Dental Scaling: The Bee’s Knees

bees drawn on kneesIt’s hard to believe knee replacement surgery is only about 50 years old. That seems a relatively short track record for a procedure now considered common. Here in the US, more than 600,000 replacements are done every year!

Knee replacement offers hope for pain relief and better daily functioning. But like any surgical procedure, there can be risks. Though rare, post-surgical infections can be devastating.

Yet a new study points toward a successful way to address it – regular appointments for dental hygiene. In fact, it might even offer more protection against infection than premedication with antibiotics.

Yes, you read that right.

Analyzing data from 1291 Taiwanese patients who had undergone knee replacement, researchers found that risk of infection was 20% lower for patients who had a dental scaling at least once within three years than for those who did not.

The risk of infection dropped by 31% among those who had scaling twice a year – the recommended frequency.

These results are particularly important for patients with knee replacement and dental disease. Patients with periodontal disease were found to have more bacteria in their blood after brushing their teeth than those with healthier gums.

Oral bacteria can enter the blood stream through dental treatments, as well. Exposure to pathogens in this way is linked with a risk of infection in total knee replacement patients.

But if you’ve had your knees – or any other joint – replaced, this may not seem like news. After all, you’ve been warned of this risk. You’ve also heard about or taken prophylactic antibiotics before your dental appointments. These are used as a premedication to prevent infection caused by bacteria in the mouth.

But if you haven’t had a dental cleaning in a while and are relying on that premed to protect you from infection, this research indicates there might be a better strategy.

Another important point, especially if it’s been awhile since surgery: Don’t assume your premedication recommendations have stayed the same. Recommendations can – and do – change.

While the ADA now considers premedication unnecessary for most people, the American Academy of Orthopedic Surgeons still recommends it for any procedure that may cause bacterial exposure from a secondary source.

That, of course, includes dental appointments.

Bottom line is this, if you want to keep the “Bee’s Knees” post-surgery, it’s best to

  • Consult periodically with your orthopedic surgeon on appropriate recommendations for prophylactic antibiotics.
  • Maintain routine hygiene visits at least twice a year. These appointments help control pathogenic – and potentially problematic – bacteria associated with infections.

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