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J Bone Joint Surg Am. 2014 Jan 15;96(2):162-8. doi: 10.2106/JBJS.L.01379.

Dental disease and periprosthetic joint infection.

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Divisions of Infectious Diseases (H.Y. and C.S.P.) and Rheumatology (J.H.), Denver Health Medical Center, 777 Bannock Street, MC 4000, Denver CO 80204. E-mail address for H. Young:
Department of Orthopaedic Surgery, Denver Health Medical Center, 777 Bannock Street, MC 0188, Denver CO 80204.


➤ The number of patients with end-stage osteoarthritis is increasing, and treatment with hip and knee arthroplasty is expected to increase over the next several decades. ➤ Dental disease has long been anecdotally associated with increased periprosthetic joint infections, although case-control studies do not support this relationship. ➤ While most recent guidelines for the prevention of endocarditis have favored treatment of fewer patients, the most recent recommendations for prevention of periprosthetic joint infection have increased the number of patients who would receive antibiotics before a dental procedure. ➤ Antibiotics given before a dental procedure decrease the risk of bacteremia from the oral cavity, but this is of uncertain clinical importance. ➤ The number of patients who would require antibiotics before dental procedures to prevent one periprosthetic joint infection greatly outnumbers the number of patients who would experience an adverse event associated with antibiotics given before a dental procedure.

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