Felis ISSN 2398-2950

Therapeutics: periodontal disease

Contributor(s): Jan Bellows, Lauren Trepanier

Antibiotics

  • Antibiotic therapy is useful as an adjunct to:
    • Periodontal surgery.
    • Oral surgery.
    • Endodontic therapy.
  • Only locally administered sustained release antibiotic marketed for veterinary use to date isDoxirobe" (Pfizer).
  • Systemic antibiotics are indicated in cases of severe periodontal disease (stages 3 and 4). In stage 4 periodontal disease, give antibiotics two weeks before professional teeth cleaning and at least one week after, but most clients request immediate teeth cleaning and extractions if indicated.
  • Antibiotics also indicated in most cases of oral surgery.

Antibiotics most commonly used in stage 3 and stage 4 periodontal disease (effective against mixed oral flora):

  • Amoxicillin  Amoxicillin  : 10 mg/kg q12h.
  • Amoxicillin-Clavulanate  Clavulanate  : 12.5 mg/kg q12h (approved for use in US).
  • Clindamycin  Clindamycin  : 5.5 mg/kg q12h or 11 mg/kg q24h. Decreases/prevents production of glycocalyx (approved for use in US).
  • Doxycycline  Doxycycline  : 10 mg/kg q24h (oral gel licensed for dogs only).
  • Metronidazole  Metronidazole  : 8-10 mg /kg q12h. Good efficacy against most anaerobes. Poor efficacy against some anaerobic gram positive cocci and non-spore forming gram positive bacilli.
  • Metronidazole-Spiramycin: 12.5 -16 mg/kg (metronidazole) + 75,000 -100,000 UI /kg (spiramycin).

Antibiotic prophylaxis

  • Used for animals at risk of developing systemic disease subsequent to bacteremia:
    • Immunocompromised organic or metabolic failure.
    • Heart disease.
    • Animals with orthopedic implants.
  • Use an injectable antibiotic, ie amoxicillin   Amoxicillin  or ampicillin   Ampicillin  at a dose of 20-25 mg/kg IV or IM 30 minutes before procedure, then 10-12.5 mg/kg IV or IM four hours after initial dose.
  • Alternately, give patient oral antibiotics for several days before professional cleaning visit if they fit antibiotic prophylaxis criteria.

Plaque retardants

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Chew toys and dental devices

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Root canal medication

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Anesthesia and analgesia

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Immunomodulation

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

Refereed papers
  • Recent references fromPubMed.
  • Robertson S A et al(2003)Systemic uptake of buprenorphine by cats after oral mucosal administration. Vet Rec152(22), 675-678PubMed.
  • Dobbins S et al(2002)Comparison of the effects of buprenorphine, oxymorphone hydrochloride, and ketoprofen for postoperative analgesia after onychectomy or onychectomy and sterilization in cats. JAAHA38(6), 507-514PubMed.

Other sources of information

  • Bellows J (1999)The Practice of Veterinary Dentistry.Iowa State University Press.


ADDED