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When Should Systemic Antibiotics Be Started During Periodontal Therapy?

When Should Systemic Antibiotics Be Started During Periodontal Therapy?

New Study: When Should You Start Systemic Antibiotics?

One of the questions I hear most often is:

“If I’m going to prescribe systemic antibiotics, when should I start them?”

A newly published study in the Journal of Periodontology looked at exactly that question by comparing patients who started systemic antibiotics during scaling and root planing with those who started after periodontal therapy was completed.

🎥 Watch my quick video below for the highlights.


Study Takeaway

This study found that patients who started systemic antibiotics during active periodontal therapy experienced a faster shift toward a healthier subgingival microbiome, although long-term clinical outcomes were similar between the two groups.


My Clinical Takeaway

I’ve always recommended collecting the bacterial sample first, reviewing the report, and—when systemic antibiotics are indicated—starting the recommended antibiotic during scaling and root planing. As we disrupt the biofilm, the antibiotics have a better opportunity to penetrate the tissues and target the bacteria identified on the report.

Remember, systemic antibiotics are not appropriate for every patient. Mechanical debridement remains the foundation of periodontal therapy, with bacterial testing helping identify the patients who may benefit most from adjunctive therapy.


Patients I Commonly Consider for Bacterial Testing

  • Advanced periodontal disease
  • Refractory periodontal cases
  • Persistent inflammation after therapy
  • Peri-implant disease
  • Patients with significant systemic risk factors

Questions?

I’d be happy to help you determine which patients may benefit from bacterial testing or review reports with you and your team.

📅 Schedule a complimentary Zoom


Reference

Fermiano D, et al. Does timing of systemic antibiotics influence periodontal treatment outcomes? Journal of Periodontology. 2026.

Shifting the Tide Perio Study Club Series

Shifting the Tide Perio Study Club Series

Where Science Meets Implementation

Join us for an engaging 4-hour CE course for dental teams designed to simplify periodontal care through practical, evidence-based protocols that can be implemented immediately.

Shifting the Tide combines the latest science on the oral microbiome with real-world clinical workflows to help practices improve patient outcomes, increase case acceptance, and create predictable periodontal protocols.

Whether you’re a dentist, hygienist, dental assistant, or office manager, you’ll leave with practical tools to strengthen your periodontal program and confidently integrate bacterial testing with Microbelink Dx®, PerioProtect® tray therapy, and oral-systemic health conversations into everyday practice.

https://shiftingthetidestudyclub.com/


What You’ll Learn

✔ Understanding the oral microbiome and periodontal pathogens

✔ How to use MicrobeLink Dx® bacterial testing to guide treatment

✔ Interpreting bacterial reports with confidence

✔ Integrating PerioProtect® tray therapy into clinical practice

✔ Oral-systemic health connections and why they matter

✔ Patient communication that improves case acceptance

✔ Simple periodontal workflows for predictable outcomes

✔ Practical implementation strategies your team can use immediately


Who Should Attend?

  • Dentists
  • Dental Hygienists
  • Dental Assistants
  • Office Managers
  • Entire Dental Teams

Event Details

📍 Cypress Point Country Club
5340 Club Head Road
Virginia Beach, VA 23455

📅 Friday, October 23, 2026

🕘 9:00 AM – 1:00 PM

🎓 4 CE Hours

🍽️ Lunch Included

💲 Course Fee: $125


Meet Your Speakers

Jennifer Seider, RDH

Founder of MicrobeLink Dx®, Jennifer has been a leader in DNA-PCR bacterial testing since 2005. She is passionate about helping dental teams simplify periodontal diagnosis and treatment through practical, science-based protocols that improve both patient outcomes and practice success.

Meghan Darr, RDH

Clinical Educator with PerioProtect®, Meghan helps dental teams successfully implement tray therapy through practical workflows, patient communication strategies, and simple systems that improve compliance and long-term periodontal health.


Reserve Your Seat

Space is limited to encourage interaction and discussion.

Register today and discover how combining science with implementation can transform your periodontal program.

Shifting the Tide flyer

Kathryn Gilliam at RDH Under One Roof 2026: The Future of Oral-Systemic Care

Kathryn Gilliam at RDH Under One Roof 2026: The Future of Oral-Systemic Care

Kathryn Gilliam to Present at RDH Under One Roof 2026

MicrobeLinkDx® is excited to share that Kathryn Gilliam, BA, RDH, MAAOSH, HIAOMT, CIABDM, will be presenting at RDH Under One Roof 2026, one of the nation’s premier continuing education events for dental hygienists.

Kathryn’s course,

From Routine to Revolutionary: The New Era of Healing in Hygiene

explores how today’s dental professionals can elevate patient care by combining evidence-based periodontal therapy, oral-systemic science, and precision diagnostics to improve clinical outcomes.


Why This Topic Matters

Research continues to strengthen the connection between periodontal pathogens and systemic health. Understanding the oral microbiome allows clinicians to identify bacterial risk factors earlier, personalize treatment planning, and have more meaningful conversations with patients about their overall health.

At MicrobeLinkDx®, we believe education and diagnostics work hand in hand to help practices deliver more predictable periodontal care.

Our paper point DNA-PCR bacterial testing helps clinicians identify key periodontal pathogens associated with:

  • Periodontal disease
  • Peri-implant disease
  • Cardiovascular disease
  • Diabetes
  • Adverse pregnancy outcomes
  • Alzheimer’s disease
  • Respiratory disease
  • Chronic inflammation

Continuing the Conversation

Kathryn’s presentation reflects the same mission we strive for every day—helping dental teams move beyond treating symptoms and toward identifying the underlying bacterial causes of disease.

If you’re attending RDH Under One Roof, be sure to add Kathryn’s presentation to your schedule.


Learn More from MicrobeLinkDx®

Interested in implementing bacterial testing in your practice?

👉 Request complimentary paper point sampling kits, schedule an online demo, or contact our team to learn more.

About RDH Under One Roof

RDH Under One Roof is one of the largest annual dental hygiene conferences in the United States, bringing together leading clinicians, educators, researchers, and industry partners for several days of continuing education and professional development.

Boots, Bugs & Biofilm Live Stream | October 2, 2026

Boots, Bugs & Biofilm Live Stream | October 2, 2026

Boots, Bugs & Biofilm Live Stream | October 2, 2026

6 AGD PACE-Approved CE Hours | Live Online Webinar

If you’ve ever walked out of a CE course genuinely inspired — and then walked into Monday morning not quite sure where to start — this one was built for you.

Boots, Bugs & Biofilm is a full-day live-stream continuing education course designed for dental hygienists, dentists, and dental teams who are ready to take modern periodontal therapy off the page and into practice. The whole idea behind the course is simple: Learn Friday. Change Monday.

Event Details

📅 Date: Friday, October 2, 2026
🕗 Time: 8:00 AM – 4:00 PM CT
💻 Format: Live Online Webinar
🎓 CE Credit: 6 Hours | AGD PACE Approved
💲 Investment: $395 per attendee
🎁 Includes: Exclusive BBB Swag Box shipped to you before the course

Register at www.bootsbugsandbiofilm.com

Flyer for the event

What You’ll Learn

This course isn’t a research recap. The entire day is built around practical application — the kind you can bring back to your team the next morning. Jennifer Seider, RDH, and Tosha Kozloski, RDH, will walk you through:

  • The oral-systemic connection — what the current research actually means for your chair-side conversations with patients
  • Bacterial testing in practice — how salivary and subgingival testing can sharpen your diagnosis, strengthen your treatment planning, and improve case acceptance
  • Understanding periodontal pathogens — and how they should be influencing your clinical decisions
  • Precision Periodontal Protocols — systems that create consistency across your hygiene department so everyone is working from the same evidence-based foundation
  • Verbal skills that work — communication strategies that help patients truly understand their periodontal diagnosis and say yes to treatment
  • Coding and documentation — the practical side of supporting comprehensive periodontal care in your records
  • A real implementation roadmap — so nothing gets lost after the course ends

Whether your practice is just getting started with precision periodontal therapy or you’re looking to tighten up what you already have in place, you’ll leave with systems you can actually use.

AGD PACE Approved | 6 Continuing Education Hours

This course has been approved for 6 CE credits through the Academy of General Dentistry’s Program Approval for Continuing Education (PACE). Approval does not imply endorsement by the AGD of any product, procedure, or technique.

Your BBB Swag Box Is Included

Every registered attendee receives an exclusive Boots, Bugs & Biofilm Swag Box delivered to their door before the course begins. Inside you’ll find:

  • Precision Periodontal Protocol Binder — your companion resource for the day and beyond
  • Custom BBB Yeti® Tumbler
  • Custom BBB Notebook

These are the tools you’ll use to follow along during the live event and continue building out your protocols long after the course wraps up.

Meet Your Instructors

Jennifer Seider, RDH and Tosha Kozloski, RDH are nationally recognized speakers, educators, and passionate advocates for advancing periodontal care through science-based, practical implementation. Together, they combine decades of clinical experience with real-world systems that help dental teams confidently integrate oral-systemic health, bacterial testing, precision periodontal protocols, and improved patient communication into everyday practice. Their goal is simple: help you learn it Friday and confidently implement it Monday.

Have questions about the course or about incorporating bacterial testing into your periodontal protocols? Text us at📱 615-587-2558 — we’re happy to help.

🔗 Oral-Systemic Health: A Medical Perspective

Featuring Dr. Trevor Eason, MD

The oral–systemic connection continues to gain attention across both dental and medical communities. In this educational discussion, Dr. Trevor Eason, MD, joins the conversation to explore how oral infection and inflammation influence whole-body health.

Early in the discussion, the link between periodontal disease and systemic conditions is clearly outlined — reinforcing that oral bacteria and inflammation do not remain confined to the mouth. Instead, they contribute to inflammatory pathways associated with cardiovascular disease, metabolic disorders, and other chronic conditions.

Later in the conversation, the importance of identifying oral pathogens is addressed. Understanding which bacteria are present allows clinicians to move beyond a one-size-fits-all approach and toward more personalized, precision-based care — a key principle in oral–systemic health.

This conversation reflects a growing interdisciplinary shift: dentistry and medicine working together to address inflammation, infection, and long-term health outcomes.

🎥 Watch the Full Discussion

🧬 Why Identifying Oral Pathogens Matters in Oral–Systemic Care

When periodontal disease is linked to systemic inflammation, the specific bacteria involved matter. Different pathogens carry different levels of inflammatory risk and systemic association.

Identifying the bacterial profile allows clinicians to:

  • Understand the systemic inflammatory burden more accurately

  • Personalize periodontal therapy based on risk

  • Monitor response to treatment over time

  • Support interdisciplinary conversations between dental and medical providers

In oral–systemic care, guessing is no longer enough. Precision begins with identifying the pathogens driving infection and inflammation.

Oral Bacteria as a Regulatory Hub: The Missing Link in Systemic Inflammation

Oral Bacteria as a Regulatory Hub: The Missing Link in Systemic Inflammation

For years, oral bacteria were viewed as a localized problem—limited to the gums and supporting structures.

But new research is shifting that perspective.

Emerging evidence suggests that periodontal pathogens may act as a “regulatory hub”, influencing inflammation and immune responses throughout the entire body.

🔬 What Is a Regulatory Hub?

A regulatory hub refers to a central point that can influence multiple biological systems at once.

In this context, oral bacteria are not just causing local infection—they may be:

  • Modulating immune responses
  • Amplifying systemic inflammation
  • Influencing disease processes far beyond the oral cavity

🦠 How Oral Bacteria Influence the Body

Periodontal pathogens can:

  • Enter the bloodstream through inflamed gum tissue
  • Release toxins and inflammatory mediators
  • Interact with immune cells and signaling pathways

This creates a ripple effect—impacting systems such as:

  • Cardiovascular health
  • Metabolic function
  • Neurological pathways

🔬 What the Research Shows

A recent study published in Oral Microbiology (2026) highlights the role of oral bacteria as a central regulator of systemic inflammation.

The study suggests that periodontal pathogens:

  • Influence inflammatory signaling pathways
  • Contribute to chronic inflammatory conditions
  • Act as a key link between oral and systemic disease

👉 Read the study:
https://www.tandfonline.com/doi/full/10.1080/20002297.2026.2635233

💡 Why This Matters

This changes how we think about periodontal disease.

It’s no longer just about managing plaque or reducing pocket depths—it’s about understanding how oral bacteria may influence overall health.

When inflammation is driven by infection, identifying the source becomes critical.

🧪 Why Identifying the Bacteria Matters

Not all bacteria behave the same way.

Some act as key drivers of inflammation—while others contribute to disease progression or persistence.

MicrobeLink Dx identifies 11 key periodontal pathogens using qPCR technology from the base of the pocket—where harmful anaerobic bacteria thrive.

This provides clinicians with actionable data to better understand infection and guide treatment decisions.

🔚 Conclusion:

The concept of oral bacteria as a regulatory hub reinforces what research continues to show:

The mouth is not separate from the body.

Understanding the role of bacteria in systemic inflammation is a critical step toward more precise, informed patient care.

📚 Reference: