AAOS Appropriate Use Criteria: Management of Patients with Orthopaedic Implants Undergoing Dental Procedures

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Little evidence exists on the use of antibiotics as infection prophylaxis before dental procedures in patients with orthopaedic implants, and the topic remains controversial 5 years after the publication of the collaborative Clinical Practice Guideline published by the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association.1 Although the simple daily act of toothbrushing can result in transient bacteremia, prosthetic infection develops in few orthopaedic patients even if they are not undergoing a course of antibiotics. Concern persists in the medical community that dental procedures may cause hematogenous infection in patients with periprosthetic joint implants. Because we have as yet insufficient evidence of the need for prophylaxis, the AAOS Appropriate Use Criteria (AUC) document Management of Patients with Orthopaedic Implants Undergoing Dental Procedures functions as a shared decision-making tool to assist surgeons, dentists, and patients in determining when it is appropriate to pursue the administration of prophylactic antibiotic treatment.
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