Aggressive periodontitis and antibiotics :

Bacteria is a critical etiologic factor in all periodontal diseases especially aggressive periodontitis. Although the different microbes associated periodontal diseases have been extensively described, the specific profiles that distinguish each disease is inconclusive.

It is prohibited to prescribe antibiotics for dental infections since they are poly microbial with 4 to 6 causative bacteria. This diversity in bacterial species present in dental diseases makes the majority of antibiotics useless, especially those with narrow spectrums of activity.

You may prescribe large spectrum antibiotics or associate different antibiotics to fight the infection, but the results won’t always be as wanted, and the risk of developing microbial resistance will be higher.

Periodontitis has two forms, which are aggressive and chronic, and each one can either be generalized or localized.

Chronic periodontitis is poly microbial like the majority of dental diseases, with frequent presence of Gram – anaerobic bacteria such as Porphyromonas gingivalis ( Pg), Prevotella intermedia (Pi), Bacteroïdes forsythus (Bf), Actinobacillus actinomycetemcomitans (Aa), Campylobacter rectus (Cr) and Fusobacterium nucleatum (Fn).

Aggressive periodontitis is a special case of periodontal diseases since it is caused mainly by Aa, and in some cases associated with Pg, therefore the majority would say antibiotherapy will work marvelously to cure this type of gum diseases. But that’s sadly not the case and antibiotic therapy alone won’t be capable of treating this disease. The reason is simple since AA has the potential to penetrate poreus cement and alveolar bone allowing them to stay away from the reach of antibiotics, this Gram – facultative anaerobe can multiply deep within periodontal structures and cause severe damage. Therefore it is necessary to do scaling and root planing first before prescribing antibiotics, these surgical procedures will eliminate any microbial colonies deep within the surrounding structures of the tooth, while proper medication will eliminate any sequels or left overs.

Medications:

Tetracycline and Doxycycline were common prescriptions. This family of antibiotics was mainly prescribed for localized aggressive periodontitis, but studies have shown that bacteria can acquire resistance to tetracycline, therefore it’s being substituted by other antibiotics like amoxicillin and metronidazole.

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