It's estimated that approximately 80% of Americans have some form of gum disease also referred as periodontal disease. Gum disease has a wide range of severity from slight inflammation of the gums to more advanced progression affecting the underlying bone tissue. If left untreated, gum disease infections can progress to more serious infections destroying teeth, bone, gums, and connective tissue. For serious infections, antibiotics are commonly used to treat gum disease.
Antibiotics are used individually or in conjunction with periodontal surgery. The use of topical forms of antibiotics is replacing oral administration by dentists. Dentists have noted the use of antibiotics for periodontal disease is more effective than surgery alone. Periodontal surgeons use antibiotics to prevent any infection after surgery, but there is a growing concern of excessive use of antibiotics in patients. Long-term use of antibiotics is associated with increased chances of resistance, making it difficult to treat future bacterial infections.
Tetracycline is a broad spectrum, potent antibiotic. Tetracycline is the primary antibiotic used by dentists to limit the chance of bacterial infection after surgery. Not only does tetracycline destroy bacteria, but it also helps limit inflammation and inhibit collegenase, the enzyme responsible for connective tissue breakdown. A standard dose of tetracycline is a 10-day cycle, but topical applications have become more popular with dentists.
Macrolides and Quinolones
Macrolides are an alternative to tetracycline for inflammation. It also acts against bacterial infections inhibiting growth. Quinolones are important in the elimination of A. actinomycetemcomitans infections. Metronidazole is used in conjunction with penicillin or tetracycline to treat severe and chronic gum disease.
Elyzol is a topical antibiotic delivered as a strip or gel applied directly to the gums. It contains metronidazole which is effective against parasites as well as bacteria.
PerioChip is a small chip placed in the gum pocket that slowly releases chlorhexidine, which is an antiseptic.
Arestin is a drug composed of tiny capsules that are placed in gum pockets. Research has shown that this antibiotic is best used for reducing the depth of gum pockets rather than maintenance after periodontal surgery.
Actisite is similar to dental floss except it has tetracycline hydrochloride contained on its string. It's used in a similar way, rubbing it in between the tooth and gums. This was one of the first antibiotics used in periodontal maintenance.