[Dental care of patients with organ transplants or prosthetic joints--a survey of specialty hospitals].
ABSTRACT The aim of the investigation was to collect information from specialized hospitals regarding dental care before and after organ transplantation or replacement of prosthetic joints. 50 transplantation centres and 100 orthopaedic hospitals in Germany were chosen. A questionnaire was used to elucidate the following aspects: Is a dental examination carried out preoperatively? When the patient is discharged, is he or she recommended to have antibiotic prophylaxis before dental treatment? If so, which antibiotic is recommended? The response rate was 56% (n = 28) for transplantation centres. 89% arranged a dental examination before the transplantation. 83% of those questioned recommend antibiotic prophylaxis before dental treatment: Amoxicillin was mentioned most frequently (36%). The response rate of the orthopaedic hospitals was 31% (n = 31). 3% of those questioned arranged a dental examination before insertion of an endoprothesis. 55% recommend antibiotic prophylaxis when dental treatment is to be carried out following the insertion of the endoprosthesis. Cephalosporine was most frequently mentioned (33%). It was not possible to identify a uniform recommendation regarding dental care before and after organ transplantation or replacement of prosthetic joints either for patients with an organ transplant or those having a prosthetic joint.
[Show abstract] [Hide abstract]
ABSTRACT: ➤ The number of patients with end-stage osteoarthritis is increasing, and treatment with hip and knee arthroplasty is expected to increase over the next several decades.➤ Dental disease has long been anecdotally associated with increased periprosthetic joint infections, although case-control studies do not support this relationship.➤ While most recent guidelines for the prevention of endocarditis have favored treatment of fewer patients, the most recent recommendations for prevention of periprosthetic joint infection have increased the number of patients who would receive antibiotics before a dental procedure.➤ Antibiotics given before a dental procedure decrease the risk of bacteremia from the oral cavity, but this is of uncertain clinical importance.➤ The number of patients who would require antibiotics before dental procedures to prevent one periprosthetic joint infection greatly outnumbers the number of patients who would experience an adverse event associated with antibiotics given before a dental procedure.The Journal of Bone and Joint Surgery 01/2014; 96(2):162-8. DOI:10.2106/JBJS.L.01379 · 4.31 Impact Factor