December 2016: New recommendations are out regarding prescribing antibiotics before routine dental care appointments for patients with joint replacements!
For a number of years there as been a discrepancy between what the dental community recommends for patients with joint replacements and the orthopedic community. But finally a consensus has been reached and it was concluded that antibiotics are no longer required for dental procedures.
Historically, it was recommended to take a dose of antibiotics 1 hour prior to dental procedures for 2 years after the joint replacement surgery. The recommendation was later changed to take these prophylactic antibiotics for the patient’s entire lifetime. The thought was that this would reduce the risk of oral bacteria getting into the blood stream and infecting the artificial joint.
However, there had never been evidence that it was in fact oral bacteria causing infections in artificial joints. New research has revealed that the most prosthetic joint infections are from bacteria that live on the skin and not the mouth.
In recent years there has been a big push to decrease the prescription of antibiotics. The misuse of antibiotics has been leading to bacterial strains that are resistant to medications thus creating ‘super bugs’.
The Canadian Dental Association released a consensus statement June 2016 stating:
- Patients should not be exposed to the adverse effects of antibiotics without sufficient evidence supporting the practice and
- Routine antibiotic use is not indicated for patients with joint replacements nor for patients with orthopedic pins, plates and screws. (https://www.cda-adc.ca/en/about/position_statements/jointreplacement/)
At Calgary Fine Dentistry we treat each patient with a joint replacement as case by case in conjunction with his or her orthopedic surgeon in order to ensure safe delivery of care.