There Are New Guidelines For Total Joint Prophylaxis During Dental Procedures
In December 2012, the American Dental Association (ADA) and the American Academy of Orthopedic Surgeons (AAOS) in a joint effort developed new guidelines for treating patients with total joint replacements. These new guidelines are called “Prevention of Orthopaedic Implant Infections in Patients Undergoing Dental Procedures”.
The recommendations back in 2003 concluded that “The risk/benefit and cost/effectiveness ratios fail to justify the administration of routine antibiotic prophylaxis” for patients with total joint replacements.
In 2009, the AAOS promoted a new protocol for antibiotic prophylaxis of total joint replacements. This guideline recommended that patients receive antibiotic prophylaxis for at least 2 years after joint replacement who are receiving invasive dental procedures. Since 2009, the orthopedic groups have suggested that patients may need to have prophylaxis of joint placements forever.
Well, here we are in 2013 and we have come full circle. The new guidelines are evidence based and showed that invasive dental procedures, with or without antibiotics, did not increase the odds of developing a prosthetic joint infection. Dr. Jevsevar, chair of the AAOS Evidence Based Practice Committee stated, “There is no conclusive evidence that demonstrates a need to routinely administer antibiotics to patients with an orthopaedic implant who undergo dental procedures.” Antibiotic prophylaxis may still be considered for immunocompromised patients.
Here is the ADA link to the guideline for you to review:
http://www.ada.org/files/dentaleditorial.pdf
Also, there is a toolkit to help discuss antibiotics with patients with orthopaedic implants. This can be found at:
http://www.ada.org/news/8107.aspx
Should you have any questions regarding periodontal or implant issues, please do not hesitate to call or email me.
