Locally Delivered Antibiotics

Local delivery antimicrobials and host modulators


Damage from periodontal diseases is caused by bacteria and your body’s response to these bacteria.  New products are available that may be recommended as part of your periodontal therapy to help your body eliminate the infection or decrease its negative effects.  These drugs are called either local delivery antimicrobials or host modulators.  In general, these medications do not lead to antibiotic resistance.


Local delivery antimicrobials are medications that are delivered directly into periodontal pockets to suppress or eradicate periodontal bacteria.  Local delivery antimicrobials may contain an antibiotic agent such as tetracycline, minocycline or metronidazole that’s released into the pocket over time.  They can be delivered directly to the pocket through several means, including a:

  • Gel or powder that is applied with special syringes and absorbed over time
  • Tiny “chip” that’s pushed into the pocket and absorbed over time

Host modulators are drugs that are taken orally for a period of time to offset the body’s response to periodontal bacteria.  They can be anti-inflammatory medications, such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), or what’s called a sub-antimicrobial class of antibiotics, which means that the dose of antibiotics contained within the drug does not contain a high enough concentration to fight the bacteria; rather, it may work by helping the body’s response to the bacteria.

1999 American Academy of Periodontology