Dental treatment and orthopedic implants--a malpractice case

A patient who required a revision of a six-year-old hip prosthesis five months following root canal therapy and removal of a root tip subsequently sued his dentist for malpractice. The alleged torts were the presence of a positive culture for lactobacillus--presumably an "oral organism" from the infected hip site one week following the dental procedures--and improper use of antibiotics by the dentist. This case underscores the need for the medical and dental communities to agree on what constitutes proper treatment for dental infections. In addition, the arbitrary use of antibiotics, which has led to increasing numbers of bacterial-resistant organisms and other side effects, needs to be addressed. The guidelines for prophylactic antibiotic administration prior to dental treatment in orthopedic implant patients must be revised significantly, based upon risk-to-benefit ratio, documented research, and the literature.