The American Academy of Periodontology (AAP) treatment guidelines have always stressed that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment, including scaling and root planing.
Because gum disease is a bacterial infection, you would think that antibiotics could be used to treat it. Research demonstrates that antibiotics can be a helpful adjunct to treating periodontal disease. However, prescribing antibiotics as a first line of defense is not only unnecessary as most patients respond well with proper periodontal treatment, but it also disregards the Centers for Disease Control recommendations for appropriate antibiotic use for health care providers. Medical and dental communities are concerned about the overuse of these medications in treating infections because of the possibility of the development of antibiotic resistant strains of bacteria. This overuse would be detrimental to patients if they develop a life-threatening illness for which antibiotics would no longer be helpful.
Antibiotics may be prescribed for periodontal patients who do not respond to conventional mechanical therapy, for patients with acute periodontal infections associated with systemic manifestations, for prophylaxis in medically compromised patients, and, on a case-by-case basis, as an adjunct to surgical and non-surgical periodontal therapy.