Clinical practice guidelines: Avoiding periprosthetic joint infections after dental care
Experts have introduced updated guidelines for the prevention of common complications among patients undergoing dental procedures following total joint arthroplasty.
In the guidelines, published in the Journal of the American Academy of Orthopaedic Surgeons, a multidisciplinary team of investigators from the academy and the American Association of Hip and Knee Surgeons analyzed data from eight research articles. The American Dental Association, in addition to the Infectious Disease Society of America and the Musculoskeletal Infection Society, provided input and endorsed the updated clinical practice guidelines.
The investigators issued two guidelines based on low-quality evidence and three based on expert consensus. They explained that dental procedures may result in transient bacteremia, potentially increasing the risk of periprosthetic joint infections that carry a large clinical and economic burden.
The investigators noted that systemic antibiotic prophylaxis and preoperative dental screenings may be ineffective in mitigating the risk of subsequent periprosthetic joint infections. Further, antiseptic and antimicrobial washes may not be necessary prior to dental procedures. Because of a lack of reliable evidence as well as several risk factors — the potential presence of transient bacteremia, occurrence of invasive surgical procedures and treatment of active dental infections — the investigators advised clinicians to delay total joint arthroplasty after dental procedures and vice versa by at least three weeks and three months, respectively.
The investigators hope the updated recommendations can inform the decision-making process in this patient population and highlight avenues for future research to fill gaps in the literature.
Read more: Journal of the American Academy of Orthopaedic Surgeons
The article presented here is intended to inform you about the broader media perspective on dentistry, regardless of its alignment with the ADA's stance. It is important to note that publication of an article does not imply the ADA's endorsement, agreement, or promotion of its content.