A new horizon for the dental hygienist: controlled local delivery of antimicrobials.

All drugs and controlled local delivery systems must be approved by the Food and Drug Administration (FDA) prior to being marketed and used in clinical practice. These systems can only be used in the clinical office setting by the dentist or under his/her supervision. One controlled local antimicrobial delivery system, tetracycline fiber, has been on the market for several years. A second system, chlorhexidine chip, was approved by the FDA in May 1998, and a third system, doxycycline polymer, was approved in September 1998. Local delivery of antimicrobials will significantly change the way periodontitis is treated. Dental hygienists may be key therapists in providing this therapy. This article discusses the science and techniques of the three systems: tetracycline fiber, doxycycline polymer, and chlorhexidine chip. The dental hygienist's role in providing local delivery treatment is stressed. Factors important in selecting the most suitable delivery system are also discussed. This article represents a large portion of the presentation, "The Local Delivery of Antimicrobials in the Treatment of Periodontitis," made at the annual session of the American Dental Hygienists' Association (ADHA) June 27 and 28, 1998.