Orthopaedic
Dental Management of Patients with Prosthetic joint replacement
No routine antibiotic prophylaxis
Current ADA/AAOMS guidance does not recommend routine antibiotic prophylaxis for patients with prosthetic joints undergoing dental procedures.
Emergency vs routine management
If EMERGENCY — what to do
- • Routine antibiotic prophylaxis is not recommended — treat the dental infection promptly and definitively.Ref: Sollecito TP et al. ADA Clinical Practice Guideline — Prophylactic antibiotics before dental procedures in patients with prosthetic joints. JADA 2015;146:11–16
- • Consult the orthopaedic surgeon if there is a history of joint infection or severe immunosuppression.Ref: Sollecito TP et al. ADA Clinical Practice Guideline — Prophylactic antibiotics before dental procedures in patients with prosthetic joints. JADA 2015;146:11–16
If ROUTINE — what to do
- • Proceed with routine care without prophylaxis.Ref: Sollecito TP et al. ADA Clinical Practice Guideline — Prophylactic antibiotics before dental procedures in patients with prosthetic joints. JADA 2015;146:11–16
- • Maintain good oral health to reduce bacteraemia from daily activities.Ref: Sollecito TP et al. ADA Clinical Practice Guideline — Prophylactic antibiotics before dental procedures in patients with prosthetic joints. JADA 2015;146:11–16
Clinical precautions
- • Routine care; prophylaxis only if the orthopaedic surgeon specifically requests it for an individual case
At a glance by procedure
Initial assessment before lab results or timing details are entered.
| Procedure | Initial assessment |
|---|---|
| Examination / radiographs | ROUTINE No routine antibiotic prophylaxis |
| Supragingival scaling / polish | ROUTINE No routine antibiotic prophylaxis |
| Deep scaling / subgingival RSD (subgingival calculus) | ROUTINE No routine antibiotic prophylaxis |
| Root canal treatment | ROUTINE No routine antibiotic prophylaxis |
| Simple extraction (1–3 teeth) | ROUTINE No routine antibiotic prophylaxis |
| Surgical / bony extraction | ROUTINE No routine antibiotic prophylaxis |
| Implant placement | ROUTINE No routine antibiotic prophylaxis |
References
- ADA 2015 / AAOMS — Prosthetic Joint Infection
- Sollecito TP et al. ADA Clinical Practice Guideline — Prophylactic antibiotics before dental procedures in patients with prosthetic joints. JADA 2015;146:11–16
This guide supports — and does not replace — professional clinical judgment. Always consider the individual patient and consult the treating physician when indicated.