Some people were told to premedicate with antibiotics before dental visits for two years after their joint surgery. Others were told they must do it for the rest of their lives. If dental work leads to infected prosthetic joints, then it would surely be wise to take antibiotics before dental visits.
Full Answer
Are antibiotics necessary before dental procedures for prosthetic joint implants?
In patients with prosthetic joint implants, a January 2015 ADA clinical practice guideline, based on a 2014 systematic review states, “In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.”
When do surgeons recommend antibiotic prophylaxis after joint replacement?
Recent graduates (n = 61 of 68, 87.1%) with 0-5 years in practice were more likely to recommend antibiotic prophylaxis than surgeons >20 years of experience (n = 44 of 64, 64.7%). Surgeons generally recommend patients wait 3 to 6 months after joint replacement before seeking dental treatment and that antibiotic prophylaxis is required at this time.
Do we need antimicrobial prophylaxis for artificial joint injuries?
On the basis of an epidemiological model, several thousand patients with artificial joints must receive antimicrobial prophylaxis to prevent a single PJI. Considering this ratio, the number of adverse events due to the antimicrobial compound exceeds the benefit of administering it by a large magnitude.
What are the recommendations for dental treatment following joint arthroplasty?
Recommendation prior to dental procedure 1. Time interval between joint arthroplasty and the dental procedure ≤ 3 months after implantation Delay dental procedure (if possible) to >3 months after implantation Dental procedure cannot be delayed Time interval is the only risk factor Mouth rinse with 0.2% chlorhexidine
What medical conditions require antibiotics before dental work?
Today, the AHA only recommends antibiotics before dental procedures for patients with the highest risk of infection, those who have:A prosthetic heart valve or who have had a heart valve repaired with prosthetic material.A history of endocarditis.A heart transplant with abnormal heart valve function.More items...
How long after hip replacement do you need antibiotics for dental work?
Surgeons generally recommend patients wait 3 to 6 months after joint replacement before seeking dental treatment and that antibiotic prophylaxis is required at this time.
Do patients with knee replacement need antibiotics for dental work?
Prosthetic joint infection (PJI) of total hip (THA) or total knee arthroplasty (TKA) after dental procedures is uncommon, and antibiotic prophylaxis remains controversial. For high-risk patients, the American Academy of Orthopedic Surgeons recommends amoxicillin prophylaxis.
Should antibiotic prophylaxis be given to a patient with a prosthetic joint before dental procedures?
In patients with prosthetic joint implants, a January 2015 ADA clinical practice guideline, based on a 2014 systematic review states, “In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.”
What are the current recommendations regarding antibiotic prophylaxis and artificial joints?
In patients with artificial joints, treatment of infections is recommended with systemic antibiotics (amoxicillin/clavulanate 1 g or - in patients with known allergy to penicillin - clindamycin 600 mg three times per day for 3 to 5 days; then evaluation of the disease course and decision to stop or continue treatment).
Does hip replacement need antibiotic prophylaxis?
The safety committee of the American Academy of Orthopedic Surgeons (AAOS) recommended in 2009 that clinicians should consider antibiotic prophylaxis for all patients with total joint replacement before any invasive procedure that may cause bacteremia.
Who needs premedication before dental work?
Any medical condition that predisposes patients to a bacteria-induced infection should be considered a candidate for premedication, reports the American Dental Association. The dental practitioner or their healthcare provider determines if the patient requires this therapy if they are at risk for infection.
What procedures require antibiotics after knee replacement?
You may need an antibioticProcedureAntibioticDoseHead and neckClindamycin Gentamicin Cefazonlin600-900 mg IV 1.5 mg/kg IV 1 to 2 grams IVObstetricsCefoxtin, Cefazolin Ampicillin/Sulbactam1 to 2 grams IV 3 grams IVGenitourinaryCiprofloxacin500 mg by mouth or 400 mg IV5 more rows
How long after TKR can you have dental work?
It is important to keep good dental hygiene before and following knee replacement surgeryknee replacement surgery. Most surgeons recommend avoiding invasive dental procedure for 8-12 weeks following knee replacement. This reduces the chance of blood borne bacteria making their way to your new prosthetic knee.
What dental procedures require antibiotic prophylaxis?
Antibiotic prophylaxis (or premedication) is simply the taking of antibiotics before some dental procedures such as teeth cleaning, tooth extractions, root canals, and deep cleaning between the tooth root and gums to prevent infection.
When should prophylactic antibiotics be given?
Prophylactic antibiotic administration should be initiated within one hour before the surgical incision, or within two hours if the patient is receiving vancomycin or fluoroquinolones. The goal of antibiotic prophylaxis is to ensure effective serum and tissue levels of the drug for the duration of the surgery.
Why do I need to take antibiotics before dental work?
Antibiotics often are prescribed before dental visits to prevent infection, but 80% are unnecessary. Antibiotics can save lives when truly needed, but should be prescribed only when necessary because misuse can cause serious side effects and lead to antibiotic resistance.
What are the factors that contribute to the risk of prosthetic joint infection?
Factors associated with a higher risk of prosthetic joint infection include prior joint surgery, failure to give antimicrobial prophylaxis during surgery, immunosuppression, perioperative wound complications, a high American Society of Anesthesiologists (ASA) score, prolonged operative time, and a history of prosthetic joint infection. 6,7
What are the predisposing factors for prosthetics?
The primary predisposing factors are related to the foreign body itself and to the opportunities for and the degree of exposure of the prosthesis to microorganisms during surgery . Bacteremia, especially with Staphylococcus aureus, has been recognized as a risk factor for hematogenous prosthetic joint infection. 6
Can prosthetic joints be treated with antibiotics?
Despite the lack of evidence suggesting an association between prosthetic joint infection and dental procedure, surveys of orthopedists, dentists, infectious disease specialists, and other health care professionals show that a significant number of them recommend antimicrobial prophylaxis for patients with a prosthetic joint prior to a dental procedure. 1