Antibiotic Prophylaxis Prior to Dental Procedures in Patients With Orthopedic Implants
Over 1 million primary hip and knee arthroplasties are performed in the United States each year. The reported risk of periprosthetic and deep implant infections ranges from 0.3% to 8.3%. Although dental procedures may result in transient bacteremia, there is no controlled evidence to suggest an association between bacteremia following dental procedures and prosthetic joint infection. Lingering historical concerns have led to inconsistent practices in antibiotic prophylaxis in this population. In 2015, the American Dental Association (ADA) published guidelines that advised against the use of antibiotic prophylaxis prior to dental procedures in patients with orthopedic implants due to the lack of evidence associating dental procedures with prosthetic joint infections (PJIs) and the absence of data supporting a benefit of antibiotic prophylaxis.