Low dose doxycycline therapy

Some patients, even in the presence of good oral hygiene, continue to show symptoms of periodontal disease. Some have predisposing health factors such as diabetes or smoking. Both can alter the immune response to bacteria present on the teeth (plaque) and in the crevice between the gum and the tooth (gingival crevices or pockets) and make the patient more prone to gum disease. For patients with these predisposing factors and for some other patients for whom more traditional gum treatments have been unsuccessful, low-dose doxycycline therapy may be an option.

Doxycycline, even at very low doses, can inhibit collagenase and the enzyme that breaks down collagen, and patients taking doxycycline may have fewer skin and gum tissue infections.

During low-dose doxycycline therapy The patient takes doxycycline 20 mg twice daily and continues this regimen for 6 weeks to 9 months (or longer). This dose is one-fifth of the normal antibiotic dose (100 mg, twice a day). When this therapy is combined with the proper use of an oral powered toothbrush and adequate intraproximal plaque control, previously uncontrolled periodontal disease can be put into remission.

The patient is placed on a three-month recall (cleanings every three months) and the dentist and hygienist monitor their progress. I have often found that over time, not only do your gums appear healthier, but the bleeding on probing and pocket depths decrease. After an adequate period of time, doxycycline use is stopped and patients are monitored again at a three-month recall.

If you have good oral hygiene and regular cleanings with your dentist, but still have swollen gums, talk to your dentist about low-dose doxycycline therapy. Keep in mind that there are health conditions that predispose patients to periodontal disease (diabetes, smoking, blood dyscrasias, HIV to name a few) and patients should visit their doctor before starting low-dose doxycycling therapy, although only either to rule out or treat any of these conditions

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