Special Instructions Following Joint Replacement Surgery

Dental Work After A Joint Replacement

Everyone knows that good dental health is important.  But, for people with artificial joints, a visit to the dentist can be especially significant.  The bacteria that cause infections in the teeth or gums can easily travel through the bloodstream and settle in the artificial joint. Because of this, preventative antibiotics are suggested for certain dental procedures for patients with artificial joints.

You won't need to get preventative antibiotics for most dental procedures.  But, because you have an artificial joint, your risk of contracting a blood-borne infection is higher than normal.  The following recommendations are from the American Academy of Orthopaedic Surgeons, who worked with the American Dental Association to develop them.

You should get preventative antibiotics before dental procedures if:

  • You have an inflammatory type of arthritis such as rheumatoid arthritis or systemic lupus erythematosis
  • Your immune system has been weakened by disease, drugs, or radiation
  • You have insulin-dependent (Type I) diabetes
  • You had a joint replacement less than two years ago
  • You've had previous infections in your artificial joint
  • You have hemophilia

You should get preventative antibiotics for the following dental procedures:

  • Dental extractions
  • Periodontal (gum disease) procedures
  • Dental implant placement and reimplantation of teeth that were knocked out
  • Endodontic (root canal) instrumentation or surgery
  • Initial placement of orthodontic bands (not brackets)
  • Injection of a local anesthetic into the gums near the jaw
  • Regular cleaning of teeth or implants where bleeding is anticipated

The following preventative antibiotics are suggested:

  • If you can take oral medications and are not allergic to penicillin, 2 grams of Amoxicillin, Cephalexin, or Cephradine should be taken one hour before the procedure.
  • If you cannot take oral medications and are not allergic to penicillin, 2 grams of Ampicillin or 1 gram of Cefazolin should be administered by injection one hour before the procedure.
  • If you are allergic to penicillin, 600 milligrams of Clindamycin should be taken orally or administered by injection one hour before the procedure.

 

All medical care should be individualized to a patient’s functional level, medical condition, and personal choice.