The main goal of periodontology is to prevent and arrest gingivitis and periodontitis to avoid tooth loss and focal infection of periodontal origin. Periodontal scaling or flap surgery of moderate-to-severe periodontitis have shortcomings, most likely because removal of herpesviruses and bacterial pathogens in deep periodontal lesions and the adjacent inflamed gingiva requires systemic antimicrobial treatment (or gingivectomy). Valacyclovir (1000 mg twice daily on day 1, and 500 mg twice daily on day 2 and on day 3) is a potent anti-herpesvirus agent. Antibiotic combinations against bacterial pathogens include amoxicillin-metronidazole (250 mg of each, thrice daily for 4 days; for systemically healthy adults) and ciprofloxacin-metronidazole (500 mg of each, twice daily for 4 days; for immunosuppressed individuals and patients exposed to contaminated water and poor sanitation). Supportive antiseptic treatment may consist of 0.1%-0.2% sodium hypochlorite (regular household bleach) as cooling spray in ultrasonic scalers, flosser fluid in oral irrigators, and mouthrinse in patient self-care. The anti-infective treatment described here helps control cases of severe periodontitis and constitutes an exceedingly inexpensive alternative to conventional (mechanical) periodontal therapy.

中文翻译：

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重度牙周炎的简明评估和治疗指南：公共卫生视角

牙周病学的主要目标是预防和遏制牙龈炎和牙周炎，以避免牙齿脱落和牙周起源的局灶性感染。中重度牙周炎的牙周刮治或翻瓣手术有缺点，很可能是因为去除深部牙周病灶和邻近发炎牙龈中的疱疹病毒和细菌病原体需要全身抗菌治疗（或牙龈切除术）。伐昔洛韦（第 1 天每天两次 1000 毫克，第 2 天和第 3 天每天两次 500 毫克）是一种有效的抗疱疹病毒药物。针对细菌性病原体的抗生素组合包括阿莫西林-甲硝唑（每种 250 毫克，每天三次，连续 4 天；对于全身健康的成年人）和环丙沙星-甲硝唑（每种 500 毫克，每天两次，连续 4 天；对于免疫抑制的个人和暴露于受污染的水和恶劣卫生条件的患者）。支持性杀菌处理可能包括 0.1%-0.2% 次氯酸钠（常规家用漂白剂）作为超声波洁牙机的冷却喷雾、口腔冲洗器的牙线液和患者自我护理中的漱口水。这里描述的抗感染治疗有助于控制严重牙周炎的病例，并且是一种非常便宜的替代传统（机械）牙周治疗的方法。