(RxWiki News) There is a history of prescribing antibiotics to patients with hip and knee implants before they have any dental work done. There are concerns that this could help reduce the risk of bacteria entering the blood stream and affecting the implants.
The American Dental Association and the American Academy of Orthopaedic Surgeons (AAOS) worked together to develop guidelines. They wanted to examine if artificial joint patients needed antibiotics before dental work.
Antibiotics should only be prescribed when truly needed. The guideline's goal is to give healthcare practitioners enough information to make that decision.
"Talk with both your dentist and doctor about your health concerns."
The workgroup did an extensive review of the literature. The review found no evidence that dental procedures cause orthopedic (hip and knee prosthetic) implant infections. The review also led to the development of a guideline that includes three recommendations.
The strength of the recommendations were also measured. The amount of evidence led to strength level. Levels included strong, moderate, limited, inconclusive and consensus.
Overall, the guidelines suggest that treatment considerations should always take into account the individual patient. It should also include communicating with all healthcare practitioners involved.
The first recommendation is considered "limited" and proposes to stop prescribing prophylactic antibiotics prior to having a dental procedure. There was not enough evidence to suggest this prevented infections. Limited means the practitioner might consider the recommendation.
The second is an inconclusive recommendation about using oral antimicrobials prior to dental work. Inconclusive means the workgroup was unable to make a conclusion for or against the treatment.
The final is a consensus recommendation that patients with prosthetic joint and prosthetic implants practice good oral hygiene habits. Consensus provides an expert opinion even though there is a lack of evidence.
The full report, Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures, as well as summaries, are available on the American Dental Association website. The members of the workgroup are also listed. The members disclosed no conflict of interest. There was no outside commercial funding for the development of the guidelines.
