“Antibiotics are frequently overused and misused in dental practice,” note the authors of a recent paper in the International Journal of Environmental Research and Public Health.
According to one 2019 study, “nearly 81% of all antibiotics prescribed before dental procedures are unnecessary.” Its authors also found “that nearly 4% of the patients given antibiotics unnecessarily before dental procedures experience serious adverse events, including allergic reactions and emergency room visits.”
Just as concerning is how this state of affairs contributes to antimicrobial resistance in dentistry – a state of affairs highlighted by new research in the journal Antibiotics, which documents the emergence of antibiotic-resistant P. gingivalis. This bacterium is one of the major players in gum disease, an oral infection that raises your risk of heart attack, stroke, diabetes, rheumatoid arthritis, chronic kidney disease, cognitive decline, and even some cancers.
For their study, scientists took P. gingivalis samples from under the gums of nearly 2200 patients with severe periodontitis. (That’s the advanced form of gum disease, in which tissue damage occurs.) These were cultured before treatment during three different time periods: 1999-2000 (936 patients), 2009-2010 (685 patients), and 2019-2020 (572 patients).
The bacteria were then lab tested for resistance to several antibiotics: doxycycline, metronidazole, clindamycin, and amoxicillin. Those last two are the antibiotics most often used in dentistry.
The research team found that within the two decades covered by their study, there was a 15-fold increase in clindamycin-resistant P. gingivalis and a 28-fold increase in amoxicillin-resistant P. gingivalis.
“These findings,” noted the study authors, “are the first to document the emergence of antibiotic-resistant periodontal P. gingivalis in the United States.”
The good news is that we don’t need to rely on these drugs for successful periodontal treatment. Here in our St. Louis office, deep cleaning with the use of natural antimicrobials is the first step, along with addressing nutritional needs that support a healthy oral microbiome. To prevent problems from returning, we emphasize ongoing maintenance that includes regular professional cleanings, good home hygiene, and optimal nutrition.
You can learn more about our three-pronged approach to periodontal health here.
One especially powerful tool we have that most conventional practices lack is ozone. Ozone’s antimicrobial power is well-established in both dentistry and medicine, and research has shown that one oral pathogen it seems quite effective against is P. gingivalis.
A study that was done as P. gingivalis was becoming more resistant to antibiotics illustrates its power nicely.
Thirty patients with chronic periodontitis took part and were tested for the presence of P. gingivalis in their mouths. Twelve of the 30 tested positive. Each of these 12 then had a cleaning followed by ozone therapy.
New bacterial samples showed that half of these patients now tested negative for P. gingivalis, while the bacterial load was significantly reduced in those who still tested positive. That group underwent a second round of ozone therapy before being tested again for P. gingivalis.
All but one now tested negative, and that was the patient who had the greatest bacterial load at the start of the study. Even though they continued to test positive, the extra dose of ozone had reduced their P. gingivalis count even further.
Ozone therapy has excellent medicinal value in the different periodontal treatments. Periodontal diseases contain more than 500 distinct microbial species. The growing microbial resistance has led to the use of higher concentrations of antibiotics which, in turn, leads to side effects including drastic alterations to the host beneficial microflora. Thus, a therapeutic modality capable of reducing the bacterial load without any significant side effect is the need of the hour. Ozone therapy is an effective antimicrobial modality which is painless, thus increases the patient’s compliance to therapeutic interventions.
And that, dear friends, is yet one more reason why we love ozone and give it such a prominent place in our practice.