Because bacteria cause periodontal disease, antibiotics are used if scaling and root planing alone are not enough to control the disease.
Systemic antibiotics are used by Dr. Layport primarily for Early-Onset Periodontitis (bone loss before age 35) and for Refractory Cases (disease that is only slowed and not stopped by our usual treatments).
Typically Doxycycline, a tetracycline type of antibiotic, is used. Metronidazole (Flagyl) and Amoxicillin or Augmentin are commonly used together in aggressive cases. Periostat is a low-dose form of Doxycycline which is primarily used for long-term use in Refractory patients. The dosage is low enough that the bacteria are not killed, and do not form resistance to the antibiotic. The beneficial effect derives from a side effect that helps prevent collagen (gum tissue fibers) breakdown by enzyme suppression.
Localized antibiotic placement is an actively changing part of periodontal therapy. Currently Dr. Layport uses Arestin, which is Minocycline in a powder form, in localized problem areas. A Metronidazole chip is expected to be approved for use soon. Chlorhexidine is an antibacterial mouthwash which can be used for irrigation in localized problem pockets as well as a general mouthwash in certain circumstances.