The role of antimicrobials in management of periodontal diseases Bilawal Aziz Firdaus Praveen Sharma Michael Milward Dental Update 2024 46:10, 707-709.
Authors
Bilawal AzizFirdaus
Final Year Dental Undergraduate Student, University of Birmingham School of Dentistry, Birmingham, B5 7EG UK
With the looming threat posed by antimicrobial resistance, appropriate prescribing of antimicrobials, including antibiotics, is increasingly relevant. In this article, the reasons why antimicrobial therapy is not the mainstay of treatment for most patients with periodontitis will be explored. Some specific exceptions to this rule will also be investigated, including why such exceptions exist. In addition, the protocols for periodontal and antimicrobial therapy to maximize the treatment response when adjuvant antimicrobials are used will be presented.
CPD/Clinical Relevance: This article highlights the need for appropriate prescribing within dentistry as a whole and specifically when it comes to the management of periodontal diseases, where antimicrobials do not form the mainstay of treatment, with some exceptions.
Article
Given that periodontitis, on a basic level, is an imbalance between the microbial load and the host-response to that microbial load, at first glance it may appear that antimicrobials, specifically antibiotics, should be the mainstay of treating periodontitis. However, this is not the case. Before we discuss this further, it is useful to clarify some terminology. An antimicrobial is a substance capable of killing or inhibiting the growth of any micro-organism, whereas an antibiotic is a substance capable of killing or inhibiting the growth of bacteria specifically. The mainstay of managing periodontitis is not via the use of antibiotics. It is rather via the lowering of the bacterial load, as discussed in other papers in this issue, by mechanical removal (brushing and interdental cleaning). This can be aided by the removal of plaque retentive factors (PRFs) by a dental care provider, along with bearing the periodontium in mind when dentally rehabilitating the patient by providing restorations that are designed to minimize plaque retention and are cleansable by the patient. In this paper, the following will be discussed:
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