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Joint Replacement

X-ray showing a joint replacement

In 2012, the ADA and American Association of Orthopedic Surgeons updated the antibiotic prophylaxis (premedication) guidelines for patients with orthopedic implants undergoing dental procedures. These new guidelines no longer recommend antibiotics for everyone with artificial joints.

As a result, your healthcare provider may rely more on your personal medical history to determine when antibiotics are appropriate for people with orthopedic implants. For example, antibiotic prophylaxis might be useful for patients who also have compromised immune systems (due to, for instance, diabetes, rheumatoid arthritis, cancer, chemotherapy, and chronic steroid use), which increases the risk of orthopedic implant infection.

If you have a heart condition or an orthopedic implant, talk with your dentist or physician about whether antibiotic prophylaxis before dental treatment is right for you.

Why did the guidelines change?

The guidelines are re-evaluated every few years to make sure that they are based on the best scientific evidence. These reviews have uncovered no evidence that taking antibiotics before dental treatment prevents infections of the heart or orthopedic implants. Therefore, for most people, the known risks of taking antibiotics may outweigh the uncertain benefits. Risks related to antibiotic use include upset stomach and allergic reactions, including anaphylactic shock (a severe allergic reaction that can be life threatening) and C. difficile infection, which causes diarrhea and other intestinal problems.

Talk to your dentist about these guidelines if you have any questions about antibiotic prophylaxis.