Helpful Information About Your Surgery
Click to download the following information sheets provided by our surgeons to help with your Post-Operative Care. All files are PDF format. More information sheets will be posted here periodically.
Mr Shaun English
Dental Information
Patients with Joint Replacements who Require Dental Treatment.
Dental problems in the first 3 months following hip or knee joint placement surgery
Infection with abscess formation: Urgent and aggressive treatment of the abscess. Remove the cause (exodontic or endodontic) under antibiotic prophylaxis.
Pain: Provide emergency dental treatment for pain. Antibiotics are indicated if a high or medium risk dental procedure is performed.
Non-infective dental problem without pain: Defer non-emergency dental treatment until 3 to 6 months after prosthesis replacement.
Dental treatment after 3 months in a normal patient with a normally functioning artificial joint
Routine dental treatment including extraction – No antibiotic prophylaxis required.
Immunocompromised patients are a particular risk:
- those with insulin-dependent diabetes
- those taking immunosuppressive treatment for organ transplants or malignancy
- those with systemic rheumatoid arthritis
- those taking systemic steroids
(e.g. patients with severe asthma, dermatological problems) Consultation with the patient’s treating physician is recommended.
Failing, particularly chronically inflamed, artificial joints:
Consultation with the patient’s treating orthopaedic surgeon is recommended.
Defer non-essential dental treatment until the orthopaedic problem has been resolved.
Previous history of infected artificial joints:
Consider if the patient is immunocompromised.
Routine non-surgical dental treatment – no prophylaxis indicated.
Recommended antibiotic regimens where indicated:
- Dental clinic local anaesthetic extractions or deep curettage- Amoxycillin 2-3g orally 1 hour prior to procedure
- Theatre procedures- Amoxycillin 1g I/V at induction and followed by 500mg amoxicillin I/V or orally 6 hours later.
- Penicillin hypersensitivity, long term penicillin, recent penicillin/other B-lactam- Clindamycin 600mg 1 hour prior to procedure or Vancomycin 1g I/V 1 hour to finish 2 hours or Lincomycin 600mg just prior to the procedure.
- High risk case (i.e. Gross oral sepsis/severely immunocompromised/previous joint infection) – Gentamicin 2mg/kg I/V just before procedure (can be administered 3mg/kg provided there is no concomitant renal disease) PLUS Amoxycillin 1g I/V just before procedure and followed by 500mg I/V or orally hours later.
If hypersensitive to penicillin replace amoxycillin with Vancomycin 1g I/V over 1 hour to finish just before procedure.
Ref: Scott JF et al, Patients with artificial joints: do they need antibiotic cover for dental treatment? Aust Dent J 2005:50 Suppl 2S45-S53
Have Other Questions?
If we have not answered your question well enough on this page or if you have a question which is not covered please get in contact with your doctor.
