Monitoring the periodontal microbiota as an adjunct to periodontal therapy: rationale, interpretation of test results and application to patient management.

Recent developments in our understanding of the relationship of the oral microbiota to periodontal diseases have led to improved approaches to controlling the pathogenic influence of certain bacterial species. In addition to non-specific control of bacterial accumulations in the sulcus region, antibiotics may be useful in suppressing persistent species with pathogenic potential. This approach is indicated in cases that do not respond adequately to mechanical plaque control measures or certain categories of periodontal diseases likely to be caused by a specific infection. Monitoring the composition of the microbiota before, during and after antimicrobial therapy is helpful in the selection of appropriate antimicrobial agents, monitoring the effectiveness of the therapy and detecting the return of undesirable microorganisms.