Antibiotic Prophylactic Treatment for Dental Work (Joint Replacement)
 

Do patients with total joint replacements need antibiotics before dental work?
Cleveland Clinic Journal of Medicine 2003; 70(4):351-352
Thomas F Keys

Antibiotic Prophylactic Treatment for Dental Work (Spine Universe)

Patients with artificial joints: do they need antibiotic cover for dental treatment?
Australian Dental Journal Medications, Supplement 2005;50:4 (S45-S53)
JF Scott, D Morgan, M Avent, S Graves, AN Goss
--> This is a great read with color pictures and charts from our friends "Down Under." :) After you click on the link above, scroll half way down the page and look for the title.

This has been discussed extensively in the patient community for years. When I started my post-op dental care, my dentist insisted on prophylactic antibiotics prior to treatment. I still go to the same dentist and she still requires 1 dose of antibiotics 1-2 hours prior to treatment.

6 years ago, all of the spine surgeons I asked recommended antibiotics prior to dental work. Now, some of them have revised their recommendations and don't require it for ADR. I don't believe that is true for other spine surgeries... I believe the criteria has to do with the location of the metal vs. blood supply???

Note that one of my mengitis from myelogram clients had a ton of hardware in his back from multiple posterior fusions. The theory is that without symptoms, the metal can provide a site for low grade infection and the access to the spinal canal can carry some of that bacteria in. Also note that my other meningitis from myelogram clients had 2-level lumbar ADR. I have no idea about technique for myelogram or other potential sources for the ADR client. I was present for the fusion guy's myelo. I used to work in sterile manufacturing, so I'm kind of hyper-aware of sterile technique and I did not see anything suspect.

Sorry for wandering, but it's all related. Back to antibiotics... I still get them. I would not if the dentist did not insist on them. As with all things spine, there is no clear path. I'd recommend that you tell your dentist... she may insist on them or defer to what your surgeon recommends. Know what your surgeon recommends BEFORE you go to the dentist and let your dentist know as well. That will give you the opportunity to get the antibiotics before you go in.

Mark

Interesting articles--and actually, reassuring with respect to the low risk.
Nevertheless, I do take clindamicin prior to dental work, which is usually routine cleaning, as prescribed by my surgeon.

I think the recommendation that patients take care of dental problems prior to surgery so that they are "orally fit" is something the community has not addressed before.

BTW, there is also an interesting article on biophosphanates and jaw necrosis
in the Australian journal.

My dentist has insisted that, for the three years following my 4 level ADR surgery, that I take a dose of antibiotics one hour prior to any dental work. Better safe than sorry in my opinion.

Terry Newton

Dental ABs or the half-pitbull woman
 

Thanks for the great articles. I've sent an email to the Pro-spine docs to see what they recommend for me. I'm thinking the risk is low but still wouldn't be surprised if it's recommended for me as my surgery was so recent. I have never had any dental problems requiring ABs, most issues have been from fracturing teeth due to bruxism-which I attributed in part to neck pain at night.
Just call me half Pitbull.

Do you have lipstick on one lip?