Periodontal disease is an inflammatory and progressive condition which can cause severe damage to gums and the supporting structures of teeth.  If left untreated, periodontal disease can even lead to tooth loss. 

Antibiotics can be used to prevent and reduce the growth bacteria that cause periodontal disease.  Highly effective in many cases, antibiotics can be used as the sole treatment method or in conjunction with other treatments such as surgery and scaling and root planing.

When used to treat periodontal disease, antibiotics can be used in different forms, including oral and topical forms.  According to dental professionals and research studies, antibiotics are particularly effective at combating acute periodontal infection, juvenile periodontal disease, prepubertal periodontal disease and refractory periodontal disease.

Oral Antibiotics

Oral antibiotics are typically used to treat acute periodontal infections.  Since oral antibiotics can have an effect on the patient's entire body, they are used less frequently than topical antibiotics.  Some specific oral antibiotics used to treat periodontal infections include:

• Tetracycline antibiotics: These are the oral antibiotics most commonly used by periodontists and include tetracycline hydrochloride, doxycycline and minocycline.  Tetracycline antibiotics combat bacteria, reduce inflammation and also have the ability to block collagenase, a protein that destroys bone and connective tissue.
• Macrolide antibiotics: This class of antibiotics can reduce the growth of bacteria that causes periodontal disease and can also reduce the inflammation associated with periodontal infections.
• Metronidazole: Most typically used for severe and chronic cases of periodontal disease, Metronidazole is generally used in conjunction withtetracycline or amoxicillin.  This antibiotic can be used to reduce bacteria growth as well as inflammation.

Direct Delivery of Antibiotics

Since topical gels, strips and other forms of direct delivery antibiotics do not affect the patient's entire body like oral antibiotics do, they are the preferred type of antibiotics in the majority of cases.  Particularly when used after scaling and root planing, direct delivery antibiotics can be highly effective at treating periodontal disease.  The following are examples of direct delivery antibiotics commonly used to treat periodontal infections:

• Atridox®: This is a doxycycline gel (doxycycline hyclate) which is placed into periodontal pockets below the gum line.  Following application into the infected pockets, Atridox solidifies.  Over a course of several days or weeks, the antibiotic is slowly released into the surrounding infected tissue.
• PerioChip®: PerioChip is placed into gum pockets following scaling and root planing procedures.  From there, the chip slowly releases Chlorhexidine, an antibacterial agent, and helps to reduce pocket depth.
• Actisite®: Containing tetracycline hydrochloride, Actisite is used in a fiber form similar to dental floss.  Once placed between the tooth and gum, Actisite continuously releases the antibiotic tetracycline hydrochloride to reduce bacteria growth and pocket depth.  Actisite can be placed between the tooth and gum for up to 10 days.
• Elyzol®: Elyzol is a metronidazole antibiotic which is available in strip form or as a topical gel.  By delivering a local dose of metronidazole to the gingival crevice, Elyzol can destroy oral bacteria as well as parasites.
• Arestin®:Arestin contains the antibiotic minocycline and is available as tiny capsules.  These capsules are placed within infected periodontal pockets following scaling and root planing procedures.  The minocycline is then released over time, killing bacteria and reducing the size of periodontal pockets.