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Dental Work After Joint Replacement

The American Dental Association and American Academy of Orthopaedic Surgeons developed the following recommendations for people with joint replacements who are planning to have dental work done.
Because there is little data on this topic, these recommendations are guidelines only.

Preventive Antibiotics

You need preventive antibiotics before dental procedures if:
  • You have an inflammatory type of arthritis such as rheumatoid arthritis or systemic lupus erythematosis.

  • Your immune system has been weakened by disease, drugs or radiation.

  • You have insulin-dependent (type 1) diabetes.

  • You had a joint replacement less than two years ago.
You do not need preventive antibiotics if your joint replacement has been in place more than two years and you do not suffer from any of the above conditions.

Use of Preventive Antibiotics

Procedures that require preventive antibiotics include:
  • Dental extractions

  • Periodontal (gum disease) procedures

  • Dental implant placement and reimplantation of teeth that were knocked out

  • Endodontic (root canal) instrumentation or surgery

  • Initial placement of orthodontic bands (not brackets)

  • Injection of a local anesthetic into the gums near the jaw

  • Regular cleaning of teeth or implants where bleeding is anticipated

Suggested Antibiotics

  • If you can take oral medications and are not allergic to penicillin, two grams of amoxicillin, cephalexin or cephradine should be taken one hour before the procedure.

  • If you are allergic to penicillin, 600 mg. of clindamycin should be taken one hour before the procedure.

  • These medications can be prescribed by your primary care physician, orthopaedic surgeon or dentist.