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Dental Implants following TKR?

Posted , 11 users are following.

nuala16574
nuala16574

I had been planning Dental Implants prior to knee replacement last April. I am wondering if it's too risky now in case of infection? I have been told to take antibiotics an hour prior to any Dental Work but don't know if that would include Dental Implants? Anyone know if it's too risky? Thanks Nuala

0 likes, 21 replies

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  • Eizie
    Eizie nuala16574

    Posted

    I work for oral surgeons. I think you'll be for dental implants but, of course, take antibiotics 1 hour before. To be really sure, call oral surgeon' office and ask them. I got dental implants 1 month before my knee surgery and was given antibiotics after to take for a week.

  • ellen57898
    ellen57898 nuala16574

    Posted

    Speak to your surgeon and dentist. I had to have dental clearance before my TKR.   Have you already had the knee surgery?

    take care and keep us posted

    • nuala16574
      nuala16574 ellen57898

      Posted

      Ellen had TKR last April. Just wondering if I can have dental implants considering its more invasive and possibly risk infection. I'll run it by dentist of course but was putting it out there to get feedback. Much appreciated indeed.

  • shirley87865
    shirley87865 nuala16574

    Posted

    Hello nuala16574, I had my TKR in July 2015. My orthopedic surgeon told me whenever I have any kind of dental work done I would have to take antibiotics for the rest of my life. I had to have a tooth pulled a month ago and the dentist had me taking antibiotics for 7 days before he pulled the tooth. You just have to make sure your dentist is on the same page as your orthopedic surgeon. I hope everything works out for you.
  • Oldfatguy1
    Oldfatguy1 nuala16574

    Posted

    Dentist and Dr should advise you. If you need antibiotics it shouldn't be for more than days

  • CHICO_MARX
    CHICO_MARX nuala16574

    Posted

    I was told to take 2g of Keflex 1 hour before dental work for up to a year when I had my hip replaced in 2009.  Some people were told 2 years...some for life.

    Now I understand that it is no longer recommended...

    January 2015 ADA clinical practice guideline, based on a 2014 systematic review states, “In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.”

    "According to the ADA Chairside Guide, for patients with a history of complications associated with their joint replacement surgery who are undergoing dental procedures that include gingival manipulation or mucosal incision, prophylactic antibiotics should only be considered after consultation with the patient and orthopedic surgeon; in cases where antibiotics are deemed necessary, it is most appropriate that the orthopedic surgeon recommend the appropriate antibiotic regimen and, when reasonable, write the prescription."

    Others may disagree but that's the latest from the American Dental Association. Other research shows that there are very few sub-populations (mostly cardiac) where this is recommended.  If you are not in one of those, then this is the current guideline.  I'd follow the American Dental Association guidelines.

    • johnny17592
      johnny17592 CHICO_MARX

      Posted

      I think you are right Chico i had a tooth pulled two weeks after my TKR the dentist told me exactly the same as in your guidlines last week i had 2 more pulled and a pallet fitted but no antibiotics.
    • nuala16574
      nuala16574 CHICO_MARX

      Posted

      Chico. just seeing your post now. Thanks for in depth report and clinical guidelines as they apply with the American Dental Association. Not sure if they apply here?I live in Ireland and did run it by my Orthopaedic Surgeon on my last visit to him. He recommended antibiotics prior to dental work and wrote me a prescription but that was 6 months ago. I haven't ventured as yet for implants as I am somewhat scared to take the risk in case of infection. I'm thinking maybe wait the 12 months post TKR and take my decision then, Regards Nuala

    • jan01779
      jan01779 CHICO_MARX

      Posted

      Both my Dentist and Orthopaedic Surgeon told me no real significant evidence for antibiotic cover only in pericarditis.

    • CHICO_MARX
      CHICO_MARX nuala16574

      Posted

      I had a tooth pulled about 6 weeks ago and the doc RX'ed the antibiotics.  Now that I know the guideline, I'll ask him why if he recommends it again.  We live and learn.  Me...I do the research!  Always have...I don't like surprises...  I was married to a pharmacist for 25 years and now to a woman who was a nurse for 30...plus, my cousin's been an MD for almost 50 years.  Believe me...we always do our homework...

    • jan01779
      jan01779 CHICO_MARX

      Posted

      Oh I am sure you do would not think otherwise with your ueeful links and advic!

      I just asked as need work done too. I too researched myself as 27 years nursing NHS Sister.

      I might still ask GP as immunosuppressive meds for RA. Don't think I want to risk infection on this tkr journey. Couldn't find research relating to that and pretty sure GP would.

    • CHICO_MARX
      CHICO_MARX jan01779

      Posted

      Yes, there ARE medical conditions (there is a list) where the antibiotics ARE recommended if you also have a joint implant...most are of the cardiac variety so you should check.  And of course, they can revise the guidelines at any time!  This is NOT a blanket guideline.  If you have other conditions, ALWAYS talk to the dentist and your doctors.

      NOTE: When you "google" something, the link WITH THE MOST TRAFFIC comes up first.  This is not always THE MOST CURRENT INFORMATION.  You must LOOK AT THE DATE OF THE ARTICLE to make sure you have the latest data on a subject.  This goes for ALL of your searches!!!

    • Oldfatguy1
      Oldfatguy1 jan01779

      Posted

      In my part of the US it seems standard protocol. 1 a day....three days prior. After having staph in the knee twice.....and being without a prosthesis for 4 months and needing twice a day infusion.....I would do anything anyone suggested to avoid the possibility of infection. If they told me to stand on my head in the middle of main street, if probably try. Anyone that's ever had to to through cleaning up a staph can vouch for the misery you are put through

    • jan01779
      jan01779 Oldfatguy1

      Posted

      Thanks for that. sounds like you have gone through hell. I found the 1st month post tk enough without complications and certainly don't want delayed return to work ( neither does the other half 😊wink

      I'm going to ignore my surgeon and dentist. Despite the guidance and research I am a bit concerned that I cannot find evidence regarding patients who are on Methotrexate which I have taken for years for RA.

      I don't want to risk it and I know my GP will give me cover. I did mention it to my surgeon and he advised no evidence but to do so if worried.

    • jan01779
      jan01779 CHICO_MARX

      Posted

      Thanks I absolutely look at the date but could not find anything relevant to RA on Methotrexate. I will try our medical library database at work and discuss with GP. I don't think I could cope with an infection post getting over tkr. I know antibiotics are over used but sort of feel better to have them for my dental work.

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