Dental clearance prior to elective arthroplasty may not be needed for everyone

J Arthroplasty. 2014 Sep;29(9):1729-32. doi: 10.1016/j.arth.2014.04.018. Epub 2014 Apr 24.


We investigated the prevalence and risk factors for preoperative dental clearance failure in joint arthroplasty patients. Over a 5-month period, all patients scheduling total joint arthroplasty completed a dental questionnaire. Data collected included demographics, medical and dental history, dental hygiene practices, frequency of dental care, and results of dental clearance. Of the 300 patients, 35 (12%) failed dental clearance. Risk factors included tobacco use, poor flossing habits, history of tooth extraction, age, narcotic use, and lack of a dentist visit within 12 months. Of 189 patients who lacked the 3 least prevalent risk factors (tobacco use, narcotic use, no dental visit within 12 months), 11 (6%) failed dental clearance. Selective dental clearance based on patient risk stratification may be a reasonable approach.

Keywords: dental clearance; total hip arthroplasty; total joint arthroplasty; total joint revision; total knee arthroplasty.

MeSH terms

  • Aged
  • Alcohol Drinking / epidemiology
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Elective Surgical Procedures
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oral Hygiene / statistics & numerical data*
  • Preoperative Care / statistics & numerical data*
  • Prevalence
  • Retrospective Studies
  • Risk Assessment / methods
  • Risk Factors
  • Smoking / epidemiology
  • Stomatognathic Diseases / epidemiology*
  • Stomatognathic Diseases / prevention & control
  • Surveys and Questionnaires
  • Unnecessary Procedures*