THR No dentist approval needed before Hip replacement ?

Jason11

junior member
Joined
Nov 6, 2021
Messages
45
Age
66
Country
United States United States
Gender
Male
I talked with the hip surgeon scheduler today, and I got my date for a hip replacement . ( October 17 ). The scheduler was explaining I need to get some test , and I would need my Primary doctor to give his ok for the surgery, I am seeing one other doctor for a skin condition, and she asked me if I wanted to see that doctor too , before I had hip surgery, and I said yes. Then I asked about seeing my dentist , and she said it was not necessary, unless i was having problems with my teeth.

Is this normal ? anyone else that does not need to see their dentist before hip surgery.? I already know I am going to see him anyway. I have had the same dentist for 30 years.

Only dental instruction's I have received, is no dental procedures 6 weeks before surgery and 3 months after surgery . When I talked with the surgeon he even told me I did not have to take any antibiotic's before seeing a dentist. Now I am looking at the paperwork they gave me and in the paperwork it says antibiotics before dental procedures for life.

Thanks for reading.
 
This subject is a huge debate. I was never told to see my dentist before my surgery, and nothing was said about antibiotics after my joint replacement. I didn’t know about this issue until after I joined Bonesmart and read about it here. Not all dentists and surgeons require the antibiotics, though it seems most do.

I am opposed to taking an antibiotic, for me, when I am not sick, so I searched and found a dentist who does not believe they are necessary after joint replacement, and in the 5 years since my surgery I have never taken them, and never had a problem.

I will add, that the only dental work I‘ve had in the last 5 years is basic cleaning, and redoing an old cavity, so nothing more extensive.

Do your own research and make the decision you are comfortable with. You can google the statement “antibiotics with dental procedures after joint replacement” and read what the American Dental Association ( ADA) and the American Academy of Orthopaedic Surgeons (AAOS) has to say.

We also have the following article in the Bonesmart library. It is long, you can scroll down to post #4.
 
@Jason11 It can be so confusing when you get different information from different sources! I know I had to get dental clearance prior to each of my surgeries. That requirement does seem to vary from place to place or doctor to doctor.

And from my HMO the requirement about antibiotics before dental procedures changed over the years. With the hips it was take them before any dental procedure for 2 years. And with the right shoulder ( 2 years after the hips) it was take them for one year. And with the left shoulder (4 years after the right one) it was "nope you don't need to take them".

I think you need to do what ever your surgeon and your dentist say to do. If your teeth are in pretty good shape and the chances of you needing any major dental procedures is slim .... then you probably don't need antibiotics .... but that is just my guess and I am neither a physician nor a dentist.
 
I had no requirement to see the dentist before surgery, but had a scheduled cleaning and check up beforehand; it was also before my pre op labs, so any sign of new infection would have been caught by the bloodwork.
My OS says antibiotics before any dental work from now on.
Both the dental office and the OS office are willing to phone in the prescription for me; I chose the dental office's offer because they'll do it prior to appointments without me having to call them. I'd have to call the OS office, just another link in the chain to mess up.
It's no big deal to me. I trust the OS's opinion because he's seen thousands of THR patients and the after effects. The prescription is for a common antibiotic, costs a couple bucks, just one dose the day of dental work.
 
I do the regular 6 mos dental exams and the OS only asked if I had any dental problems. My OS recommends the antibiotics before dental work so I stick to it, and the OS and the paperwork were very clear about it. In your case with conflicting paperwork from what your OS said I'd be contacting them and wanting the confusion cleared up. Good chance the OS changed his policy and the paperwork was never updated.
I see the antibiotics as no big deal and I'll continue to take them as a precaution. The way I look at it is I'm the one that will suffer the consequences of the infection.
 
@djklaugh , I have the same HMO as you (Kaiser Permanente). My bilateral hip replacement surgery, 11 weeks ago, did require a dental clearance. I go every 6 months like clockwork.

Also, Kaiser’s requirement for antibiotics after THR is none required for routine dental work. Not necessary, which backs up the recent research.

I think antibiotics have always been prescribed for extensive dental work, like an implant.
 
@Jason11 After I had a TKR July 2021, my then OS confirmed what my dentist had said; that I need to take an antiobotic an hour before any dental procedure, so I did so when I had my teeth cleaned in January. I was supposed to have my teeth cleaned in July, but I thought I was supposed to wait for three months after my last THR, which was June 27. So I scheduled my routine cleaning for more than three months after. But my now OS said it is not necessary to take antiobiotics before any medical or dental procedure. And he said I don't need to wait until three months after surgery for any of the routine medical things that I have postponed. So I'm gong to be quite busy catching up.

I agree it is probably best to do what the OS recommends. But if one feels more confident taking an antiobotic and the dentist will prescribe it, why not. Unless one has an aversion to taking antiobotics, which I also understand.
 
I followed the protocol described here regarding dental appts prior to surgery and took antibiotics before dental visits after my THR. I kept it up until four years after my THR when both OS and dentist said it was long enough. I’ll wait to hear from my OS what his recommendation is now as it’s been eight years since my first THR. Lots has changed so I’ll update when I find out.
 
It’s very surgeon specific. The big thing I was told for mine and keep reading here as well, is if you do need dental care is to do it 6-8 weeks BEFORE surgery so that you have time to heal and lower the risk of infection. I find it more strange that they are replying on your family doctor to give the ok for surgery. The surgeon should be along with the docs of the pre-admission clinic. It’s actually the first time that I have ever read that. I think your team is being very cautious and there is nothing wrong with that.
 
When I talked with the surgeon he even told me I did not have to take any antibiotic's before seeing a dentist. Now I am looking at the paperwork they gave me and in the paperwork it says antibiotics before dental procedures for life.
After my knee surgery, the surgeon gave me an antibiotic to take an hour before my teeth were to be cleaned. When I arrived, the hygienist checked to make certain I had taken an antibiotic.

When I meet with my hip surgeon for my six weeks checkup after my left THR, I asked how long I needed to wait to have my teeth cleaned, have a colonoscopy, get a pedicure, and all the other things I had put off because I thought I was supposed to wait at least three months after surgery to have them done. He said I didn't need to wait any longer. I could have any of them done whenever I wanted. I was surprised, but pleased.

I asked for an antibiotic prescription since I was going to have my teeth cleaned. He said that I didn't need to take antibiotics for dental procedures or anything else. He said that procedure has been followed for a long time, but when he is at national meetings, the general consensus (of the surgeons) is that it is not necessary. It obviously varies from surgeon to surgeon, but I'll do what my hip surgeon advocates.

When I had my teeth cleaned after that appointment, the hygienist called the dentist to make certain that he would approve her cleaning my teeth without an antibiotic. When she told him my surgeon said I didn't need an antibiotic, he approved her proceeding.
 
Last edited:

BoneSmart #1 Best Blog

Staff online

  • Jaycey
    ADMINISTRATOR Staff member since February 2011

Members online

Forum statistics

Threads
65,167
Messages
1,596,864
BoneSmarties
39,356
Latest member
JanieMarie
Recent bookmarks
0
Back
Top Bottom