, tonsils and in the saliva. Killing the bacteria helps to prevent and treat the disease.

Antimicrobial therapy uses chemicals to kill or slow down the growth of bacteria that cause periodontal disease. The two most common types of antimicrobial therapy are:

  • Antiseptics
  • Antibiotics


Antiseptics


Antiseptics are found in mouth rinses. They typically are used to help prevent periodontal disease by controlling excess growth of the disease-causing bacteria. The active ingredients in these rinses are:

  • Alcohol-type drugs
  • Chlorhexidine
  • Povodine iodine

Rinses also can be used with home irrigation devices to wash out the pockets around the teeth.


Antibiotics


Antibiotics are used to kill specific bacteria. Microbiological testing can be done to identify exactly which bacteria are causing the infection, as well as the levels that are present. Antibiotics can be administered locally by placing them under the gums, or given orally.

Local Antibiotic Therapy

Local antibiotic therapy is an office procedure that involves placing the antibiotic directly into the affected parts of the mouth. There are several types of local therapy, including:

  • Gel - The gel contains doxycycline and is placed under the gums at the time the roots and teeth have been cleaned. The areas are allowed to heal 4 to 6 weeks and are then reevaluated to see whether the bacterial infection has subsided.

  • Chip - Chips contain chlorhexidine and are placed under the gum. The chips dissolve over 7 to 10 days to help decrease the infection.

  • Powder - A powder is a microsphere of minocycline. The powder is placed under the gum and takes 3 weeks to dissolve, helping to decrease the infection.


Oral Antibiotic Therapy

The type of oral antibiotic prescribed depends on the specific bacteria that are present in the mouth. Several antibiotics have been used to treat aggressive periodontal disease, including:

  • Penicillins
  • Tetracyclines-HCL
  • Doxycycline
  • Metronidazole
  • Ciprofloxacin
  • Clindamycin

The oral anitbiotic must be taken exactly as directed, and for the full amount of time prescribed. This reduces the risk that surviving bacteria will become resistant to the medicine. Preventing resistance will help make sure the medicine works.

 

NOTE: Antibiotics by themselves are not a cure for periodontal disease. They are only part of the treatment regimen.