• Home
  • Joint Replacements and Dental Procedures – Wellesley, MA

Joint Replacements and Dental Procedures – Wellesley, MA


Patients with prosthetic joints frequently ask me if they need to premedicate before dental cleanings and procedures. In the past, I have deferred to contacting the patients’ surgeons and found that some surgeons recommended premedicating for life, some said only for the first two years, and others said no pre-medication at all. In 2014, the American Dental Association (ADA) Council on Scientific Affairs (CSA) assembled an expert panel to update and clarify the clinical recommendations found in a 2012 joint ADA and American Academy of Orthopaedic Surgeons (AAOS) evidence report and guideline.4, 5 In accord with the 2012 ADA/AAOS evidence report, the updated ADA systematic review (published in the January 2015 issue of The Journal of the American Dental Association) found no statistically significant association between dental procedures and prosthetic joint infections (PJI). On the basis of the review of the evidence, the 2015 ADA Clinical Practice Guideline stated, “In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.”5

The ADA panel found no association between dental procedures and PJIs and no scientifically based efficacy for using antibiotics to prevent PJIs.5 The panel did acknowledge that there may be special circumstances in which a clinician may consider antibiotic prophylaxis despite the lack of scientific evidence. However, the guidelines did not list any special circumstances.

Some of the “Take home messages” from the guidelines are the following:

There is no evidence to support an association between dental procedures and risk of experiencing PJIs

Discussion of available treatment options applicable to each patient relies on communication between the patient, dentist, and orthopedic surgeon, weighing the potential risks and benefits for that patient

Discussion of available treatment options applicable to each patient relies on communication between the patient, dentist, and orthopedic surgeon, weighing the potential risks and benefits for that patient

If you have a prosthetic joint replacement, talk to your dentist about managing your dental care. Discuss if you are immunosuppressed or immunocompromised, glycemic control (diabetic), history of prosthetic joint infection, and time since last surgery. These will help identify if you need premedication for dental procedures.

For more information, contact Newton Wellesley Dental Partners.

Source: jada.ada.org


Tags: , ,

Leave a comment

NEWTON WELLESLEYOrthopedic Associates iconDENTAL PARTNERS
    • Location

      Newton Office:
      447 Centre Street
      Newton, MA - 02458
      Tel : (617) 965-1225

      Wellesley Office:
      332 Washington Street - Suite 240
      Wellesley, MA 02481
      Tel. 781.235.6300

      info@newtonwellesleydentalpartners.org

      Follow us

    • Contact us