Should Dental Hygienists Use Antibiotics to Treat Severe Periodontal Disease?

While dental hygienists do their best to treat severe periodontitis with mechanical debridement, the condition frequently persists and even worsens over time. This is particularly true for patients with a compromised immune system from conditions such as diabetes.

The overuse of antibiotics in medicine poses severe risk to the general public. Some practitioners are highly over zealous and prescribe antibiotics to treat viral infections. In fact, the US recently encountered its first case of a homegrown bacterial pathogen resistant to all known antibiotics. Previous cases involved people traveling to the US from other countries.

The fear of overusing antibiotics has caused dental hygienists and dentists to shy away from prescribing antibiotics to treat severe periodontitis. Some experts urge the reexamination of this paradigm. They argue that antibiotic treatment can effectively treat such severe cases when combined with mechanical debridement.

Periodontitis can have severe risks to overall health from the amount of inflammation that it causes. At worst, the condition can cause a cardiovascular event.

Traci Warner, RHD, argues in a recent issue of Dentistry Today that “the adjunctive use” of antibiotics systemically “must become dentistry’s new standard of care.” Lab tests for high-risk patients can identify the specific types and concentrations of pathogens, thus permitting the use of antibiotics specific for the microflora of a particular high-risk patient.

The mitigation of pathogens can enable the body to heal and regenerate much more efficiently than by simply scraping pathogens off the teeth. Since severe periodontitis can degrade the bones and cause eventual loss of a patient’s teeth, it might be wise to consider bacterial typing and subsequent systemic antibiotic treatment.