Systemic Antibiotics and Tooth Loss in Periodontal Disease

J. Cunha-Cruz,1* P.P. Hujoel,1 G. Maupome,2 and B. Saver3


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.