What Antibiotics Are Used For Periodontal Disease

Is Amoxicillin Good For Periodontal Disease

AmoxicillinClavulanate Potassium The combination of amoxicillin and clavulanate potassium makes the antibiotic resistant to penicillinase enzymes produced by some bacteria. It has been found to be useful in the management of localized form of aggressive periodontitis, and also to arrest alveolar bone loss.

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:

• 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.

Rationale Of Antibiotic Therapy

Mechanical and surgical treatment combined with proper oral hygiene measures can arrest or prevent further periodontal attachment loss in most individuals by reducing total supra-subgingival bacterial mass. However, despite diligent dental therapy, some individuals continue to experience periodontal breakdown, may be due to the ability of major periodontal pathogens like Porphyromonasgingivalis, Aggregatibacteractinomycetemcomitans, Fusobacterium-nucleatum, Treponemadenticola, bacteroids, to invade periodontal tissues or to reside in furcations or other tooth structures outside the reach of periodontal instruments, or due to poor host defense mechanisms. In addition, the putative periodontal pathogens tend to reside in the section of the biofilm attached to the epithelial surface of the periodontal pocket and the patient cannot reach this site during the oral hygiene efforts.

The prime candidates for systemic antimicrobial therapy are those patients exhibiting attachment loss after seemingly adequate conventional therapy, or patients with aggressive forms of periodontitis or associated with predisposing medical conditions or refractory periodontitis. Patients with acute or severe periodontal infections may also benefit from antibiotic therapy.

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Do Adjunctive Systemic Antibiotics Offer An Advantage Over Surgical Mechanical Therapy Alone

Periodontal surgery may be indicated where there is inadequate access for effective mechanical debridement. A systematic review by Haffajee et al. reported an additional clinical benefit in attachment level gain when systemic antibiotics were prescribed as an adjunct to surgical mechanical debridement in deep pockets. In this meta-analysis the authors pooled results of three studies- using different antibiotics comparing periodontal surgery plus antibiotic versus periodontal surgery plus placebo. However, the most recent review of the literature by Hererra et al. concluded that there was insufficient data as to whether adjunctive antibiotics were beneficial when combined with periodontal surgery.

Serial And Combination Therapy

Periodontal infections contain a wide diversity of bacteria hence, no single antibiotic can be effective against all putative pathogens. This mixed infection can include a variety of aerobic, microaerophilic, and anaerobic bacteria, both gram negative and gram positive. This scenario makes it mandatory to use more than one antibiotic, either serially or in combination. The metronidazoleamoxicillin and metronidazoleamoxicillinclavulanate potassium combination caused excellent elimination of many organisms in localized aggressive periodontitis that had been treated unsuccessfully with tetracycline and mechanical debridement. Metronidazoleciprofloxacin combination is effective against A. actinomycetemcomitans metronidazole targets obligate anaerobes, and ciprofloxacin targets facultative anaerobes. This is very powerful combination against mixed infections. This combination provides a therapeutic benefit by reducing or eliminating pathogenic microorganisms and offers a prophylactic benefit by giving rise to predominantly streptococcal microflora.

Antibiotics that are bacteriostatic generally require rapidly dividing microorganisms to be effective. They do not function well if a bactericidal antibiotic is given concurrently. When both these drugs are required, they are best given serially, not in combination.

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Topical And Systemic Antibiotics In The Management Of Periodontal Diseases

ADOPTED by FDI General Assembly September, 2003 in Sydney, AustraliaREVISED by FDI General Assembly October, 2007 in Dubai, United Arab Emirates

The realization, over the past three decades or so, of the microbial aetiology and specificity of periodontal diseases has led to an increasing use of antimicrobial agents in the management of periodontal infections. These include systemic antibiotics, topical antibiotics and topical antiseptics. Despite such frequent use of antibiotics in the management of periodontal diseases, the literature indicates only a few good controlled clinical trials that compare the efficacy of adjunctive antibiotic use to conventional periodontal therapy alone. This topic continues to generate interests among the dental research and clinical practice communities, especially in view of the global problem of the emergence of antibiotic resistant organisms. Hence, the knowledge base on the subject is increasing rapidly and, at the time of writing, FDI takes the following position:

How Antimicrobial Treatment Of Gum Disease Works

Gum disease is caused by the action of dental plaque bacteria. The toxins produced by bacteria cause initially the inflammation of the gums and, if not treated, the infection of periodontal tissues results in loss of bone and connective tissues that keep teeth in place and finally in tooth loss. The purpose of antimicrobial treatment is to decrease the amount of bacteria in the mouth that cause periodontal disease.

Antiseptics which are mainly used for prevention and mild gingivitis have bacteriostatic action. They suppress the metabolism of bacteria cells inhibiting or slowing down the growth of dental plaque.Antibiotics have bactericidal action they work by killing bacteria. Antibiotic therapy is used for the treatment of advanced periodontitis.

However, antimicrobial therapy alone is not enough for eliminating dental plaque or treating gum disease. The preventive action of antiseptics is effective only if combined with daily oral hygiene. Antibiotics can not provide treatment of periodontal disease unless used in conjunction with tooth scaling and root planingand/or surgical gum disease treatments. They are also prescribed for acute types of periodontal disease such as aggressive juvenile periodontitis and acute necrotizing ulcerative gingivitis .

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Choice Of Systemic Antibiotic Which Antibiotic Is The Best To Use

Therapeutic success of an antimicrobial depends on the activity of the antimicrobial agent against the infecting organisms. Periodontitis is a mixed microbial infection making the choice of antibiotic regimen difficult. Certain antibiotics target specific parts of the subgingival biofilm. For example, metronidazole targets the gram-negative strict anaerobes from the red and orange Socransky complexes such as Fusobacterium nucleatum, Tanerella forsythia, Porphyromonas gingivalis and Treponema denticola, while members of the genera Actinomyces, Streptococcus and Capnocytophaga are minimally affected by metronidazole. Metronidazole also has a limited effect on the species Aggregatibacter actinomycetemcomitans, which is a facultative anaerobe rather than a strict anaerobe. Amoxicillin has a broader spectrum lowering counts of gram negative anaerobes as well as decreasing the counts and proportions of Actinomyces species during and after antibiotic therapy. Micro-organisms can be intrinsically resistant to antimicrobials or can develop acquired resistance by emergence of resistant strains of bacteria that would otherwise be considered to be sensitive to the antimicrobial.

Examples of antibiotic regimens documented for treatment of periodontitis

Iiia Limiting Tetracycline Access To The Ribosome

Reduced uptake

For tetracycline to inhibit protein synthesis, it must enter the bacterial celland bind to the ribosome. Some Gram-negative bacteria limit the diffusion oftetracycline into the periplasm by altering the porin proteins presentin the cell wall. This type of resistance, which can decrease susceptibility 6- to18- fold, has been found in a number of Gram-negative bacteria,,. Cohen, etal. have shownthat the multiple antibiotic resistances of some E. coli strainsare due not only to change in OmpF but also to changes in other outer membraneproteins.

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Antibiotics And Gum Disease

Antimicrobial treatment is a non-surgical periodontal disease treatment, commonly used to fight gum disease by either inhibiting bacterial growth or/and by killing harmful bacteria. Antiseptics which stop the growth of bacterial plaque are usually used as a preventative measure to reduce the risk of developing periodontal disease or treating early stages of gingivitis. Antibiotics which kill bacteria are prescribed by dentists for the treatment of dental abscesses and periodontitis, the most severe form of gum disease.

What Is The Treatment For Aggressive Periodontitis

Both access surgery and regenerative techniques have shown good results in patients with aggressive periodontitis. Once good periodontal health has been obtained, patients must be enrolled in a strict maintenance program that is directed toward controlling risk factors for disease recurrence and tooth loss.

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What Is The Fastest Way To Get Rid Of A Gum Infection

10 Simple Ways to Relieve Painful Gums Warm and Cold Compresses. A great and easy way to relieve painful gums is by applying compresses on your gum to relieve your pain. Salt Water Rinses. Hydrogen Peroxide. Tea Bags. Tea Tree Oil. Turmeric Paste. Over-the-Counter Pain Killers. Oral Anaesthetic Gels.

Are Adjunctive Systemic Antibiotics Useful For The Treatment Of Aggressive Periodontitis

Aggressive periodontitis is a form of periodontitis where there is a rapid progression of disease in either a localized or generalized pattern affecting otherwise healthy individuals. Aggressive periodontitis is frequently associated with the presence of high levels of subgingival Aggregatibacter actinomycetemcomitans, A.a and/or Porphyromonas gingivalis, P.g. It has been shown that adjunctive antibiotics may be required to eradicate or suppress these pathogens, which have the potential to invade the periodontal tissues. In the systematic review by Hererra et al. it was concluded that adjunctive systemic antibiotics should be considered in cases of aggressive periodontitis. A recent randomized clinical trial found that the adjunctive use of azithromycin has the potential to improve the treatment outcome in young patients with aggressive periodontitis compared to non-surgical debridement alone. Due to the rapid progression of the disease it is advisable to refer patients diagnosed with aggressive periodontitis for specialist treatment.

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Drugs Used To Treat Gum Disease

Antibiotic treatments can be used either in combination with surgery and other therapies, or alone, to reduce or temporarily eliminate the bacteria associated with gum disease or suppress the destruction of the tooth’s attachment to the bone.

Chlorhexidine is an antimicrobial used to control plaque and gingivitis in the mouth or in periodontal pockets. The medication is available as a mouth rinse or as a gelatin-filled chip that is placed in pockets after root planing and releases the medication slowly over about 7 days. Other antibiotics, including doxycycline, tetracycline, and minocyclineà may also be used to treat gum disease, as determined by your dentist.

Other treatment options for gum disease include

Toothpaste. Some nonprescription toothpastes that are marked as antibacterial may contain fluoride and an antibiotic called triclosan to reduce plaque and gingivitis.Ã

Lasers. Check the Academy of Laser Dentistry for information.

Can Dogs Take Amoxicillin

Amoxicillin/Clavulanate generally is appropriate for use in cats and dogs, but it should never be administered to small animals like ferrets, rabbits, guinea pigs, chinchillas, or hamsters because the antibiotic nature of the medicine affects the normal bacteria in a small animals gastrointestinal tract, as this can.

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Using Oral Antibiotics For Gum Infection

If you are provided antibiotics in oral type, you will take them for 7 to 10 days.

Your dental professional likewise can place an antibiotic straight into the affected parts of your mouth. This is called local therapy. It can take numerous kinds, including:.

• Gel: Your dental expert injects a gel including doxycycline under your gums. The area is sealed and covered with an unique plaster called a periodontal pack. After 7 to 10 days, your dentist removes the plaster and any staying gel.
• Powder: Your dental professional squirts a powder including minocycline under your gums. The powder liquifies over 3 weeks.

Periostat is another kind of pill that sometimes is used. It consists of doxcycline at extremely low levels. It does not eliminate bacteria. Rather, it reduces the bodys immune-system action to the bacteria. This response is what causes gums and bone to become swollen and damaged. Minimizing the immune action helps to stop bone from dissolving. Patients typically take Periostat for 6 months or more to manage bone loss.

If your dental practitioner owns a dental laser, it will be used after root planing and scaling. The dental practitioner places the laser tip in the space in between your tooth and gum, then moves it around the whole tooth. This process begins from the base of each pocket. The dental professional can treat your whole mouth at one time. This will remove the bacteria in the pockets throughout your mouth.

How Do You Regrow Bone Loss From Periodontal Disease Naturally

In this procedure, a small piece of mesh-like material is inserted between the gum tissue and bone. This stops the gum from growing into bone space, giving the bone and connective tissue a chance to regrow. The dentist may also use special proteins, or growth factors, that help the body regrow bone naturally.

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Doxycycline In The Treatment Of Aggressive Periodontitis

• Study Details

This comparative clinical study was conducted in the department of Periodontology, Center for Dental Consultation and Treatment , Rabat, Morocco.

Prior to participation, the purpose of the investigation was fully explained to all participants and written informed consent was obtained from all patients. The study protocol was approved by the biomedical ethical committee of University Mohammed V in Rabat, Morocco, and conducted according to the principles outlined in the Declaration of Helsinki on experimentation involving human subjects.

Patients : Twenty four subjects diagnosed with localized or generalized aggressive periodontitis were enrolled in the study. Patients were aged between 16 and 26 years and were from both genders .The diagnosis was based on the classification of the American Academy of Periodontology .

Clinical variables were pocket depth, plaque index, gingival index

What Are Antibiotics Used For Infected Gums

Antibiotics Used for Gum Infection Doxycycline. Doxycycline is an antibiotic in the class of tetracycline antibiotics. It works by preventing the growth and spread of bacteria. Chlorhexidine. Chlorhexidine is an antimicrobial agent thats effective against a wide range of bacteria. Minocycline. Minocycline belongs to the tetracycline group of antibiotics.

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Treatment Of Aggressive Periodontal Disease With Systemic Antibiotics

Beside the previously mentioned study , that almost exclusively relied on systemic antibiotics, Slots and colleagues described the clinical and microbiological changes of patient diagnosed with juvenile form of periodontal disease treated with non-surgical and chemical therapies. The antibiotic used was tetracycline for 2 weeks. The composition of microbial flora was altered by scaling and root planing, but not excessively. Betadine did not have any apparent effects on the flora, while tetracycline eliminated AA, although the total elimination occurred after 2 weeks and not earlier. Therefore the authors recommend to prescribe tetracycline for at least 3 weeks. It is also interesting to mention that AA recolonized the majority of the pockets during the study period . More recently, Guerrero evaluated, in a RCT, the benefit of adjunctive antibiotic therapy for the non-surgical treatment of generalized aggressive periodontal disease. The antibiotic used was a combination of amoxicillin and metronidazole for 7 days. Patients were treated according to the full mouth disinfection protocol , half of them were assigned to the antibiotic treatment. The results of this study showed:

There is a beneficial effect of supplementation with antibiotics. This was particularly true for pockets > 7mm.

Understanding The Principles Of Using Antibiotics For Treating Periodontitis: What Is The Significance Of The Periodontal Biofilm When Prescribing Systemic Antibiotics

Periodontitis is an infection caused by bacteria residing in biofilms at or below the gingival margin . It is, therefore, not surprising that a wide range of systemic antibiotics have been used as part of periodontal treatment aimed at targeting potential pathogenic bacterial species within the periodontal biofilm.

Figure 1

Chronic periodontitis: deep probing depths, abundant supra- and subgingival biofilm.

The complex structure of the periodontal biofilm, consisting of multiple bacterial communities residing in a glycocalyx matrix, has been well described by Marsh et al. It has been demonstrated that once bacteria attach to a tooth surface and reside within a mature biofilm structure they have a reduced susceptibility to antimicrobials compared to planktonic or free floating bacteria. Hence mechanical debridement is considered critical to disrupt the biofilm when using systemic antibiotics to treat periodontitis. The rationale for use of adjunctive systemic antimicrobials is to further reduce the bacterial load enabling resolution of the inflammation in the periodontal pocket.

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