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Premedication for artificial joints
PREMEDICATION FOR ARTIFICIAL JOINTS
The oral cavity is a portal of entry as well as the site of disease for microbial infections
that affect general health.
Streptococcus viridian is the main infective agent that can enter the bloodstream from
areas with considerable bleeding such as the oral cavity, urinary tract and gastrointestinal
tract. This bacteria may lodge on the heart valves, inflame the myocardium and cause
ulcerations on the inner walls of an artery. Patient with artificial joints, prosthesis or
pervious severe infections are at higher risk. These risks are from an implied association
between dental treatments and joint infections. For the first two years following a total joint placement, antibiotic prophylaxis is
recommended for everyone. After two years, only high-risk patients may need to
receive antibiotics for high-risk procedures.
Do any of these high-risk situations apply to you?
Other medical conditions that cause you to be Immunocompromised or immunosupressed
Immunosupression caused by drug or radiation treatment
All patients in these high-risk categories may need antibiotics for all high-risk dental procedures. Premedication is recommended for antibiotic prophylaxis for any dental procedure likely to cause bleeding.
The American Dental Association recommends antibacterial prophylaxis for at-risk individuals with any dental procedure that may cause bleeding such as the following procedures:
Subgingival placement of antibiotic fiber or strips
Initial placement of orthodontic bands (not brackets)
Intraligamentary local anesthetic injections
Cleaning of teeth or implants where bleeding is anticipated
penicillin and unable to take Cefazolin or ampicillin
intravenously 1 hours prior to the dental procedure
penicillin and unable to take Clindamycin
* source JADA Vol 134, 7/03 pgs 895-899
is two grams of amoxicillin, one hour prior to treatment with no follow-up dosage required. Clindamycin, cephalexin, cefadroxil, axithronycin or clarithromycin as also suggested alternatives.
At our office we also reduce bacteremias by using an antiseptic mouthrinse for 30
The most effective reduction in bacteria in your mouth is accomplished by you. It
is urgent that you improve your oral hygiene care in order to improve your oral health by:
Rinsing your mouth with an antiseptic mouthrinse like BreathRx or Perioguard to reduce the bacteria count in your mouth BEFORE you do the following:
1. Use a Waterpik irrigator on a daily basis.
2. Brushing at least twice a day for 2 minutes or more using a
3. Flossing daily or using an automatic flosser.
All these with “stir up” the bacteria in your mouth, yet by using a consistent and
regular self care maintenance routine along with the frequent check-ups and professional cleanings will result in an overall reduction of oral bacteria to improve not only your oral health but your total well-being. Poor oral hygiene and periodontal (gum disease) or periapical infections increase your risk for joint infections.
If you have any questions or concerns please e-mail our office at:
edwardgloverdds@yahoo or call our office at: (903) 455-7673
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