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                                                        DR. DAN PETERSON

                                                                      1415 SAGE STREET ~ GERING, NEBRASKA 69341 
                                                             
      Call: 308-436-3491       www.dentalgentlecare.com           

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PREMEDICATION FOR ARTIFICIAL JOINTS

Medication taken before a procedure is performed can protect your health.

To Prevent Joint Infections

      The oral cavity is a portal of entry as well as the site of disease for microbial infections that affect general health.   

     Streptococcus viridian is the main infective agent that can enter the bloodstream from areas with considerable bleeding such as the oral cavity, urinary tract and gastrointestinal tract.  This bacteria may lodge on the heart valves, inflame the myocardium and cause ulcerations on the inner walls of the an artery.    Patients with artificial joints, prosthesis or pervious severe infections are at a higher risk.  These risks are from an implied association between dental treatments and joint infections.  

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For the first two years following a total joint placement, antibiotic prophylaxis is recommended for everyone. After two years, only high-risk patients may need to receive antibiotics for high-risk procedures.

Do any of these high-risk situations apply to you?
        

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Rheumatoid arthritis

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Systemic lupus

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Other medical  conditions that cause you to be Immunocompromised or immunosupressed

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Immunosupression caused by drug or radiation treatment    

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Malnourishment        

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Hemophilia

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HIV infections

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Insulin dependent (Type 1) diabetes       

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Cancer

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Some Elderly patients  


All patients in these high-risk categories may need antibiotics for all high-risk dental procedures.
Premedication is recommended for antibiotic prophylaxis for any dental procedure likely to cause bleeding.
 

     The American Dental Association recommends antibacterial prophylaxis for at-risk individuals with any dental procedure that may cause bleeding such as the following procedures:

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Tooth extractions

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Periodontal surgery

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Scaling and root planing

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Probing

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Recall maintenance

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Dental implant placement

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Replantation of avulsed teeth

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Subgingival placement of antibiotic fiber or strips

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Initial placement of orthodontic bands (not brackets)

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Intraligamentary local anesthetic injections

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Cleaning of teeth or implants where bleeding is anticipated

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Endodontic surgery

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Instrumentation beyond the apex

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    The current regimen:

Patient type Suggested Drug Regimen
Not allergic to penicillin Cephalexin, cephradine, amoxicillin 2 grams orally 1 hour prior to dental procedure
Patients not allergic to penicillin and unable to take oral mediations Cefazolin or ampicillin Cefazolin 1 g or ampicillin 2g intramuscularly or intravenously 1 hours prior to the dental procedure
Patients allergic to penicillin Clindamycin 600 mg orally 1 hours prior to dental procedure
Patients allergic to penicillin and unable t take oral medications  Clindamycin 600mg intravenously 1 hr prior to dental procedure

*Source JADA Vol 134, 7/03 pgs 895-899

 is two grams of amoxicillin, one hour prior to treatment with no follow-up dosage required.  Clindamycin, cephalexin, cefadroxil, azithronycin or clarithromycin as also suggested alternatives.

     At our office we also reduce bacteremias by using an antiseptic mouthrinse for 30 seconds before any procedures are done.

     The most effective reduction in bacteria in your mouth is accomplished by you.  It is urgent that you improve your oral hygiene care in order to improve you oral health by:
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Rinsing your mouth with an antiseptic mouthrinse like BreathRx or Perioguard to reduce the bacteria count in your mouth BEFORE you do the following:

  1. Use a Waterpik irriagator on a daily basis.

  2. Brushing at least twice a day for 2 minutes or more using a Sonicare toothbrush.

  3. Flossing daily or using an automatic flosser.

     All these will  "stir up" the bacteria in your mouth, yet by using a consistent and regular self care maintenance routine along with frequent check-ups and professional cleanings will result in an overall reduction of oral bacteria to improve not only your oral health but your total well-being.

Poor oral hygiene and periodontal (gum disease) or periapical infections increase your risk for joint infections.

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AAOS Guidelines for Joint Replacement

AHA guidelines. Guidelines with joint replacement

ADA guideline and updates

ADA PREMEDICATION forms, recommendation and medication table.

 Premedication Index       Patient Education      Home        Site Index

 

          If you have any questions please e-mail me at: drdpeterson@scottsbluff.net
                                                                                 308-436-3491 Office number

PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
This site is privately and personally sponsored, funded and supported by Dr. Peterson.  We have no outside funding.
Confidentiality of data including your identity, is respected  by this Web site. We undertake to honor or exceed the legal requirements of medical/health information privacy that apply in Nebraska.

Copyright 1998-2008 Family Gentle Dental Care, all rights reserved.