Q: Recently my husband and I went to a new dentist whose hygienist said we both needed periodontal scaling of our teeth where they scrape underneath the gums. It is quite painful. Anyway, I mentioned this information to my brother who advised against it…take metronidazole (Flagyl) instead. His father-in-law was a periodontist in Houston for over 50 years and when a dentist told my brother he needed the same procedure, he was told about the treatment instead of the painful scraping. The periodontist said he had a 90% success rate with his patients.
So, we refused the periodontal scaling at the dentist’s office and just had a regular cleaning procedure performed. I asked the dentist for prescriptions for both my husband and myself and he indicated he would have to check with his off-site periodontist. He acted like he wasn’t familiar with the Fagyl but indicated he would get back to me. Several weeks later my dentist gave me a prescription but not my husband and that was only after I showed him several articles regarding Flagyl. FYI, both of us are asymptomatic with no visible signs of gum disease.
Wouldn’t it be prudent for most patients with periodontal disease to take antibiotics as a first course of treatment before having a painful, invasive treatment performed? It is inexpensive and worth a shot. Please educate your readers and save them a lot of money and pain.
A: Periodontitis is a gum infection that damages the soft tissue and destroys the bone that holds teeth in place. The condition is often the result of poor oral hygiene. It is quite common but on the good side, it is commonly preventable simply by brushing and flossing at least twice daily and getting regular checkups from a dentist. Symptoms may include bad breath, a bad taste in the mouth, bright red to purple colored gums, receding gums, loose teeth, and more.
Plaque forms on teeth when bacteria normally found in the mouth interacts with the sugars and starches from the foods we ingest. Regular brushing and flossing will remove the plaque, but the problem is ongoing since plaque will form again within a day once we forget to brush. Plaque that remains on teeth longer than two or three days can harden under the gum line. The longer it remains, the more damage can result. Initial problems begin with irritation and inflammation that, if left untreated, may cause pockets of bacteria, tartar and plaque to develop. Inflammation at the gum line at the base of the teeth is called gingivitis – a mild form of periodontal disease. Could there have been some confusion as to whether you both had active gingivitis, periodontitis, or were you being referred for prophylactic cleaning because of a buildup of plaque? If, indeed, it was the latter, there are no studies available justifying the use of Flagyl in lieu of cleaning.
Here is where issues can occur. Many dentists feel it is necessary to completely clean the pockets around the teeth in an attempt to prevent damage to nearby bone. If the condition is mild, a dentist, dental hygienist or periodontist may remove the bacteria and built up tartar beneath the gums and on the surface of the teeth. Then come the antibiotics to fight the bacteria, followed by a surgical procedure for advanced cases of the disease.
Antibiotics in varying forms are often used to treat gum disease and Flagyl (metronidazole) is one of the choices. While other choices may be applied topically (for gum disease in its earliest stages), some are in pill or capsule form, some in the form of a mouthwash, or actually inserted into the pockets of infection at the gum line(for periodontitis). There are even toothpastes available OTC with antibacterial components to help fight gingivitis and reduce plaque that may be used. Because of potential side effects, I recommend patients speak with their dentist prior to initiating any course of treatment. So , thank you for sharing your story. Prevention is paramount. Brush and floss regularly. Visit your dentist on a timely schedule. And, above all, refuse a recommended treatment if you disagree with the course of action.
