Arestin, An Antibiotic Treatment for Gum Disease

By Catherine M. Fascilla, D.D.S.

If you have periodontal disease, your dentist will have likely recommended scaling and root planing (“deep cleanings”) to remove the plaque and tartar from the roots of the involved teeth. This procedure helps to reduce bacterial counts and results in decreased inflammation and decreased pocket depths. Arestin is an antibiotic that can be used to make scaling and root planning more effective.

Arestin contains microspheres- tiny particles, that are smaller than a grain of sand and are not visible to the eye. The microspheres are filled with the antibiotic minocycline hydrochloride. They release the antibiotic over time, killing bacteria so that your gums can heal better than with scaling and root planing alone. This form of antibiotic is different than taking a pill because it is placed directly into the pocket where it is needed and it provides a much higher concentration of antibiotic to that site than a pill can deliver.

Arestin is contained in small cartridges that are placed in a special syringe -like device that allows the microspheres to be gently expressed below the gumline. It can be applied to the pocket after completing scaling and root planning or after routine maintenance visits. Once placed in the pocket, Arestin will dissolve on its own so that removal is not necessary.

Arestin should not be used in any patient who has known allergies to minocycline or tetracyclines. Arestin is an antibiotic in the tetracycline class. Tetracylclines have been known to cause permanent discoloration in developing teeth. Therefore, Arestin should not be used in children or in pregnant or nursing women.

The cost of Arestin varies from office to office and depends on the number of teeth and pockets involved. Each pocket greater than 5mm will require one dose and is considered one site. Each tooth can potentially have six sites that might require Arrestin. Most dental offices charge between $45 and $85 per site. So as you can see, the cost of Arestin can be considerable.

In my office, Arestin is applied at maintenance visits to pockets that persist after scaling and root planning has been performed. This greatly reduces the cost of treatment because there are fewer sites or deep pockets to treat. We also participate in a program called Arestin Rx Access which allows our patients with medical insurance coverage to have Arestin covered through their pharmacy plan. A prescription is submitted on the patient’s behalf. Their plan collects the copay and a supply of Arestin is shipped to our office for that patient’s next visit. We charge a small fee to administer the Arrestin. It is one fee per hygiene visit regardless of the number of sites involved.

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