Traditionally, antibiotics have been provided before dental procedures in patients with orthopaedic implants to minimize the bacteria that get into the blood. Best evidence, however, does not show that antibiotics provided before oral care help prevent infections of orthopaedic implants. The routine use of antibiotics in this manner has potential side effects, such as increased bacterial resistance, allergic reactions, and diarrhea, and may even cause death.

Patients who are immune-compromised might wish to consider antibiotics before dental procedures because of their greater risk for infection in patients with prosthetic joint implants, a January 2015 ADA clinical practice guideline states: “In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.”

Decisions with regard to antibiotic premedication should be made by patients, dentists, and physicians in a context of open communication and informed consent.