Antibiotic Prophylaxis in Patients with Orthopedic Implants Undergoing Dental Procedures: A Review of Clinical Effectiveness, Safety, and Guidelines [Internet]

Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2016 Feb 17.


Oral antibiotics are often used prophylactically in patients undergoing invasive dental procedures, with the aim of preventing oral bacteria from entering the bloodstream, and causing serious complications due to infection among susceptible patients.

Patients with prosthetic joints have historically been prescribed antibiotics prior to dental procedures. A 2014 survey found that 71% of Canadian dentists and 77% of orthopedic surgeons routinely prescribed prophylactic antibiotics for patients with total join arthroplasty prior to dental procedures. While this practice has been commonplace, it has been carried out with little supporting clinical evidence. Individuals who have undergone total joint replacement are considered to be at a generally higher risk of developing infection. Given the frequency with which dental procedures are performed, the potential for antimicrobial resistance, and potential cost, clinical effectiveness should be demonstrated.

The present review was conducted as an update to a 2013 CADTH Rapid Response report on the same topic. The 2013 report identified one guideline that recommended practitioners could consider ceasing the routine use of antibiotics prior to dental procedures for patients with prosthetic joints. This review will seek to identify any recently published clinical evidence for the prophylactic use of oral antibiotics during dental procedures in patients with orthopedic implants and to review current evidence-based guideline recommendations for this patient group.

Publication types

  • Review