Dental procedures & Joint replacements
Do You Need Antibiotics Before a Dental Visit If You Have a Joint Replacement?
If you've had a joint replacement—such as a hip or knee implant—you might wonder whether you need to take antibiotics before visiting the dentist. It’s a common question, and one that dentists, orthopedic surgeons, and patients alike have debated for years.
Let’s clear up the confusion and explain when (and if) antibiotics are needed before dental procedures.
The Concern: Protecting Your New Joint
The concern behind prescribing antibiotics before dental work stems from the possibility that bacteria from your mouth could enter your bloodstream during a procedure (like a tooth extraction or even a deep cleaning). Once in the bloodstream, the fear is that the bacteria could travel to your artificial joint and cause an infection—a serious complication that may require hospitalization or even joint replacement revision surgery.
This type of infection is called prosthetic joint infection (PJI). While it’s rare, it can be devastating.
What Do the Experts Say?
For years, the practice of prescribing "prophylactic antibiotics" (antibiotics taken before a dental procedure) was common for anyone with a joint replacement. But recent research and expert guidelines have shifted.
Here’s what the latest recommendations say:
American Dental Association (ADA) and American Academy of Orthopaedic Surgeons (AAOS) currently do not recommend routine antibiotics before dental procedures for most patients with joint replacements.
They advise that only certain high-risk patients may benefit from antibiotics.
Who Is Considered High Risk?
You might still need antibiotics if you:
Have a weakened immune system (due to conditions like cancer, diabetes, or HIV).
Had a previous joint infection.
Had a recent joint replacement (some providers may be more cautious within the first 3–6 months after surgery).
Have certain blood disorders or are on immunosuppressive therapy.
Ultimately, your orthopedic surgeon and dentist should work together to assess your risk and make a personalized recommendation.
The Risks of Unnecessary Antibiotics
While antibiotics can be life-saving, overusing them can lead to:
Antibiotic resistance (making infections harder to treat).
Side effects, such as stomach upset, allergic reactions, or yeast infections.
C. diff infections, a potentially serious bacterial illness linked to antibiotic use.
That’s why guidelines have moved toward conservative antibiotic use—only when truly needed.
What Should You Do Before Your Dental Appointment?
Tell your dentist about your joint replacement.
Share any relevant medical history, including immune issues or past infections.
Ask your orthopedic surgeon if they recommend antibiotics in your case.
Follow your dentist’s instructions carefully if antibiotics are prescribed.
Final Thoughts
If you’ve had a joint replacement, don’t assume you need antibiotics before every dental visit. In most cases, they aren’t necessary—and may even do more harm than good. That said, everyone’s situation is different. Talk with your healthcare providers so they can make the safest decision based on your individual risk.
Taking care of your oral health is important—not just for your teeth, but for your overall well-being. Regular checkups and cleanings are safe and important, joint replacement or not!
Discuss your concerns with Dr Collins directly if worried.
For further information see the Australia Arthroplasty Associations guidelines here:
