For how long after a hip replacement do I need to keep my dentist informed?
Q) During the post-operative follow-up after a hip replacement, the consultant recommended that in the event that I had a tooth extracted, I should advise the dentist about this, since the dentists may want to cover this with antibiotics. Does this advice just refer to the post-op period or continually?
C E Hawker, Princes Risborough, Buckinghamshire (Winter 2009)
A) I know that surgeons who do artificial joints are worried about them becoming infected, as this can lead to failure of the implant. Hence, the surgery is carried out in a clean-air environment with sterile technique and the surgeon won't proceed if there's any infection, such as a leg ulcer. This is a long-winded way of explaining the problem with pulling teeth. The mouth is full of bacteria and when a tooth is pulled a good number of these are released into the blood stream. If there's a vulnerable place in the circulation where they might settle, and faulty heart valves are usually the main worry, then it's standard practice to give antibiotic cover for the extraction. I haven't heard of orthopaedic surgeons worrying about this procedure but I can understand why they might. As to the duration of this precaution, I suspect no one knows the answer, but to err on the side of caution it seems reasonable to continue to follow this advice.