The American Academy of Periodontology (AAP) treatment guidelines have always stressed that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment, including scaling and root planing.
Because gum disease is a bacterial infection, you would think that antibiotics could be used to treat it. Research demonstrates that antibiotics can be a helpful adjunct to treating periodontal disease. However, prescribing antibiotics as a first line of defense is not only unnecessary as most patients respond well with proper periodontal treatment, but it also disregards the Centers for Disease Control recommendations for appropriate antibiotic use for health care providers. Medical and dental communities are concerned about the overuse of these medications in treating infections because of the possibility of the development of antibiotic resistant strains of bacteria. This overuse would be detrimental to patients if they develop a life-threatening illness for which antibiotics would no longer be helpful.
Antibiotics may be prescribed for periodontal patients who do not respond to conventional mechanical therapy, for patients with acute periodontal infections associated with systemic manifestations, for prophylaxis in medically compromised patients, and, on a case-by-case basis, as an adjunct to surgical and non-surgical periodontal therapy.
Local Delivery of Antibiotics
Various local and systemic drugs have been introduced over the years to serve as an adjunct in the treatment of periodontal disease.
Frequently, Scaling and Root Planing alone are not enough to reduce periodontal pockets. In these instances, local antimicrobials are utilized to kill the deeper bacteria and restore gum health. Forms of local delivery systems include microspheres, gels and fibers, most of which resorb or dissolve after 10 - 14 days. These medications attack plaque bacteria aiding our immune system in reducing periodontal pockets and allowing gums to heal.
One systemic medication includes Arestin (Minocycline). This drug helps reduce overactive host enzymes which break down the patient's own periodontal tissues.