Dental Antibiotic Prophylaxis: What to do with Current Recommendations

Periprosthetic joint infection (PJI) leads to increased patient morbidity and mortality. Current literature reveals a strong link between bacteremia and oral procedures, and therefore elevated risk of PJI. However, evidence that dental procedures do not increase risk of PJI and that antibiotic prophylaxis does not decrease PJI risk exists. In Arkansas, we continue to see patients with bacteremic-induced PJI, therefore we recommend routine prophylaxis for all dental pro- cedures for patients who can tolerate the antibiotics during the first year after joint replacement. Antibiotics are associated with known risks, therefore, a discussion between the physician, dentist, and patient is recommended.