Antibiotic prophylaxis for dental procedures at risk of causing bacteremia among post-total joint arthroplasty patients: a survey of Canadian orthopaedic surgeons and dental surgeons

J Arthroplasty. 2014 Jun;29(6):1091-7. doi: 10.1016/j.arth.2013.11.024. Epub 2013 Dec 2.


To elicit current practice and attitudes toward use of antibiotic-prophylaxis among TJA patients prior to dental procedures, a cross-sectional survey of practicing Canadian orthopaedic (OS) and dental surgeons (DS) was undertaken. Of respondents, 77% of OS and 71% of DS routinely prescribe antibiotic-prophylaxis, but while 63% of OS advocate lifelong use, only 22% of DS choose to do so (P<0.0001). Both groups nonetheless recognize the importance of treatment within 2-years post-TJA as per AAOS/ADA guidelines. However, greater duration of practice pointed to potential inadequacy of these guidelines based on reported experience with late-hematogenous infection post-TJA. While discrepancies in attitude toward antibiotic-prophylaxis between surgeon groups remain, both groups agreed that the evidence to support decision making regarding antibiotic-prophylaxis for TJA patients undergoing dental procedures remains inadequate.

Keywords: antibiotic prophylaxis; bacteremia; dental; dental surgeons; orthopedic surgeons; survey; total joint arthroplasty.

MeSH terms

  • Antibiotic Prophylaxis*
  • Arthroplasty, Replacement*
  • Bacteremia / etiology
  • Bacteremia / prevention & control*
  • Cross-Sectional Studies
  • Dental Care / adverse effects*
  • Health Care Surveys
  • Humans
  • Prosthesis-Related Infections / etiology
  • Prosthesis-Related Infections / prevention & control*