Could Evidence Based Adjunctive Antibiotic Therapy Effectively Treat Gum Disease? A New NIH Trial Aims to Find Out.

The University of Texas and the American Dental Association Science and Research Institute have teamed up to study antibiotic treatment in periodontal disease and to further promote antibiotic stewardship in dentistry.

By Genni Burkhart

Periodontal disease impacts nearly 40% of people in the United States, with periodontitis representing more than one billion cases worldwide.

Directly addressing this issue, the National Institutes of Health recently awarded The University of Texas Health Science Center at San Antonio (UT Health San Antonio) a four-year $2.4 million grant looking at treatment alternatives and antibiotic stewardship.

Researchers at UT Health San Antonio will work in collaboration with the American Dental Association Science and Research Institute (ADASRI) in conducting a clinical trial that will study various treatment methods in combination with the responsible use of antibiotics in treating periodontal disease.

Antibiotic Stewardship

Dentists often use a combination of antibiotics and deep cleaning to treat periodontitis caused by plaque and oral bacteria. But the data on the benefits of using adjunctive antibiotics for this purpose isn’t exactly clear – yet. That’s why the goal of this research project is to generate real-world data on antibiotic supplemented treatments for gum disease, or adjunctive antibiotic therapy.

Clinicians in this study will share data on the effectiveness of the antibiotics they administer. The hope is that this data can then be used to create evidence-based clinical guidelines that provide treatment alternatives as well as responsible, antibiotic stewardship.

The lead investigator and principal grant recipient, Georgios Kotsakis, DDS, MS, Associate Professor of Periodontics at the UT Health San Antonio School of Dentistry will direct this study with Marcelo Araujo, DDS, Ph.D., ADASRI Chief Executive Officer, serving as the co-investigator and collaborator.

In a press release issued by UT Health San Antonio, Dr. Araujo states, “ADASRI is thrilled to partner with as respected of a researcher as Dr. Kotsakis on this important project.”

“Antibiotic stewardship is one of the most important topics in dentistry today, and given Dr. Kotsakis’s track record of successfully translating clinical trials into data that improves clinical practice, we are confident that our work will advance the future of oral health.”

– Dr. Araujo

Research Methods

More than 30 clinicians belonging to the National Dental Practice-Based Research Network (PBRN) will collect data for the study titled, "Shaping the Indications for Periodontal Adjunctive Antibiotics in Dental Practice: A PBRN Clinical Trial." This study will enroll 1,050 periodontal patients receiving dental care across the United States.

This clinical trial will begin in the spring of 2023, with the treatment of periodontal patients followed for one year.

Updating Guidelines

Dr. Araujo also suggests the results of this randomized clinical trial as an opportunity to update the American Dental Association’s (ADA) antibiotic-related guidelines – not updated since 2019 – on treating intraoral swelling and dental pain.

Additionally, this trial provides further opportunity to use the updated American Academy of Periodontology’s Comprehensive Periodontal Evaluation (CPE), which the ADA endorsed in 2021, to diagnose periodontal disease and peri-implantitis.

The Need for Better Treatment Options

Dr. Kotsakis highlights that treating advanced stages of periodontitis is difficult, with a high chance of relapse and in the most severe cases, jawbone destruction, loss of teeth, and increased risk of developing additional inflammatory illnesses.

As quoted in the press release, Dr. Kotsakis further enforces the need for this study: “With the current rise of superbugs, which are multi-resistant bacteria that kill tens of thousands of Americans every year due to antibiotic resistance, there is a critical need to determine if specific patient populations benefit from adjunctive antibiotics.”

Researchers hope to discover methods dentists can most effectively use antibiotics in treating various, and particularly more advanced, stages of gum disease, allowing treatment alternatives through antibiotic stewardship and ultimately benefiting the overall health of dental patients.

Author: With over 12 years as a published journalist, editor, and writer Genni Burkhart’s career has spanned politics, healthcare, law, business finance, technology, and news. She resides on the western shores of the idyllic Puget Sound where she works as the Editor in Chief for the Incisor at DOCS Education out of Seattle, WA.

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