Hi there. Having been away for ten days I'm now catching up a bit, although I don't seem to have as much time for being on the computer now - I am too well!!!
I seem to remember having this same query after my first TKR but before my second, and it is still not resolved. When I was originally told the only option to sort out my knees was two TKRs, I was given a little booklet written by the 'boss' consultant at the local hospital, and that definitely said we should take antibiotics before any dental treatment, including teeth cleaning, fof the rest of our lives.
After the first TKR I had an appointment to have my teeth cleaned. At my six week check with my consultant I was told that the advice had now changed, and it was up to the individual as to whether or not to take antibiotics, but to discuss it with the dentist. Before I went to the dentist I thought I'd see what my GP said. He is married to a dentist - he didn't know what the latest advice was but said he's ask his wife and get back to me. He phoned me later and said it was probably advisable for things like root canal treatment or an extraction, but teeth cleaning was a very 'grey' area. I then asked my dentist, who said his latest advice was that it wasn't necessary for teeth cleaning unless the OS said it was - i.e. only necessary for patients with particular problems.
I therefore went ahead and had my teeth cleaned without taking any antibiotics. I don't think much, if any, bleeding went on. Thankfully, as far as I am aware, I have had no ill effects, but it is a worry. I have now postponed my next teeth cleaning session, as I reckon the longer the time after the operation, the less risk there would be - although that might well not be true! I am one of those people who won't take anything unnatural if I can help it. I don't even like taking painkillers, although with my TKRs I have given in to that!
So, what is the best? The book that my GP showed me -possibly the latest NICE book that Brian and Jo have mentioned - contained information about all the latest advice for GPs etc. It certainly said that there was no evidence that antibiotics were needed for dental treatment, and therefore they would not advise taking them. Too many antibiotics are not a good idea.
I have a neighbour who had a TKR several years ago. She was never even advised to take antibiotics before any dental treatment, and was very surprised when I showed her my booket. She has never taken any before treatment.
I wish someone would sort this problem out for us all!!!