When patients receive their OralDNA® MyPerioPath® test results, one of the most common questions is: “Why aren’t we prescribing antibiotics?” After all, the test identifies bacteria linked to periodontal (gum) disease. Shouldn’t antibiotics be the next step?
Dr. Lee Sheldon explains that the answer often goes back to the root cause of periodontal disease itself.
“Periodontal disease is the loss of support for the teeth. It comes primarily from bacteria that go below the gum line and lodge on the root surface, with heavy accumulations of calcified bacteria. That’s called calculus,” says Dr. Sheldon. “Within the calculus, there are little openings where bacteria lodge. So the source of the bacteria in your mouth very often is the calculus.”
In other words, the first step is not medication—it’s removing the source of the infection. Scaling and root planing, along with good home care, target the calculus deposits where harmful bacteria thrive. Once these deposits are cleared, the bacterial load often decreases naturally.
That’s why antibiotics aren’t automatically prescribed. “Our primary goal is to remove that calculus, and the bacteria within that calculus will go away if we’re able to do that,” Dr. Sheldon explains. “Then we don’t have to prescribe an antibiotic.”
There are exceptions. For patients with aggressive or advanced cases, antibiotics may be necessary. But even then, the decision is made carefully. “It’s clear that when we prescribe an antibiotic, it removes the balance of the bacteria, the viruses, and the fungi within the body,” notes Dr. Sheldon. Many people are familiar with side effects like yeast infections, which can occur when the body’s natural microbiome is disrupted.
OralDNA® tests help clinicians tailor care to the individual. By identifying which bacteria are present, providers can decide whether the infection can be managed with mechanical therapy alone, or if medication is warranted. Dr. Sheldon emphasizes a conservative approach: “What we want to do is as little as we need to in order to control the infection.”
And the statistics back it up. “By our statistics, 50% of the people that we see will heal without antibiotics,” says Dr. Sheldon. “And if you don’t have antibiotics, your system doesn’t have to recover.”
The takeaway? Antibiotics are a tool—but not always the first tool. For most patients, treating the underlying calculus and maintaining strong home care can resolve the problem without disrupting the body’s natural balance. MyPerioPath® provides the roadmap, helping clinicians choose the least invasive, most effective treatment path for periodontal disease.
If you would like to watch to Dr. Sheldon’s full video please click here or watch the video below.
He was the Chairman of the dental department at Holmes Regional Medical Center. He has chaired the Brevard Study Club since 1995, bringing dental continuing education to Brevard County dentists. As an associate clinical professor in the University of Florida College of Dentistry’s graduate department of periodontology for over eight years, he helped train periodontists of the future. He, along with our office manager, Danyel Salmela, are founders of the Institute for Dental Specialists. They have lectured at national and regional periodontal meetings in nearly every area of the U.S.A.
Dr. Sheldon was the first dentist from central Florida to use computer-guided surgery for implant placement. He was also the first to use the dental endoscope to assist in the effective nonsurgical treatment of gum disease. These innovations have led to the Solid Bite concept, providing beautiful, functional and efficient dental restorations.
As an author, Dr Sheldon has answered questions such as “Do you feel that there are no dental answers for you?” "The Ultimate Mouth Manual,"is authored by Drs. Sheldon, Sheldon, and Furtado and the book available in book stores, which contains information patients need to make dental decisions in the 21st century!
Dr. Sheldon is also a regular contributor to the column, “Focus on Seniors,” in the Senior Scene Magazine. His topics range from dental care to overall health care. He is also a regular panelist on the Focus on Seniors programs on radio and television, as well as a sought-after speaker on health care and nutritional topics.
- Do We Really Need Antibiotics for Periodontal Disease? - September 5, 2025
- Saving Teeth, Avoiding Implants: Dr. Lee Sheldon’s Strategic Approach to Aggressive Periodontitis - June 20, 2025
- Bacteriological Testing Offers Many Opportunities - February 21, 2025