Dental Antibiotics after TKR

Posted by doodles418 @doodles418, Mon, May 6 8:03am

I have read that many of you take antibiotics before any dental work. I want to get back to my dental cleanings, I'm 4 months post-op from bilateral. My OS said he doesn't believe in prescribing antibiotics for dental work, but my dentist said it's the first he's heard of a DR not prescribing and would want my OS to put that in writing for him before he would do any work. Now I'm wondering what's the harm of taking them before dental work? An ounce of prevention…thanks for any replies to this.

I had a partial replacement and needed to wait 6 months after surgery before I could go to the dentist for a cleaning, and needed to do antibiotics prior.

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@kibe75

I had a partial replacement and needed to wait 6 months after surgery before I could go to the dentist for a cleaning, and needed to do antibiotics prior.

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Thanks for your reply. It will be interesting to see if anyone was told "no antibiotics and to wait 3 months before dental work", from my OS.

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@doodles418 I had been taking antibiotics (amoxicillin) prior to dental cleanings (TKR was in 10/2017) but the Rx ran out recently and the dentist needed to know what my doctor wanted me to do. I had been told to wait 6 months after the TKR, and to take antibiotics after that. Some doctors say for two years. My ortho surgeon wants me to do that for life. He said to call him when I run out and he will prescribe. My dentist said if he will give them a letter that he wants that they will write the prescriptions.
I actually called my transplant surgeon first because I figured if anyone wanted me to be on antibiotics prior to work being done it would be him. He does not find it necessary but since I expressed that I would be more comfortable taking an antibiotic he prescribed them, saying there was no harm in doing so.
I think they all have their own ideas about what is necessary. I know there is concern these days about people taking antibiotics too much, rendering them less effective, but I doubt that taking them two times a year would cause a problem.
JK

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@contentandwell

@doodles418 I had been taking antibiotics (amoxicillin) prior to dental cleanings (TKR was in 10/2017) but the Rx ran out recently and the dentist needed to know what my doctor wanted me to do. I had been told to wait 6 months after the TKR, and to take antibiotics after that. Some doctors say for two years. My ortho surgeon wants me to do that for life. He said to call him when I run out and he will prescribe. My dentist said if he will give them a letter that he wants that they will write the prescriptions.
I actually called my transplant surgeon first because I figured if anyone wanted me to be on antibiotics prior to work being done it would be him. He does not find it necessary but since I expressed that I would be more comfortable taking an antibiotic he prescribed them, saying there was no harm in doing so.
I think they all have their own ideas about what is necessary. I know there is concern these days about people taking antibiotics too much, rendering them less effective, but I doubt that taking them two times a year would cause a problem.
JK

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I'm not one that has had a lot of antibiotic use over the years but I think I will request that he writes the prescription for this. And I'm not comfortable with the 3 months so I will extend to 6 months

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Hi @doodles418 – Like some of the others, my surgeon asked me to wait 6 months after the surgery to have a dental cleaning. After that, he wants me to take antibiotics before dental cleaning for the rest of my life. It's not a lot – just 4 amoxicillin capsules prior to each cleaning. I'm kind of opposite of you – my surgeon wants me to do it, but my dentist says there is no need for it. I do it anyway! Good luck in sorting this out.

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I work in a dental office and have a TKR. There has been alot of back and forth on this issue forever! The orthopedic surgeons are the ones who "make the call" but then leave it up to the dentists to explain and administer the protocol. Currently, around here, we are told to wait 3 months for any invasive procedures (definitely including cleanings!) and then take 2 grams Amoxicillin (assuming no allergy) 1 hour prior to therapy and continue that for life. The unmedicated risk is that bacteria from your mouth is released into the bloodstream which targets the artificial joint. There are always risks with taking any medication and that's why some don't want to do it. (Example: new allergic reaction, GI issues, etc.) I had a cleaning right before my surgery so I didn't have to think about it for 6 months. Someone on a more frequent cleaning schedule (Example: 3-4 month recall) or someone with poor oral hygiene probably can't wait that long and has a higher risk for said bacteria. Clear as mud, isn't it??

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I have had two TKR (2015 and 2018). Both successful and not a bad experience (although will have a sore spot checked this week). First surgeon said take for life. Second surgeon said take for 2 or 3 years. Four 500 MG Amoxicillin pills. Since I always seem to have lots of dental work (implants, crowns), I will probably take for life unless new research indicates otherwise. Even though I take excellent care of teeth, I now have an abscess (not painful; no problem) and doctors are after me to get rid of it – probably root canal.

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Hi @doodles418 I had my right TKR last May and my surgeon made it very clear that I would have to take an antibiotic before any dental procedure for the rest of my life. He even sent instructions to my dentist. I take 2000 mgs of amoxicillin an hour before my appointments.

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Be careful. I had a reaction to amoxicillin and it attacked my liver. Turned yellow. Told i had liver cancer, but switched hospitals and they found the answer.. good luck

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