By Dr. Paul Donohue
Dear Dr. Donohue: After 30 years of going to one dentist, my wife and I changed for convenience.
We made an appointment for teeth cleaning. In the forms that had to be filled out, my wife listed
her hip replacement and my knee replacement, both 15 to 20 years ago. The dentist refused to
clean our teeth until we took antibiotics before the visit. We haven’t done this in the past 20 years.
Did you ever hear of this?
Have you ever heard of endocarditis? It’s a heart and heart valve infection. People with a damaged
heart valve or with an artificial heart valve take antibiotics before dental procedures that cause bleeding.
In those procedures, mouth bacteria can get into the blood, and they home in on those valves.
Antibiotics afford protection.
A similar situation holds for artificial joints. The fear is that mouth bacteria can home in on the new joint,
causing an infection that’s hard to treat and may require joint removal.
However, there is a revision of thinking. In the United States, about half a million artificial joints are
implanted yearly. Multiply that number by the number of years this kind of surgery has been done
and you come up with a huge figure. Since the first artificial joint was replaced, there have been
only 25 cases of artificial joint infection after dental work. Many doctors feel that the potential
danger of antibiotics is greater than the minuscule chance of joint infection.