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JADA commentary addresses antibiotic use for dental patients with joint implants

January 31, 2017

By Michelle Manchir

Only in very few situations are prophylactic antibiotics recommended to prevent joint infection for patients with prosthetic joint implants prior to dental procedures, according to commentary published in the February 2017 issue of The Journal of the American Dental Association.

The article, written by ADA-appointed experts, offers guidance for using appropriate use criteria published by the American Academy of Orthopaedic Surgeons in January that address managing care for patients with orthopedic implants undergoing dental procedures. The criteria, developed by the American Academy of Orthopaedic Surgeons in conjunction with ADA Council on Scientific Affairs volunteers, were published in The Journal of Bone and Joint Surgery.

While the appropriate use criteria may be useful in certain scenarios, the guest editorial in February JADA encourages dentists to continue to use evidence-based clinical practice guidelines that the ADA Council on Scientific Affairs developed in 2015 on the use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints.

As stated in the 2015 guidelines, data shows no association between dental procedures and prosthetic joint infections, so there is no scientific base for suggesting efficacy in using antibiotics to prevent the infections.

The editorial calls the appropriate use criteria "a decision-support tool to supplement clinicians in their judgment" and it emphasizes discussion of available treatment options between the patient, dentist and orthopedic surgeon, weighing the potential risks and benefits.

 "The ADA Council on Scientific Affairs and ADA-appointed expert panel members encourage dental health care professionals to continue to use the 2015 ADA clinical practice guideline, consult the appropriate use criteria as needed and respect the patient's specific needs and preferences when considering antibiotic prophylaxis before dental treatment," the editorial says.
 
To read the commentary in February JADA, visit JADA.ADA.org.