Periodontitis is a bacterial induced chronic inflammatory disease that is modified by the host immune response. At the center of this disease is an interaction between the bacterial biofilm vs. immune response. The problem is that this bacterial biofilm is protected from a patient’s immune response and antibiotics due to a multilayered ecosystem that a mature biofilm forms.
Antibiotics have different spectrums of effiency against certain bacteria. Examples of these antibiotics are Amoxicillin, Metronidazole, Clindamycin, Tetracycline, Augmentin, and Azitromycin.
There is some evidence to support the use of antibiotics with non-surgical scaling and root planing. Also, the research has shown that antibiotic treatment without scaling and root planing has no effect. This is due to the inability of the antibiotic to penetrate a mature biofilm structure.
A risk/benefit analysis should be considered with regards to the aggressive nature of the disease and the possibility of antibiotic resistance.