If I have had a hip or joint replaced, do I need antibiotics before a dental teeth cleaning

Based on current evidence-based guidelines, routine antibiotic prophylaxis is generally NOT recommended for patients with joint replacements undergoing dental procedures like routine cleanings. The 2017 clinical practice guideline from the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA) concluded that the evidence does not support routine antibiotic prophylaxis for dental procedures in patients with prosthetic joints. The risk of antibiotic-associated adverse events may exceed the benefit of preventing prosthetic joint infections. However, there are specific high-risk scenarios where prophylaxis might be considered, such as patients who are immunocompromised, have a history of prosthetic joint infection, or are within the first two years post-implantation (though even this is debated). The decision should ultimately be individualized based on patient-specific risk factors and made in consultation with both the orthopedic surgeon and dentist.

Confidence: 8/10

Current guidelines from organizations such as the American Dental Association (ADA) and the American Academy of Orthopaedic Surgeons (AAOS) suggest that routine antibiotic prophylaxis is not necessary for patients with hip or joint replacements prior to dental procedures, including teeth cleaning. The risk of developing prosthetic joint infections from dental procedures is considered very low, and the potential for antibiotic resistance and adverse effects from unnecessary antibiotic use outweighs the benefits. However, patients with specific risk factors, such as a history of joint infections or certain immunocompromised conditions, may still require antibiotics, so it's essential to consult with a healthcare provider for personalized advice.

Confidence: 8/10

Based on my knowledge of current medical guidelines, patients with hip or joint replacements generally do not need prophylactic antibiotics before routine dental procedures like teeth cleaning. Historically, this was recommended to prevent prosthetic joint infections from bacteria entering the bloodstream during dental work. However, evidence from studies and updated guidelines from the American Dental Association (ADA) and the American Academy of Orthopaedic Surgeons (AAOS) since around 2015 indicate that the risk of such infections is very low, and routine antibiotic prophylaxis is not necessary for most patients. Antibiotics can have side effects, including allergic reactions and antibiotic resistance, which outweigh the benefits in low-risk scenarios. That said, individual cases may vary—patients with compromised immune systems, a history of joint infections, or specific risk factors (e.g., recent joint surgery within the last two years) should consult their orthopedic surgeon or dentist for personalized advice. In the absence of such factors, the standard recommendation is no antibiotics needed.

Confidence: 9/10

The American Dental Association (ADA) and the American Academy of Orthopaedic Surgeons (AAOS) have revised their guidelines regarding the use of antibiotics before dental procedures for patients with joint replacements. According to these updated guidelines, the use of antibiotics before dental procedures, including teeth cleaning, is not routinely recommended for most patients with joint replacements. The risk of prosthetic joint infection (PJI) from dental procedures is considered low, and the potential risks associated with antibiotic use, such as antibiotic resistance and side effects, outweigh the benefits for most patients. However, it's essential to note that some patients may still require antibiotics before dental procedures, such as those with a history of PJI, compromised immune systems, or other underlying health conditions. Ultimately, the decision to use antibiotics before a dental teeth cleaning should be made in consultation with the patient's orthopedic surgeon and dentist, taking into account the individual's specific medical history and risk factors.

Confidence: 8/10