When to initiate antibiotics in periodontitis treatment: Creating a healthy oral microbiome
Researchers examined whether systemic antibiotic timing may affect the clinical and microbiological outcomes of periodontal therapy, according to a news article from Oral Health.
Experts cited in the article underscored the impact of the oral microbiome on systemic health. For instance, patients with periodontitis may have a greater risk of developing cardiovascular disease, respiratory disease and diabetes. Therefore, better understanding the dynamics of the oral microbiome could help clinicians protect a patient’s overall health through their oral health.
In a study published in the Journal of Periodontology, the researchers randomly assigned nearly 70 patients with stage III or IV periodontitis who were undergoing scaling and root planing to receive either metronidazole and amoxicillin thrice daily during treatment followed by placebo or placebo during treatment followed by metronidazole and amoxicillin. They subsequently examined clinical parameters such as probing depth, clinical attachment level, visible plaque bleeding on probing and suppuration.
The researchers found that the clinical outcomes between both groups were comparable. However, those who received antibiotics during treatment were more likely to exhibit quicker ecological reorganization with both decreased centrality of red and orange complex species and earlier proliferation of beneficial bacterial species that formed a stable community, whereas those who received placebo during treatment experienced slower microbial restructuring and higher numbers of pathogenic bacterial species associated with oral microbial dysbiosis.
The findings indicated that the timing of antibiotic initiation may not impede the success of periodontal therapy but may influence the subgingival microbiome following treatment. As a result, the researchers emphasized the potential benefit of earlier antibiotic initiation in order to establish a beneficial community of oral bacteria to potentially protect against periodontitis recurrence long term.
Read more: Oral Health
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