Your Oral Health, Pre-Medications, and Joint Replacements

If you have been in our office on Brook Street in Darien, CT for an oral health check-up, you know that we will ask you, "Have there been any changes in your medical history since your last visit? Have you had any surgeries?" Our patients are usually quick to say, "No, everything is the same as last time". Most people do not think there is a significant connection between their oral health and the rest of their body; when in actuality there is and an important one at that!

It is important that you let us know if you are planning on having a joint replacement, so that we can see you before that surgery. We can make sure all your dental needs are met and review what protocol, if any, we will need to follow for you after the surgery. We are here to work with your physicians and surgeons to do what is best for your overall health!

The following information is from the Yale Medicine Orthopaedic & Rehabilitation Program and is based on the latest recommendations from the American Academy of Orthopaedic Surgeons and the American Dental Association:

You should know that in the past, patients who had full-joint replacement surgery were routinely told that they either needed antibiotics prior to a dental appointment for the first two years after surgery, or possibly for their lifetime. This was due to the possibility of infection of a total joint replacement from the bacteria in their mouth that could enter their bloodstream during or after a dental procedure. Recently, studies have shown the association between dental procedures and prosthetic joint infections to be rare, but when they do occur, these infections can be very serious. That is why there are different guidelines for different cases.

For all patients, it is strongly recommended that before your surgery you should have a dental check-up and exam, and complete any required dental work. Patients should maintain a good daily oral hygiene practice, to avoid dental infections. Most surgeons will require the patient to have no dental treatment for a minimum of 3 months and up to 6 months after their surgery.

The requirement of taking an antibiotic prior to a dental appointment after that waiting period is based on a case by case basis. For procedures that are routine and low risk, and if you are an otherwise healthy individual you may not need to premedicate. If you are a "high risk" patient, which would be determined by your surgeon, and if you are having an invasive dental procedure like and extraction or root canal, you most likely will have to premedicate prior to that dental appointment.

The premedication, if needed, is one dose taken one hour prior to the appointment. The usual prescription is Amoxicillin, however, if you are allergic to Penicillin, then the drug of choice is Clindamycin.

So now you know just how important your oral health is important and can have a huge impact on your entire body. But luckily, we are here to help you stay happy and healthy! Visit our website or visit us in person to learn more.