There are multiple agents that have antimicrobial activity. Generally speaking, these agents fall into two categories…..disinfectants or antibiotics.
Disinfectants kill everything in sight (friendly as well as pathogenic bacteria). Examples of disinfectants are Lysol®, chlorhexidine, Clorox®, hydrogen peroxide etc. Disinfectants are NOT what we want as the active ingredient in a LAA. There are 100 trillion cells in the human body and 90% of those cells are bacterial. Friendly bacteria perform very important functions (make clotting factors, digest food, control pathogenic organisms etc) and are necessary for life. The last thing we want to do is across the board wipe out all bacteria. Disinfectants do have a role in other areas of dentistry such as pre surgical rinse, hand washing and cleaning countertops etc. Click here to read a publication by Dr. Britt investigating the use of chlorhexidine as a chemotherapeutic agent in the management of periodontal disease. This paper was published before chlorhexidine was approved for use in the United States but was available for use in Canada and Europe. Chlorhexidine is the active ingredient in PerioChip®, Peridex® and Periogard®. Hydrogen peroxide is the active ingredient in Perio Protect®.
Antibiotics are subcategorized into broad spectrum and narrow spectrum. For a LAA, we want a narrow spectrum antibiotic (antimicrobial specificity) that targets the pathogenic gram negative anaerobes associated with periodontal disease. For any of you ladies reading this narrative, you know what happens when you take a broad spectrum antibiotic and upset the delicate microbial balance between friendly and pathogenic bacteria.
As a result of multiple studies, many scientists agree that the antibiotics of choice for a LAA are in the tetracycline family (tetracycline hcl, doxycycline, minocycline). Actisite® uses tetracycline hcl, Arestin® uses minocycline, Atridox® uses doxycycline, Periostat® uses doxycycline/systemic application and P3 uses doxycycline/local application.
P3 Dental Technologies then takes the native active ingredient doxycycline and subjects it to multiple proprietary pharmacological enhancements to make it an ideal formulation for LAA dental application.