Antibiotics and Dental Treatment

1I have a joint replacement. Do I need to take an antibiotic before dental treatment?

This is a confusing topic because the guidelines have changed several times. Based on the most recent studies, there is no association between receiving invasive dental treatment and developing prosthetic joint infections. Additionally, most prosthetic joint infections are not caused by oral bacteria. Given this information, for most people with joint replacements, prophylactic antibiotics are not recommended. In other countries that do not promote antibiotic prophylaxis (the UK, Australia, and others), studies do not show any significant increase in the amount of prosthetic joint infections. Given the lack of evidence showing that dental work causes joint infections, it is no longer recommended to take antibiotics prior to dental work in patients with prosthetic joints.

This article does a great job explaining this subject: Rethinking antibiotic prophylaxis for patients with prosthetic joints

2My orthopedic surgeon told me to take a pre-med for life.
Many patients have joints that were replaced many years ago, when the guidelines still recommended taking antibiotics prior to dental procedures. Since the guidelines have changed, it would be wise to reach out to your surgeon and see if their recommendations have also changed. Occasionally, surgeons will recommend that you continue taking your antibiotic. In this case, it is up to them to prescribe you this antibiotic if they deem it necessary.
3It doesn’t hurt to take antibiotics, so I’m just going to keep taking them.

Although antibiotics can help prevent infections, taking them unnecessarily can have negative consequences. The more often antibiotics are used, the more likely it is for bacteria to develop resistance against these medications. With higher bacterial resistance, antibiotics become less effective and over time we will start seeing more cases of antibiotic-resistant bacterial infections, which are very difficult to treat.

There are many other negative side effects from taking antibiotics including skin rash, yeast infections, upset stomach/diarrhea, and in some cases, C.diff infections. C. diff causes an intestinal infection that can lead to dehydration and, in extreme cases, death.

Therefore, it is prudent that we reserve antibiotic use only when absolutely necessary. Since studies have not shown any benefit to taking prophylactic antibiotics when it comes to prosthetic joint infections, they are not necessary prior to dental appointments.

Oral Probiotics

1What are Probiotics?
Probiotics are a type of supplement that provide populations of live, healthy bacteria in an effort to stop pathogenic bacteria from causing disease.
2How do they help?
Our bodies are full of bacteria. Disease occurs when the pathogenic (“bad”) bacteria start outnumbering the healthy bacteria. In our mouths, there are many different types of “bad” bacteria that can cause cavities, gum disease, bad breath, and other problems. By populating our mouth with more of the “good” bacteria, we can help outnumber these bad bacteria before they have the ability to cause any of these problems. Studies are showing that taking an oral probiotic once a day can help with getting whiter teeth, better breath, and prevent cavities and gum disease.
3I already take a gut probiotic, is that enough?

Gut probiotics are carefully formulated with specific types of bacteria that are beneficial in the stomach and elsewhere in the digestive tract. In the mouth, studies have found 3 specific bacteria to be the most beneficial in competing with the bacteria that cause oral disease. Additionally, because we want the bacteria to be released in the mouth, oral probiotics are meant to be dissolved in the mouth, instead of swallowed (like gut probiotics).

Our office now provides oral probiotics from Probiora Health®. Their products are soy-free, wheat-free, nut-free, and gluten-free. Please ask us about it at your next visit, or feel free to place an online order by scanning the QR code below or clicking here .