There has been debate for years about whether or not antibiotics should be given to patients who have had a hip replcement, and who then need dental treatment. My advice has been to take a broad spectrum antibiotic such as augmentin if you are to have an extraction, or treatment of an abscess. Routine dental treatment such as a filling or scale and polish doesn’t require any prophylactic antibiotics. Recent statements from the American Academy of Orthopaedic Surgeons and NICE suggest that there is no evidence that antibiotics make any difference to the risk of developing a joint replacement infection. I’ve attached a summary of the relevant article for information. If you are in doubt, speak to your surgeon and dentist (or me!) Good oral hygiene is essential in patients with joint replacements and I advise my patients to see a dentist if they haven’t had a check up for a year before undergoing surgery.

‘The new AAOS-ADA guideline, Prevention of Orthopaedic ImplantInfection in Patients Undergoing Dental Procedures, addresses the weaknesses of previous efforts with an exhaustive systematic review of available evidence. Similar to previously published guidelines, the work group identified the need for further research in this area to provide clear evidence regarding the correlation between dental procedures and PJI in patients with orthopaedic implants. Evidence-based practice incorporates three components: scientific evidence, the clinician’s experience, and the patient’s values. Therefore, this CPG is not meant as a stand-alone document; rather, all three of these elements should be incorporated into the decision-making process in an effort to improve patient care. Physicians, dentists, and patients should work collaboratively to customize a treatment plan that is based on the evidence, clinical judgment, and patient preferences.’