Infections of orthopedic implants are uncommon events and are rarely caused by bacteria found in the mouth. Although dental procedures such as extractions cause transient bacteremia, most bacteremia of oral origin occurs with activities of daily living, including brushing, flossing and chewing. There is no reliable evidence that antibiotics prior to dental procedures prevents prosthetic joint infections. Patients should not be exposed to the adverse effects of antibiotics when there is no evidence of benefit.
Sources:
Berbari E, et al. Dental procedures as risk factors for prosthetic hip or knee infection: a hospital-based prospective case-control study. Clin Infect Dis. 2010 Jan 1;50(1):8-16. PMID: 19951109.
Canadian Agency for Drugs and Technologies in Health. Antibiotic Prophylaxis in Patients with Orthopedic Implants Undergoing Dental Procedures: A Review of Clinical Effectiveness, Safety, and Guidelines. CADTH Rapid Response Reports. 2016 Feb. PMID: 27030856.
Morris A, et al. Recommendations for antibiotics in patients with joint prosthesis are irresponsible and indefensible. J Can Dent Assoc. 2009 Sep;75(7):513-5. PMID: 19744360.
Sollecito TP, et al. The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: Evidence-based clinical practice guideline for dental practitioners–a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc. 2015 Jan;146 (1):11-16.e8. PMID: 25569493.
Sutherland, S. Science over dogma: Dispelling myths about dental antibiotic prophylaxis for patients with total joint replacements [Internet]. 2018 Feb [cited 2018 Mar 12].
Related Resource:
Consensus Statement: Dental Patients with Total Joint Replacement