Call for an Appointment Today
(518) 861-5136

Your partners on the road to education,
prevention, and dental health

Antibiotics and Artificial Joints

May 16th, 2013

It seems that we are seeing more people with joint replacements.  Prosthetic hips, knees, and shoulders have become quite commonplace today in all age groups.  As we are living longer generally, it seems that replacing body parts will become more routine.
One of the risks of joint replacements has to do with infection of the new joints after they are placed.  Bacteria in the blood stream can find their way to the joint and begin to grow.  This can compromise the attachment of the implant to the bone and surrounding tissue and can eventually cause the implant to fail.  How do the bacteria get there?  Any break in the skin can allow bacteria in.  In the mouth, any procedure that causes bleeding of the gums may also allow bacteria to enter the blood stream (called “Bacteremia”).  This can be worsened with gum disease present.  So any dental procedure, fillings, cleanings, or any work around the gum line can cause this short term bacteremia.
The simple solution is to have some antibiotic already in the bloodstream when the bacteria enter.  The protocol has changed dramatically from long ago.  Now just a single dose of medication one hour before the appointment is all that is needed for protection.  This is a pretty simple regimen and is very effective.  Some patients question how long this is required.  The answer depends on your individual circumstances and your orthopedic surgeon.  While current evidence suggests that the antibiotic may not be necessary after 2 years, the facts are not conclusive.  Many doctors want their patients to continue on after the 2 years, and some even suggest the protocol for life.
Talk to your dental team and your orthopedist for their recommendations.
There is some question as to how necessary pre-medicating for dental visits might be.  After all, there is some degree of bacteremia after just brushing your teeth every day.  But for now, the best evidence shows us that you need to medicate for routine dental appointments, but not for everyday exposures.

Copyright © ICOM 2010. All rights reserved.
This page is created by ICOM
Please report problems to webmaster.