dental cleanings?

[Guest guest]

Actually, now I am shocked, when I did an internet search on dental cleaning, antibiotics, the first few results were about breast implants! It seems as if there is some concern about this, (though some want to downplay it for sure.) I've listed some of the first links that came up, along with this important warning that I think we need to heed.

http://dr-dowden.com/faqs/impldent.html

http://www.breastimplants411.com/forum/topic.asp?TOPIC_ID=4417

http://www.info-implants.com/ALB/0037.html

http://implants.clic.net/tony/Corner/H/0418.html

http://hipuniverse.homestead.com/files/Dental.htm

Antibiotics before Dental Care

Microbiologists have shown that, during a proper tooth cleaning in a healthy mouth, bacteria that normally live just under the gums are released into the bloodstream (bacteremia). Germs released from the gums—or from an untreated infection elsewhere in the body, such as a cut or bladder infection—can find their way to an artificial joint (hematogenous dissemination) and attach themselves to the metal, forming a colony. As the colony grows, it forms a scum (glycocalyx) on the metal, which is impervious to the immune system and antibiotics, even intravenous antibiotics. The bacterial colony then serves as a “toxic dump” that continually infects and re-infects the surrounding bone (periprosthetic infection).[1]

An implant is a sitting duck for such colonization, especially during the first two years after surgery, because it is not living tissue—it has no blood vessels carrying white blood cells to fight infection. After about two years, bone and fibrous tissues have grown onto the implant and brought white blood cells closer. So, a clean implant becomes less hospitable for traveling bacteria by about two years post-op.

For those reasons, the American Academy of Orthopedic Surgeons and American Dental Association (AAOS and ADA) classify routine dental cleaning as a “high risk” procedure. They recommend that patients planning implant surgery should complete any needed dental work before surgery, to be sure the mouth is healthy and as free as possible from bacteria. Patients with an artificial hip or knee should then maintain scrupulous oral hygiene and take prescribed antibiotics one hour before dental cleaning, for the first two years after joint replacement—and even later, for certain high-risk patients. The Advisory Statement: Antibiotic Prophylaxis for Dental Patients with Total Joint Replacements can be printed out and discussed with your surgeon and dentist.

If the pills bother your stomach, take them with as much water as you can hold—at least a quart. Warn the hygienist you’ll probably need to interrupt her work for a trip to the bathroom.

beth -Matej

February, 2003

[1] Acute metastatic infection of a revision total hip arthroplasty with oral bacteria after noninvasive dental treatment. Kaar TK, Bogoch ER, Devlin HR. J Arthroplasty 2000 Aug;15(5):675-8