Infection and Artificial Jo...

Infection fear lessens for artificial joints

 

By Dr. Paul Donohue

 

07/08/2007

 

Dear Dr. Donohue: After 30 years of going to one dentist, my wife and I changed for convenience. We made an appointment for teeth cleaning. In the forms that had to be filled out, my wife listed her hip replacement and my knee replacement, both 15 to 20 years ago. The dentist refused to clean our teeth until we took antibiotics before the visit. We haven't done this in the past 20 years. Did you ever hear of this?

 

Have you ever heard of endocarditis? It's a heart and heart valve infection. People with a damaged heart valve or with an artificial heart valve take antibiotics before dental procedures that cause bleeding. In those procedures, mouth bacteria can get into the blood, and they home in on those valves. Antibiotics afford protection.

 

A similar situation holds for artificial joints. The fear is that mouth bacteria can home in on the new joint, causing an infection that's hard to treat and may require joint removal.

 

However, there is a revision of thinking. In the United States, about half a million artificial joints are implanted yearly. Multiply that number by the number of years this kind of surgery has been done and you come up with a huge figure. Since the first artificial joint was replaced, there have been only 25 cases of artificial joint infection after dental work. Many doctors feel that the potential danger of antibiotics is greater than the minuscule chance of joint infection.

 

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