Plaque-induced inflammatory periodontal disease affects a significant number of the population, and raises the question as to why antibiotics are not universally used to treat a disease in which bacteria are the main aetiological agent. This article describes the reasons why antibiotics may not be effective in treating periodontitis, and why their use is not more widespread. However, antibiotics have been shown to be helpful in periodontal treatment in some cases, and evidence for this is presented and suggestions where their use may be indicated are made.
Clinical relevance: To rationalize the selective use of antibiotics in the treatment of periodontitis and avoid inappropriate prescribing.