Beyond Antibiotics: Exploring Alternative Adjuncts for Periodontitis

Abstract

Background: Periodontitis is a chronic, microbially driven inflammatory condition affecting the gums and supporting structures of the teeth. Clinically, periodontitis is characterized by inflamed gingiva, clinical attachment loss, bleeding on probing, deep periodontal pockets, and alveolar bone loss. The pathogenesis involves an intricate interaction between specific gram-negative anaerobic bacteria— particularly the “red complex” species (Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola)—and a compromised host immune response. The definitive method for nonsurgical periodontal therapy is scaling and root planing to remove supra- and subgingival calculus; however, advanced cases may require adjunctive systemic antibiotics. But due to the current global surge in antibiotic resistance, alternative non antibiotic therapies are under investigation.

Objectives: This study aims to explore novel, non-antibiotic therapeutic approaches for the management of periodontitis.

Materials and methods: A comprehensive literature search was conducted using keywords such as periodontitis, non-antibiotic, bacteriophages, phytotherapy, nanoparticles, and metallic salts across databases including PubMed, ScienceDirect, and Google Scholar.

Results: The reviewed literature indicates that phytotherapy, manuka honey, metallic salts, nanoparticles, bacteriophages, photodynamic therapy, probiotics, and vaccine-based strategies can significantly reduce inflammation, bacterial load, and gingival bleeding.

Conclusion: In the context of multidrug resistance, these novel therapies present promising potential for periodontal treatment.