A guide to antimicrobial therapy

What is antimicrobial therapy?

Antimicrobial therapy refers to using chemicals that will inhibit the growth of bacteria or completely eradicate it. The bacteria that cause periodontal gum disease will be eliminated or inhibited through the use of antimicrobial therapy. Two of the most familiar forms of antimicrobial therapy are antibiotics and antiseptics. Products that have antiseptics are used to prevent periodontal disease while products that contain antibiotics are used to treat existing periodontal disease. You can find antiseptics in most oral rinses. You can read more about antibiotics placed under the gums or taken as pills during procedures like scaling and root planing.

What is antimicrobial therapy used for?

Since periodontal diseases are caused by bacteria, dentists and periodontists will usually use antibiotics. Periodontists are dentists who specialize in gum disease. In dentistry, antibiotics are used to treat acute, sudden, and short term infections that relate to the gums like abscesses. Antibiotics could also be used to treat

  • necrotizing ulcerative gingivitis or NUG is a rare and aggressive form of periodontal gum disease
  • rapidly progressive and aggressive forms of periodontitis
  • advanced stages of gum disease
  • periodontal diseases that have not responded to other forms of treatment
  • periodontal disease in people who have weakened immune systems
  • periodontal disease in people who have serious medical conditions


Scaling and root planing is a type of dental treatment that is commonly used to treat periodontal disease. Antibiotics are normally used to supplement the effects of this dental treatment. Many forms of periodontal disease are successfully treated using this combined approach although some periodontal diseases cases may need more additional treatment. In some cases, periodontal surgery may have to be performed.

Periodontal disease is caused by bacteria. You may be wondering why antibiotics are still being considered as routine treatment for periodontal therapy. Keep in mind that bacteria can become resistant to the effects of certain antibiotics already. These situations happen when you take too much of the antibiotic or when you do not take the prescriptions as instructed by your doctor or your dentist. Periodontal diseases can be treated successfully without antibiotics. You should avoid taking antibiotics if you can afford not to take them.

How do you prepare for antimicrobial therapy?

When your dentist has decided on a type of antibiotic, you will go through scaling and root planing. It is a procedure that will remove plaque and tartar under your gum line. It will smooth out any bumps or irregular areas on your tooth from the crown all the way to the roots. You may be given an anaesthetic injection in that area so that it will become numb.

How is antimicrobial therapy performed?

Antimicrobial therapy for periodontal disease can be applied directly as a gel or given in the form of a pill. If you take antibiotics in the form of pills then you may take them for seven to ten days.

Local therapy is given in your dentist’s chair. This will involve applying the antibiotic directly to the part of your mouth that has been affected. There are a lot of types of local therapy and they include

  • gel form. Your dentist will inject a gel that contains doxycycline beneath your gums. This area will be sealed and it will be covered with a special bandage. This bandage is referred to as a periodontal pack. Your periodontal pack will be removed after seven to ten days. The remaining gel will be removed as well
  • chips. Your dentist will place a chip that has chlorhexidine beneath your gums. This chip will dissolve on its own over a period of seven to ten days
  • powder form. This is when your dentist will squirt a powder with minocycline beneath your gums. This powder will dissolve over a period of three weeks


What are the follow-up procedures after antimicrobial therapy?

Oral therapy is needed after antimicrobial therapy. You must practice good oral hygiene all the time. You should brush your teeth twice a day and you should floss your teeth once a day. You should take your medication as directed. This includes the right dosages at the right time. This will reduce the risk that surviving bacteria becomes resistant to medication. It will also ensure that the medication will work as it was meant to.

Local antibiotic therapy is important after antimicrobial therapy. You may feel discomfort under your gums after the local antibiotics are placed although this should not bother you so much. You should avoid flossing the teeth that were treated because this could simply dislodge the medication. Dentists may also place a covering called a periodontal pack in the gum area. You should not disturb the periodontal pack when it is applied because it will be examined once more after seven to ten days and it will be removed afterwards. After this period, you can resume your normal tooth brushing and flossing habits.

Both oral and local antibiotic therapy could be applied at the same time during antimicrobial therapy. If your disease does not respond properly to antibiotics then the next step will depend on several variables like the severity of your disease. Your dentist can prescribe a different antibiotic or your dentist may even schedule you for a periodontal surgery. Others will go through several types of antibiotics before their disease responds. When you have successfully treated the periodontal gum disease, you should make sure that it is kept under control from then on. Maintenance therapy includes regular visits to your dentist or your periodontist and it can include

  • evaluation of your oral hygiene and the review of the proper techniques for brushing and for flossing
  • a periodontal exmamination
  • cleaning your teeth
  • polishing your teeth
  • x-rays every few years


What are the risks of antimicrobial therapy?

One of the major risks involved in antibiotic therapy is an allergic reaction. You should tell your dentist if you are allergic to certain antibiotics. If you are unaware of your allergies or if you experience an adverse reaction like a rash, an upset stomach, or hives then you should stop taking the medication and get in touch with your dentist right away. Your dentist will most likely switch you to another antibiotic.

If you do not use antibiotics properly then you may become resistant to its intended effects. Your dental professional will guide you on the best way to use antibiotics properly. You should follow the instructions for taking antibiotics including when to take them and how much of it you should take. You should report any side effects from antimicrobial therapy right away.