Riverwalk Dental- Protecting your joints!



We recently had a patient  come in who had forgotten to take his necessary antibiotics prior to his cleaning, and needed to reschedule. When we told him, he said he simply forgot, but it was clear that he didn’t understand why he took them.

The underlying concern is that certain mouth bacteria can get into the bloodstream and latch onto the artificial joint, causing infection. This can be extremely serious, needing anything from long-term antibiotics to removal of the infected joint, and can even be fatal.

Because of this fear, antibiotics have been prescribed to be taken prior to having dental appointments that can cause bleeding. The idea for the use of antibiotics is that if the antibiotics are already present in the bloodstream at a high enough concentration when bacteria enter, they will destroy the bacteria and prevent complications.

Of course, avoiding your mouth can be an even bigger problem, as things like active gum disease cause bleeding and entry of potentially dangerous bacteria into the bloodstream continually. The best course of action is a clean mouth, with good home care and professional treatment with us.

Antibiotics used to be given for lifetime prophylaxis, but things have changed over the past ten years. We have realized that the risks of infection are not as high as we once thought. Also, we now realize that taking antibiotics have their own risks, such as allergies and growing bacterial resistance.

For patients who have prosthetic joint replacements, the joint recommendations of the American Dental Society and the American Association of Orthopedic Surgeons recommends routine prophylaxis for two years following insertion of the prosthesis. This should be extended if there have been previous infections, or if the patient is immunocompromised, has cancer, is malnourished, or has inflammatory arthritis or diabetes. These recommendations also have more variables, so it is best to discuss your particular case with us as well as your orthopedic surgeon to get individualized recommendations.


As far as what procedures require prophylaxis, the answer is that anything that can cause any bleeding at all. So, for instance, you’ll want to take your medicine prior to a cleaning or root canal, or a surgical procedure such as an extraction, dental implant, or gum surgery. However, for routine fillings, impressions and x-rays, prophylaxis is not needed. You’ll want to talk with us to make sure to get the correct recommendations.


So, what can I do?


The best way to minimize risk is to maximize the health of your mouth. Make sure you are routinely brushing and flossing, at least twice daily. Make sure you see us for regular checkups twice yearly, or more frequently if you have gum disease.

If you currently take antibiotics prior to routine dental care, and have not reviewed your reasons with us and your physician for several years, you may want to bring this up with us prior to your next appointment. You may no longer need to take medication.

If there have been major changes to your health, and you are concerned that you may require medication, please feel free to contact us and also review with your physician.

Working together, we can make sure to follow the latest recommendations and keep you safe.


Drs. Beninato and Patsi