Since
periodontal diseases are mainly of bacterial origin, the use of
antibiotics could seem justified for their treatment. Numerous studies, however, have shown that these drugs are not a first choice treatment for acute and
chronic periodontitis.
Chemotherapy can represent a valuable adjunct to routine mechanical
debridement, particularly for adult recurrent
periodontitis, juvenile periodontitis and rapidly progressive
periodontitis. Furthermore, prophylactic
chemotherapy should be provided for patients at risk with systemic diseases, notably when congenital or acquired valvular heart defects are present. For the treatment of adult recurrent
periodontitis, the most appropriate systematic drugs are, presently,
tetracyclines or
imidazoles.
Juvenile periodontitis can be treated with the help of
tetracyclines and rapidly progressive
periodontitis with
imidazoles. As for high risk patients, the use of various
penicillins is mandatory. A decision to use
antibiotics must be made only after due consideration of their potential disadvantages. One should also remember that the possible positive or negative effects of
antibiotics upon the host defence mechanisms are for the moment unknown.