Antimicrobial Therapy for the Treatment of Gum Disease

Bacterial infection causes gum disease. Gum disease can cause loss of tissue and tooth if not treated in time. Scaling, root planing, gum surgery help treat gum disease. Along with these modes of treatment, your dentist may prescribe antimicrobials. Antimicrobials help in treating certain gum conditions such as acute periodontal infection, pediatric periodontal disease, refractory periodontal disease, etc.

Dental antimicrobials prescribed usually as low concentration and long duration or higher concentration and shorter duration dosage. These medications can be in the pill form or topical gel form. In this article, let us understand antimicrobial therapy, its use in dentistry, procedure, and importance of maintenance therapy after treatment.


Antimicrobial therapy

Antimicrobial therapy is the administration of antimicrobials which deter bacterial growth or kill harmful bacteria. Antiseptics are used to prevent gum disease, and antibiotics are used to treat existing periodontal disease. Majority mouthwashes are antiseptic. Oral antibiotics such as tetracycline and metronidazole kill bacteria. When taken orally, these antibiotics affect the whole body hence are prescribed less often.

Topical gels act on the affected gum directly and hence preferred over oral antibiotics. Doxycycline, chlorhexidine, and minocycline are some of the antibiotics delivered topically.

Use of antimicrobial therapy

Bacteria causes gum disease and using antibiotics as an adjunct to scaling, gum surgery, etc. helps to inhibit bacterial growth while accelerating healing. Antibiotics are also used to treat acute cases of periodontal disease such as abscesses, ulcerative gingivitis, etc. Other gum diseases in which your dentist may use a combined approach to treat the condition include –

  • Advanced periodontitis.
  • Gum disease in people with a weak immune system.
  • Gum disease which is not responding to scaling, root planing.
  • Aggressive Periodontitis.

Preparation for antimicrobial therapy

Before antimicrobial therapy commences, your dentist will do scaling and root planing to remove plaque, tartar, and bacteria from the tooth surfaces and below the gum line. The periodontal pockets are cleaned for the antimicrobials to be effective. During root planing your dentist will also smoothen any bumps on the root surface since bacteria inhabit these regions. While root planning and deep cleaning, your dentist will numb your mouth, so that you don’t feel pain.

Procedure for antimicrobial therapy

The antimicrobial gels, powders or chips can be applied directly to the affected area. Few of the commonly used topical antimicrobials are (1)


This chip contains chlorhexidine a powerful antibacterial and antiseptic. The dentist will insert this chip into the periodontal pocket between teeth and gum tissue. Chlorhexidine is slowly released for 7 to 10 days. PerioChip has helped reduce the pocket depth in many cases. After a week the chip will dissolve on its own.


Doxycycline gel is the constituent ingredient. The gel takes the shape of the gum tissue and solidifies. The gel releases the medication slowly. After applying the gel, your dentist will cover the region with a periodontal pack. After 7-10 days the periodontal pack will be removed along with the remaining gel.


The constituent antimicrobial in Arestin is minocycline. Minocycline topical antibiotic comes in the form of mini-capsules. The dentist will place the capsules into the gums after scaling and root planing. These capsules take approximately three weeks to dissolve.

If you are allergic to any particular antimicrobial agent, then inform your dentist so that he can prescribe medication accordingly. Also, you should report about any side effects to your dentist at the earliest so that he can change medication.

Follow up procedure after antimicrobial therapy

After scaling, and root planing combined with antimicrobial therapy is over, you need to take good care of your oral hygiene to prevent gum disease in the future.

  • Brush twice every day. Use a soft to medium bristled brush and change your brush after every three months.
  • Floss every day, once daily. If you don’t like the traditional dental floss, then you can use WaterPik (water flosser) for flossing.
  • Take all medications prescribed by your dentist, on time. Also, make sure that you take the right dosage to prevent the bacterial strain from becoming resistant to antibiotics.
  • In case your dentist prescribed oral antimicrobial therapy, it is likely that he will prescribe topical antibiotics after oral antimicrobial therapy is over.
  • Placing of topical antibiotics under the gum tissue may cause slight discomfort. While the topical antibiotic is in place, do not floss the particular area to prevent dislocation of the medication.
  • Your dentist may administer both oral and topical antibiotic at the same time during antimicrobial therapy. (2)

In case your gum tissue doesn’t respond adequately then your dentist will look for other treatment options depending on the severity of your disease.

Maintenance post antimicrobial therapy

After successful treatment of the periodontal condition, you will have to take care to maintain your gum health to prevent gum disease. Your maintenance therapy will include visiting the dentist every three months to review your gum health, review your oral hygiene status.

Your dentist may perform a Round of scaling (in case there is calculus deposition) and Polishing of teeth (to smoothen any area that could act as a reservoir of bacteria). Your dentist will take x-rays (as and when required) to check the status of the bone surrounding the affected region.


Over to you on antimicrobial therapy

Antimicrobial therapy can take care of gum disease and prevent it from becoming worse but only when you visit the dentist at the earliest. If you take care of your oral health, get your teeth cleaned regularly then you can very well avoid the whole procedure of antimicrobial therapy.


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