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After joint replacement surgery, it is important to take precautions to prevent infection, especially when it comes to dental procedures. In this blog post, we will discuss the importance of taking prophylactic antibiotics before dental work after joint replacement surgery and the potential risks and side effects of these medications.

  • Why are prophylactic antibiotics prescribed? After joint replacement surgery, the risk of infection is higher due to the presence of a foreign object (the prosthesis) in the body. The bacteria that are commonly found in our mouths can be introduced into the bloodstream during dental procedures and can travel to the artificial joint, potentially causing an infection. To prevent infection, prophylactic antibiotics are prescribed before dental procedures to prevent bacteria from entering the bloodstream and potentially infecting the joint replacement.
  • Types of antibiotics: The most commonly prescribed antibiotics for prophylaxis before dental procedures after joint replacement surgery include amoxicillin, cephalexin, and clindamycin. These antibiotics are effective against the most common types of oral bacteria that can cause infection.
  • Risks and side effects: Taking antibiotics can cause side effects such as nausea, diarrhea, and allergic reactions. It's important to inform your dentist and primary care physician of any allergies you have to antibiotics, as well as any other medications you are taking, as some drugs can interact with antibiotics.
  • Timing: It's important to take prophylactic antibiotics as prescribed by your surgeon or dentist, usually one hour before the dental procedure. Some surgeons/dentists prefer patients to continue taking the antibiotics as directed, typically for a day or two after the procedure, to ensure that the bacteria are eliminated.
  • Alternative therapies: In some cases, alternative therapies, such as rinsing with an antiseptic solution, may be used instead of antibiotics. It's important to consult with your surgeon and dentist to determine the best course of treatment for you.

This topic has been debated back and forth between the dental community and the orthopedic community. Some believe that the risk is very small and so no antibiotics are needed. I prefer to be cautious, even if it is small risk. Taking one dose of antibiotics an hour before dental cleanings/procedures is a minor inconvenience compared to having an infected joint (requiring another 1-2 surgeries, hospitalizations, and several weeks of IV antibiotics) (but that’s just me).