If you're planning to undergo joint replacement surgery, there's an important step you might not have considered: visiting your dentist or oral surgeon. While it may seem unrelated, your oral health can significantly impact the success of your joint surgery.
“The American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA) both recommend that patients undergoing joint replacement surgery should receive a dental clearance before their procedure,” explains the American Academy for Oral Systemic Health (AAOSH), a non-profit dedicated to awareness of the relationship between oral and whole-body health. “This clearance involves a comprehensive dental examination to identify and treat any existing oral infections, particularly periodontal disease, which could pose a risk for postoperative complications.”
At Northwest Oral & Maxillofacial Surgery, we want to ensure you're fully prepared for your upcoming procedure. Let's explore why dental clearance is essential before joint replacement and what you need to know.
Joint replacement surgeries are common procedures, with over one million performed annually in the United States.
“About 790,000 total knee replacements and 544,000 hip replacements are done every year in the U.S. This number continues to grow as our population ages,” says the American College of Rheumatology.
While generally successful, about 1 in 10 will require revision due to complications, including infections.
“Modern hip and knee implants are better than ever. For most patients, they will function well for at least 20 to 30 years,” says UCI Health. “However, about 10 percent of all implants will fail, requiring a second procedure. In this procedure, called a revision, the old joint is removed and replaced with a new one.”
Post-surgical complications, including infections, can lead to revision procedures. One often overlooked factor contributing to these infections is periodontal disease.
Characterized by chronic bacterial infection and inflammation of the gums, periodontal disease can have far-reaching effects on your overall health.
“The bacteria responsible for periodontal disease can enter the bloodstream, leading to bacteremia, and potentially seed remote sites, such as prosthetic joints,” says the AAOSH. “This systemic spread of bacteria, particularly in immunocompromised or elderly patients, can result in prosthetic joint infections (PJIs), among the most devastating complications of joint replacement surgery.”
A dental exam before surgery helps rule out dental abscesses, infections, or gum disease. These conditions, if left untreated, could lead to bacteria entering your bloodstream and causing complications in your surgical area.
“A pre-surgical dental clearance is not merely a formality but a critical step in the preoperative planning process. Periodontal infections, even without apparent symptoms, can be insidious and may remain undetected without a thorough examination,” says the AAOSH.
While periodontal disease is often detected by the presence of bleeding gums, it can also be asymptomatic, making it difficult for those about to undergo joint replacement to understand the severity of their condition.
Neglecting your oral health before joint replacement surgery can lead to severe complications.
“Once bacteria from an oral infection reach the prosthetic joint, they can cause a deep joint infection, which is challenging to treat and often necessitates surgical revision. These infections lead to prolonged recovery times and increased healthcare costs and significantly impact the patient’s quality of life,” says the AAOSH.
A study published in the British Medical Journal in 1994 highlighted that the mouth is a principal source of bacterial infection in patients with prosthetic joints. Numerous studies since then have reinforced this link between oral health and PJIs.
When you visit your dentist for pre-surgical clearance, they will perform a thorough examination to detect any potential issues. This may include:
If any issues are found, your dentist will work with you to resolve them before your surgery. This might involve treating gum disease, filling cavities, or even extracting problematic teeth.
You should schedule your dental clearance as soon as you know you'll be having joint replacement surgery.
Many orthopedic surgeons require that dental work be done at least four weeks before hip or knee replacement surgery. This timeline allows for proper healing and ensures that any dental issues are fully resolved before your procedure.
It's also important to note that you should avoid routine dental cleanings for at least three months after surgery.
If you need urgent dental work within this timeframe, consult with your surgeon first.
Maintaining good oral health remains crucial even after your joint replacement surgery. The AAOS recommends that patients who have undergone joint replacement take prophylactic antibiotics before future dental procedures to reduce the risk of infection.
“However, the decision to use antibiotic prophylaxis should be made on a case-by-case basis, in consultation with the patient’s dentist and orthopedic surgeon, to balance the benefits against potential risks such as antibiotic resistance,” says the AAOSH.
At Northwest Oral & Maxillofacial Surgery, we play a vital role in ensuring your readiness for joint replacement surgery. Our experienced team can:
Don't underestimate the importance of your oral health when preparing for joint replacement surgery.
A simple dental visit could be the key to ensuring a successful procedure and smooth recovery. At Northwest Oral & Maxillofacial Surgery, we're committed to providing the care you need to approach your surgery with confidence.
Contact Northwest Oral & Maxillofacial Surgery today for comprehensive care with your referring dentist to ensure your oral health is optimized for your upcoming joint replacement surgery.