https://ahc.aurorahealthcare.org/fywb/x34713.pdfA
lways remember that bacteria in your bloodstream can get into your artificial joint and cause an infection. To help keep that from happening: • Do not have any dental work done for 6 to 8 weeks before your surgery. • Do not have any dental work until 6 weeks after your surgery. • Any infection in your teeth, sinuses, throat, bladder, or any place else, must be treated. • You may need antibiotics before dental work, endoscopy procedures, or other surgical procedure that may put you at risk for infection. • Tell your family doctor or any other doctor who takes care of you, including your dentist, that you have a joint replacement. This is something you should do for the rest of your life.
The following are general recommendations from the American Dental Association and the American Academy of Orthopedic Surgeons. Your dentist and your orthopedic surgeons, working together, will recommend the right treatment for you. When do you need preventive antibiotics? Because you have an artificial joint, your risk of getting a blood-borne infection is higher than normal. It is best to take preventions if the dental procedure involves high levels of bacteria. You should take preventive antibiotics before dental procedures if you: • Have an inflammatory type of arthritis such as rheumatoid arthritis or systemic lupus erythemotosis • Have a weakened immune system from disease, drugs or radiation • Use insulin to treat diabetes • Had a joint replacement less than two years ago • Have had infections in your artificial joint • Are undernourished or malnourished • Have hemophilia
What procedures require preventive antibiotics? You should take preventive antibiotics for: • Dental extractions (pulling teeth) • Periodontal (gum disease) procedures • Dental implant placement and reimplantation of teeth that were knocked out • Endodontic (root canal) procedure 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 expected.
https://www.brigliadentalgroup.com/blog/oral-hygiene/dental-clearance-before-knee-hip-surgery/Getting hip or knee surgery generally doesn’t make you think about your dental health, but before you can get your surgery, you’ll need to get a dental clearance. Why? Because bacteria in the mouth can spread through the bloodstream. When it does, one of the places it settles is the joints. That can mean joint infections, especially when surgery has taken place and the joint area may be vulnerable to bacteria and other organisms that can allow an infection to develop.
While there is always bacteria in the mouth, determining how much and what kind with an oral health exam may be necessary. In other cases, a simple dental checkup to ensure good oral health can be enough. Here’s what you need to know about dental clearances, dental health, and joint surgery.
Joint Replacement Surgery Includes Revision Surgery
If you have had a joint replaced and it now needs a revision, that still counts as the type of joint surgery that needs a dental clearance. In fact, it’s possible that an infection from poor dental health was what caused the joint to fail and make the revision necessary. Of course that’s not true in every case, but it can certainly be possible in some of the seven percent of joint surgeries every year that are revisions. That may seem like a low percentage, but there are over one million joint replacement surgeries in the United States every year. Seven percent of those add up to a lot of surgeries, and some of those are from infection problems with the first surgery performed.
Revisions are stressful enough without the risk of getting sick from them. That risk can never be completely eliminated simply because bacteria exists in the body and there is no way to remove all of it. Some bacteria is actually beneficial, as well, so killing off all the bacteria wouldn’t be a good choice anyway. However, there are ways to reduce the chances of getting sick from an infection after a joint replacement revision surgery, and one of the biggest ways to lower your risk is to be sure your oral and dental health is as good as it can possibly be. With good dental health, you greatly reduce the chances of any periodontal bacteria traveling from the mouth throughout the bloodstream. If it’s not in the bloodstream, it won’t settle at the joint surgery site.
Good Dental Health Can Mean Better Overall Health
The bacteria that is found in the mouth can lead to high blood pressure, strokes, heart attacks, and other problems if it is left unchecked or allowed to become a problem. That’s why we always recommend that everyone brush, floss, and see their dentist regularly for checkups. That way your mouth will stay clean and healthy, and if a problem does develop it will be caught and treated faster. That’s good news for anyone with oral health issues, because prompt treatment can mean a reduction in loss of teeth, bad breath, pain, and other issues. It can also mean that a much needed joint surgery or revision can be completed, because dental bacteria is minimal and not spreading through the bloodstream to other parts of the body.
When you have good dental health, you have the opportunity to improve your overall health more easily, which can include surgery to replace a damaged hip or knee. People with better overall health also recover faster from these kinds of procedures and have a lower chance of needing revision surgery. That can mean not only a faster recovery but a less painful and difficult one. With that in mind, people who have good dental and overall health will generally be better candidates for joint surgery, because they have fewer underlying conditions which could cause complications if they have a joint replacement procedure or a revision surgery performed.
Periodontal Disease is a Prevalent Issue
Nearly seventy-five percent of adults in the United States today have some form and degree of periodontal disease. Because of that, they can be putting themselves at risk. That is true for their overall health, but also true if they need joint surgery at any point in time. Rather than take the risk or add in a stronger or longer course of antibiotics during and after the surgery in an attempt to combat the issue, it is generally a better choice to focus on correcting the problem itself. The way to do that is through good oral health habits, being consistent, and following the recommendations of your trusted oral health provider. We encourage all of our patients to see us anytime they need to, and to ask plenty of questions so they can care for their teeth and gums as well as possible.
Many people who have the beginnings of periodontal disease don’t realize it, and they only find out when they go to the dentist for another problem, or they come see us in order to get a dental clearance so they can have joint replacement surgery of their hip or knee. Before the problem gets out of hand, we want to see people come in and get a full checkup. It’s much easier to prevent something or treat it at its very earliest stages than it is to treat it after it has become a significant problem or gotten severe. Tooth loss can occur, and the spread of bacteria throughout the body can endanger other organs and tissues, too.
Antibiotics Are Important After a Joint Replacement Surgery
When you have joint replacement surgery you’ll need to take antibiotics, but you’ll also need to be aware that you might be asked to take antibiotics for future dental procedures, too. That’s because a joint replacement will always be a vulnerable spot, and if your dental health is questionable you could end up at risk even after your joint procedure has been done and has healed up. Anytime there is an infection anywhere in the body it can compromise the immune system, too, and that can lead to further problems. So you want to make sure you’re doing what your doctors recommend. We see many patients who need antibiotics when they have dental procedures, and it protects not only their oral health but their overall health and the joint they have had replaced.
Before going in for joint replacement surgery, having a dental health clearance can really make a difference in the outcome of the procedure. It will protect your new joint and the incision area, along with lowering your risk of other types of problems throughout the body. If there are issues with your oral health you can get them treated and improved before you have your joint replacement surgery, so your risk of complications will be lower. That can give you not only better health and an easier recovery, but it can also provide you with a higher level of peace of mind before, during, and after your hip or knee joint replacement procedure or surgery.
