Fact Sheet for Patients with Prosthetic Joints

Dr. Paumier has recommended that you should NOT take antibiotics to prevent a prosthetic joint infection before having dental work done.  This is a change from previous recommendations that have been used for the last 12 years.  You may hear conflicting recommendations from your orthopedic surgeon.  We are confident there is no additional risk of infection of your joint by not taking antibiotics before dental work. There are significant potential risks associated with taking antibiotics.  We are committed to providing you the best oral health care to enhance your general health using the latest scientific research to guide our decisions.  If you prefer to continue taking antibiotics prior to dental work, please contact your orthopedic surgeon to prescribe them in advance of your treatment.

Current Guideline, January 2015, Journal of the American Dental Association
(Authors:  Thomas Sollecito, DMD; Elliot Abt, DDS; Peter Lockhart, DDS; Edmond Truelove, DDS; Thomas Paumier, DDS)

In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.

EVIDENCE TO SUPPORT CURRENT GUIDELINE

• Dental procedures are not associated with prosthetic joint infections
• Antibiotics taken before dental procedures do not prevent prosthetic joint infections
• The vast majority of prosthetic joint infections are caused by Staph; bacteria commonly found on the skin
• The bacteria of the mouth are mostly Strep with very few strains of Staph
• Similar amounts of bacteria enter the bloodstream from normal daily activities such as brushing teeth and chewing food as from dental procedures such as cleaning and extraction
• Overuse of antibiotics are associated with resistant strains of bacteria making antibiotics less effective to fight life threatening infections
• Antibiotic use is associated with serious infections of the bowel known as C. diff infections causing an estimated 500,000 infections and 29,000 deaths yearly
• There are no clinically relevant medical conditions which might increase your risk for prosthetic joint infection when having dental work done