Joint Replacements and Antibiotics

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YOU WILL NEED PROPHYLACTIC ANTIBIOTIC BEFORE ALL DENTAL PROCEDURES IF YOU HAVE HAD A JOINT REPLACEMENT. THIS IS A LIFETIME REQUIREMENT.

The bacteria commonly found in the mouth may travel through the bloodstream and settle in your artificial joint. This increases your risk of contracting an infection. Ask your dentist about preventive antibiotics for all dental procedures with a high risk of bleeding or producing high levels of bacteria in your blood. Your dentist and your orthopaedic surgeon, working together, will develop an appropriate course of treatment for you.

The following dental procedures have a high risk of bleeding or producing high levels of bacteria in your blood:

All dental extractions
All periodontal procedures
Dental implant placement and replantation of teeth that were knocked out
Some root canal work
Initial placement of orthodontic bands
Certain specialized local anesthetic injections
Regular dental cleanings (if bleeding is anticipated

You may also need antibiotic treatment prior to the following procedures – check with your physician:

Any infection
Barium enema
Genitourinary instrumentation
Kidney surgery
Liver biopsy
Prostate and bladder surgery
Sigmoidoscopy
Tonsillectomy
Vaginal exams and gynecological surgery.

One of these preventive antibiotics may be prescribed for you:

If you are not allergic to penicillin – 2 grams of amoxicillin, cephalexin or cephradine (orally) OR 2 grams of ampicillin or 1 gram of cefazolin (intramuscularly or intravenously) 1 hour before the procedure.
These guidelines were developed by the American Academy of Orthopedic Surgeons and the American Dental Association. They are designed to help practitioners make decisions about preventive antibiotics for dental patients with artificial joints. They are not a standard of care or a substitute for the practitioner’s clinical judgment. Practitioners must exercise their own clinical judgment in determining whether or not preventive antibiotics are appropriate. Pediatric doses may be different.