FAQ

How important is a periodontal culture versus simply taking amoxicillin and metronidazole?

This self treatment regimen was implemented for pragmatic reasons recognizing that large numbers of dental consumers would have to travel 100 miles or more simply to find a dentist or periodontist willing to take a culture and prescribe the appropriate antibiotics. The prime shortcoming with this regimen is that it may be overkill. It is possible that a single antibiotic may be all that is necessary. If the disease recurs at some point in the future, without taking a culture there will be some question whether the amoxicillin metronidazole regimen was the most effective treatment available. This author feels it is regrettable that so many American dentists and periodontists are failing to provide effective treatment of common periodontal disease, leaving informed American consumers no alternative but self treatment.

What do I do if the disease recurs?

Disease recurrence will happen occasionally, even in persons who have taken antibiotics as indicated by laboratory culture. The most common reason for this is re‑infection from a significant other. Less common is there is no re‑infection of bacterial pathogens but an overgrowth of cytomegalovirus. If pocket probings are 6 mm or less, one can self differentiate with the following test. Use 10% povidone iodine in the oral irrigator once every four weeks. If the condition improves markedly over the next few months, then it is safe to assume the problem was primarily an overgrowth of cytomegalovirus and it is not necessary to retake the antibiotics. If the condition does not improve significantly or there are multiple pockets greater than 6 mm, it may be necessary to retake the antibiotics. Consider finding a dentist who will perform a periodontal culture. Consider having your significant other take the antibiotics simultaneously and adhere to the self treatment guidelines.

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