Drug of choice to treat juvenile periodontitis is:

• A. Tetracycline
• B. Pen VK
• C. Amoxicillin
• D. Metronidazole

Answer: (A)

Treating juvenile periodontitis hinges on targeting the bacteria most closely linked to the condition and delivering the drug where the infection resides. Tetracycline is preferred because it has strong activity against Aggregatibacter actinomycetemcomitans, a key pathogen in juvenile periodontitis, and it concentrates in gingival crevicular fluid and bone, providing high drug levels at the site of infection. It also inhibits host tissue enzymes (collagenases) that drive connective tissue destruction, helping to limit attachment loss. Penicillin V and amoxicillin are less active against Aa, and metronidazole targets anaerobes but may not adequately address the primary pathogen on its own. Therefore, tetracycline offers the most comprehensive antimicrobial effect for this condition. Note: in children, tetracyclines can affect developing teeth, so use is considered carefully and typically for specific indications.