PERIO - Periodontal Practice Today
PERIO - Periodontal Practice Today 1 (2004), No. 4     12. Jan. 2005
PERIO - Periodontal Practice Today 1 (2004), No. 4  (12.01.2005)

Page 311-320

Periodontitis as a Contagious Infection: Contemporary Use of Antimicrobial Agents.
Part I: Bisbiguanides

Saxer, Ulrich/Hassell, Thomas
Bacteremia is a common occurrence in patients with periodontal diseases, even simple gingivitis. Tooth brushing, especially improper and/or overzealous tooth brushing, routinely occasions a significantly perceptible elevation in the quantity of oral-origin microorganisms in the circulating blood. Initial therapy, whether a routine prophylaxis in a gingivitis case, or scaling and root planing in a periodontitis patient, always leads to bacteremia, often massive; hitherto, most such bacteremias have been assumed to be both transient and inconsequential for the patient's systemic health. This assumption is no longer tenable in the light of new clinical and scientific knowledge. The purposes of the present article are: 1) to critically review the contemporary use of antimicrobial agents in dental and dental hygiene practice in the USA and internationally; 2) to revisit and review the peculiarities that characterize inflammatory gingival/periodontal disorders which may demand more aggressive use of antimicrobial agents now and in the future; and 3) to conceptualize the emerging treatment concepts that are targeted towards treatment of gingival/ periodontal diseases as acutely contagious clinical entities.

Keywords: periodontitis, contagion, full mouth disinfection, chlorhexine, medicinal treatment