Routine prophylactic antibiotics for arthroplasty patients receiving dental care. Is it necessary?

Much of the debate regarding the prophylactic use of antibiotics for patients who have had a total joint replacement has focussed on their use before dental procedures. Despite the fact that almost all orthopaedic surgeons routinely recommend antibiotics for patients with prosthetic joints who require dental treatment, there is little evidence of a definitive link between transient bacteraemia occurring during dental procedures and late infections around prosthetic joints. An extensive review of the literature reveals that most authors recommend prophylactic antibiotics in high-risk patients or in those who undergo extensive dental surgery.