Chronic Periodontal Infections

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Chronic periodontal infections are due to prolonged bacterial infection around the teeth, which leads to destruction of periodontal and bony supporting tissue of the tooth.  This usually leads to pocket formation, gum recession, tooth mobility and or loss.

Cause

• Bacteria

Symptoms

• Recurrent painful chewing
• Mobility of teeth
• Bleeding gum margin

Signs

• Gum recession
• Pocket formation
• Loss of supporting bony tissue 

Investigations

• X-ray of involved teeth and supporting tissues

TreatmentTreatment Objectives

• To restore tooth function 
• To treat infection 
• To relieve pain

Non-pharmacological management 

• Debridement
• Reconstructive surgery

Pharmacological treatment

Adjunctive Antimicrobial therapy

• Clindamycin, oral,

Adults

300-450 mg 6-8 hourly for 7 days

Children

12-18 years; 150-300 mg 6 hourly for 7 days

1 month-11 years; 3-6 mg/kg 6 hourly for 7 days

Or

• Amoxicillin + Clavulanic Acid, oral,  

Adults

1 g 12 hourly for 14-21 days

Children

>12 years; One 500/125 tablet 12 hourly

6-12 years; 5 ml of 400/57 suspension 12 hourly

1-6 years; 2.5 ml of 400/57 suspension 12 hourly 

1 month-1 year; 0.25 ml/kg body weight of 125/31 suspension 8 hourly 

< 1 month;  0.25 ml/kg body weight of 125/31 suspension 8 hourly 

For pain relief 

• Paracetamol, oral, 

Adults

500 mg-1 g 6 hourly as required 

Children

6-12 years; 250-500 mg 6 hourly as required

1-5 years; 125-250 mg 6 hourly as required

3 months-1 year; 62.5-125 mg 6 hourly as required

Referral CriteriaRefer all patients to the dental specialist.