Total Joint Surgery Dental Antibiotic Recommendations

If you have undergone a total joint replacement procedure, there are instances when infection in one part of the body may cause bacteria to circulate in the blood, possibly resulting in infection at the site of your implant.

Therefore it is essential that your personal physician and dentist be informed of your surgery.

It is important to maintain good dental hygiene and visit your dentist for routine care, whether you are experiencing a dental problem or not.

Prompt treatment of infections, particularly involving the skin and urinary tract, are also important.

For patients in their first two years following total joint replacement, it is recommended that you be considered to receive antibiotic treatment in preparation for certain dental procedures:

• Dental extractions
• Periodontal procedures including surgery, subgingival placement of antibiotic fiber strips, scaling and root planning, probing, recall maintenance
• Dental implant placement and re-implantation of avulsed teeth
• Endodontic instrumentation or surgery only beyond the apex
• Initial placement of orthodontic bands, but not brackets
• Intraligamentary local anesthetic injections
• Prophylactic cleaning of teeth or implants where bleeding is anticipated

Suggested antibiotic prophylaxis regimens:

• Patients not allergic to penicillin: Cephalexin, Cephradine or Amoxicillin; 2 grams orally one hour prior to procedure
• Patients unable to take oral medications: Cefazolin 1 gram or Ampicillin 2 grams IM/IV one hour prior to procedure
• Patients allergic to penicillin: Clindamycin 600 mg orally one hour prior to procedure
• Patients unable to take oral medications: Clindamycin 600 mg IM/IV one hour prior to procedure.

These recommendations come from the American Dental Association and the American Academy of Orthopaedic Surgeons.