ANTIMICROBIAL TREATMENT OF PERIODONTAL-DISEASES DISTURBS THE HUMAN-ECOLOGY - A REVIEW

Periodontal diseases are associated with specific pathogenic microorga nisms and therefore antimicrobial agents are often used in the treatme nt of patients with periodontitis refractory to conventional mechanica l therapy. Perorally administered antimicrobial agents often lead to e cological disturbances in the normal oral and intestinal microflora wi th overgrowth of potentially pathogenic microorganisms, which may spre ad within the host or from patient to patient, causing infections. The use of antimicrobial agents also promotes the emergence of bacterial drug resistance, both in the periodontal pocket and in the normal oral and intestinal microflora. Topical administration of antimicrobial ag ents in the periodontal pockets causes restricted disturbances in the intestinal microflora, although there is a substantial risk of develop ment of resistance at the site of application. A number of clinical st udies imply that correct use of antimicrobial agents might be benefici al for a subset of patients with adult or juvenile periodontitis. The choice of antimicrobial agent should always be based on accurate micro bial analyses of the subgingival microflora and in vitro antimicrobial susceptibility tests of the most important periodontal pathogens. Pre ferably, agents with low potential of causing ecological disturbances should be used.