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Journal of Dental Research, Vol. 87, No. 9, 871-876 (2008)
DOI: 10.1177/154405910808700916

Clinical

Systemic Antibiotics and Tooth Loss in Periodontal Disease

J. Cunha-Cruz1,*, P.P. Hujoel1, G. Maupome2 and B. Saver3

1 University of Washington, Dental Public Health Sciences, B509, 1959 NE Pacific Street, Box 357475, Seattle, WA 98195-7475, USA;
2 Department of Preventive and Community Dentistry, Indiana University School of Dentistry, and The Regenstrief Institute, Inc., Indianapolis, IN, USA; and
3 Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, USA

Correspondence: * corresponding author, silvajcc{at}u.washington.edu

Systemic antibiotics have been recommended for the treatment of destructive periodontal disease. Our goal was to relate antibiotic use for medical or dental reasons to subsequent tooth loss in a cohort of 12,631 persons with destructive periodontal disease. After adjustment for age, smoking, and other confounders, the dispensing of antibiotics for 1–13 days, 14–20 days, or 21 or more days was not associated with reduced tooth loss [Adjusted rate ratio (RR) = 1.0; 95% Confidence Interval (CI) = 0.8–1.1; RR = 1.2; 95% CI = 0.9–1.4, and RR =1.2, 95% CI =1.0–1.3, respectively]. Numerous subgroup analyses were consistent with these overall null findings, with two exceptions: Longer courses of tetracyclines were associated with reduced tooth loss among persons receiving periodontal care, and penicillin was associated with reduced tooth loss among persons with more severe disease. Long-term, larger randomized trials are needed to provide evidence that antibiotics reduce tooth loss when used in the management of destructive periodontal disease.

Key Words: antimicrobials • systemic antibiotics • tooth loss • cohort study


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