Guidelines issued to prevent infection with dental work

(HealthDay)—Practitioners might consider discontinuing prophylactic antibiotics for patients with prosthetic implants undergoing dental procedures, and these patients should be encouraged to maintain appropriate oral hygiene, according to clinical practice guidelines approved by the American Academy of Orthopaedic Surgeons (AAOS) and published in the April 17 issue of The Journal of Bone & Joint Surgery.

Michael P. Rethman, D.D.S., from the AAOS, and colleagues reviewed the available literature and developed evidence-based guidelines together with the American Dental Association. A shared decision-making tool to be used by both orthopedic surgeons and dentists was also developed to be used in conjunction with the guidelines.

According to the guidelines, based on low-quality evidence, practitioners may consider suspending the practice of routinely prescribing prophylactic antibiotics for patients with hip and knee prosthetic joint implants who are undergoing dental procedures. The evidence remains inconclusive regarding the use of topical oral antimicrobials in patients with prosthetic joint or other orthopedic implants who are undergoing dental procedures. In the absence of reliable evidence linking oral health with prosthetic joint infection, experts support the recommendation that patients with prosthetic joint implants or other orthopedic implants should maintain appropriate oral hygiene.

"This guideline is an educational tool to guide clinicians through treatment decisions in an effort to improve the quality and effectiveness of care," the authors write. "This guideline should not be construed as including all proper methods of care or excluding methods of care reasonably directed to obtaining the same results."

Several authors disclosed financial ties to the pharmaceutical and dental health industries.