Critical Thinking: The Systemic Antibiotic Option

The MyPerioPath® test provides a wide variety of valuable information for the clinician to consider in the care of their patients. In one example, the Treatment Consideration section of the report provides a recommendation for a regimen of oral antibiotics when the test results show bacteria levels greater than the black lines, called the therapeutic threshold.  Where did this recommendation come from?  This choice of drug, along with the recommended doses, are based on published research of outcome-based clinical studies.  Importantly, this regimen is an option, and only one of several potential ways to treat your patient that would be a standard of care. Before prescribing an oral (systemic) antibiotic take into consider these questions:

• Is the periodontal inflammation localized or generalized?
• Have you asked the patient about a history of allergy or intolerance to antibiotics?
• Is the patient known to have some type of colitis such as Crohn’s disease, chronic ulcerative colitis, or IBS (irritable bowel syndrome)? If so, co-management of the patient should be considered. Reach out to the patient’s medical provider to determine best therapies for your mutual patient.
• Has the patient recently been on systemic antibiotics for another condition such as bronchitis or urinary tract infection? What may happen if the patient is on back-to-back systemic antibiotics?
• Does the patient have bacteria possibly complicating systemic diseases?

Investigating and answering these questions may help the clinician determine the use of a systemic antibiotic. A responsible approach to the use of systemic antibiotics (aka antibiotic stewardship) is always encouraged. Another great adjunct is to recommend a gastro-intestinal probiotic when administrating a systemic antibiotic, to help curb potential side effects.

Treating periodontal disease can be accomplished through many different methods. Sometimes the patient responds to the systemic antibiotic option favorably and sometimes they don’t respond at all. Critical thinking is needed when considering any adjunct therapy of periodontal treatment. The sure thing to do is to Test, Don’t Guess by performing MyPerioPath^®.

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Diane Larson RDH, BSDH

Diane Larson, RDH, BSDH has over 20 years of dental experience. She is a member of the ADHA/ MnDHA. Although she is no longer providing patient care chair side, her passion is helping clinicians provide a higher quality of care for their patients by assisting in developing an evidence based treatment plan. She considers herself an extension of every team that utilizes OralDNA services. Her total health approach is complimented by her nutritional knowledge. She is from the Midwest and calls Minnesota home, where she lives with her husband.

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