Introduction

What do your joints have to do with your teeth? Quite a bit, if you have a joint replacement. Patients with joint replacements should be sure to mention their new joint replacement to their dentist before undergoing any procedures.

Why? Because certain dental procedures could cause bacteria found in the mouth to travel through the bloodstream and settle in your artificial joint.  This increases your risk of contracting an infection, according to the American Dental Association ("Receiving antibiotics before dental treatment,? JADA , Nov 2003).

"Any time you work in the mouth, there is a possibility of bleeding,? said Matthew L. Creech, DDS, of Fort Wayne Dental Group in Indiana.  ?If bleeding occurs, germs can enter the bloodstream and travel to the newly replaced joint area,? Dr. Creech said.

Dental procedures carrying a higher risk of bleeding or producing high levels of bacteria in the blood include tooth extraction, periodontal treatment, dental implant placement, some root canal work, initial placement of orthodontic bands, certain specialized local anesthetic injections, and regular dental cleanings, if bleeding is anticipated.

Preventative antibiotics can be prescribed for you to help decrease the chances of getting an infection after your dental work. ?Pre-medication with an antibiotic is recommended for a period of time after a joint replacement," Dr. Creech said. The American Dental Association and the American Academy of Orthopaedic Surgeons agree that for the first two years after a joint replacement, you may need antibiotic therapy for dental procedures. After that, only high-risk patients may require antibiotics for certain dental treatments. 

According to the American Academy of Orthopaedic Surgeons, you should also get preventive antibiotics before dental procedures if:

• you have an inflammatory type of arthritis such as rheumatoid arthritis or systemic lupus erythematosis.
• your immune system as been weakened by disease, drugs or radiation.
• you have insulin-dependent (Type I) diabetes.
• you are undernourished or malnourished.
• you have hemophilia.

Also, be sure to talk with your dentist about any new or different medicine you may have started taking since your last dentist appointment.