Do I Need Dental Antibiotics After a Joint Replacement?

Recent Joint Decision announced by the ADA and AAOS

Improvements in surgical techniques and the quality of artificial joints have many patients considering hip, knee and other forms of joint implants. Since these procedures are serious surgical endeavors, they come with a risk of infection, both before and after the operation. Physicians recognize that the mouth harbors many types of potentially dangerous bacteria and that the presence of gum disease may indicate that a patient should fix their dental problems before undergoing joint replacement surgery. Dentists, such as those working with the Placerville Dentistry Group, are best qualified to rate the severity of any oral infections and are readily positioned to inform a surgeon about the state of a patient’s mouth.

Commenting on this situation, Dr. John Reitz noted that the American Dental Association (ADA) “suggests that dentists and orthopedic surgeons work together to minimize risks associated with prosthetic joint infections.” In recognition of the need for teamwork, the ADA and the American Academy of Orthopaedic Surgeons recently highlighted a joint document produced in Pennsylvania by Dr. Reitz and a cohort of dentists and physicians working together. This collaborative statement basically makes the following important points:

• Patients should be seen by their dentist no less than twelve weeks before their procedure to confirm the absence of serious oral infection. Areas of inflammatory gum disease should be treated before any joint replacement procedure is scheduled.
• Patients should use antibiotics for up to two years when visiting the dentist for invasive procedures (not including ordinary dental cleanings), and longer if the patient has a weakened immune system.
• Dentists are responsible for advising the physician of the patient’s state of oral health, but the surgeon takes responsibility for whether or not to proceed with a joint replacement, after considering the dentist’s findings.

What Does It Mean For Me?

If you are considering a joint replacement procedure in the near future, maintaining your oral hygiene routine and visiting the Placerville Dental Group twice a year is essential. By limiting the oral bacteria found in gum disease, you increase the chance of having a successful surgery and you decrease the likelihood of post-operative infections. If such a surgery is in your plans, please inform one of our Placerville dentists right away, and we will do our best to keep you ready for the procedure.