Dental or tooth extractions and joint prostheses

Advice of a Working Party of the British Society for Antimicrobial Chemotherapy is that patients with prosthetic joint implants (including total hip replacements) do not require antibiotic prophylaxis for dental treatment

• the Working Party considers that 'it is unacceptable to expose patients to the adverse effects of antibiotics when there is no evidence that such prophylaxis is of any benefit, but that those who develop any intercurrent infection require prompt treatment with antibiotics to which the infecting organisms are sensitive'
• the Working Party has commented that joint infections have rarely been shown to follow dental procedures and are even more rarely caused by oral streptococci.
• in the US, the American Academy of Orthopaedic Surgeons also concluded that routine antibiotic prophylaxis was not required in patients with total joint prostheses

Reference:

1. Pulse (2004); 64 (29): 52.