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Gum Diseases

Antibiotics and gum disease treatment



I am about to have a root planing and scaling procedure to treat moderately severe periodontal disease. When undergoing similar dental treatments in the past, including ordinary cleaning, I have sometimes experienced a pronounced "sick" feeling, including fatigue and overall weakness. Sometimes (including now) I experience this feeling in general, in intervals between dental appointments.

My blood work and heart tests seem to be normal, and my primary care physician cannot identify any apparent physical cause. So though I`m not sure, and since I have no dental phobias, I have thought this sick feeling might be due to infection from oral bacteria having entered my bloodstream.

Therefore, would it be wise to take antibiotics (e.g., amoxicillin) prior to undergoing root planing and scaling, or when it begins? If so, would one ten-day treatment be likely to be effective for the four-week course of the four appointments? If antibiotics are not recommended, are there other ways I can protect against systemic bacterial infection, or other hypotheses on why I might experience sickness in conjunction with dental treatment? Thanks; I`ll be very grateful for your guidance.


From the information that you are providing, being considered a healthy individual by your physician, it could be possible that the overall fatigue and weakness is caused by bacteria from the periodontal infection that enters your bloodstream - both with treatment and in between appointments. Amoxicillin alone is not particularly that effective against these specific groups of bacteria. However, I do not see any other way to protect your body's health than using antibiotics by mouth to prevent these symptoms from occurring.

Different groups of antibiotics should be considered as well. Amoxicillin given in combination with another antibiotic called metronidazole is considered by research data to be a good choice. Also, doxycycline could be a good alternative too. The antibiotics should be administered, for them to be more effective, during or after the scaling and root planing, not before. I consider that based on the information you have provided, you should be evaluated by a periodontist, if you had not seen one yet.

I hope the information presented is of use to your current situation.

Let us know if we could be of any further help.

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Response by:

Jose I Arauz-Dutari, DMD Jose I Arauz-Dutari, DMD
Formerly, Assistant Professor of Periodontics
School of Dental Medicine
Case Western Reserve University