Hip Replacement Guidebook
For Primary Care Providers and Dentists: Update on Dental Prophylaxis for Joint Replacement Patients
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Following are the latest set of guidelines on dental care for patients who have received a total joint replacement at Dartmouth-Hitchcock Medical Center.
These guidelines are from the American Academy of Orthopaedic Surgeons.
Guidelines as of August 2009:
Antibiotic prophylaxis can be considered for patients who have had total joint replacement for the life of the prosthetic.
Routine dental cleaning should take place no later than one week prior to the patient’s joint replacement surgery.
Patients should refrain from any non-emergent dental procedures, including cleaning, for six months after their surgery.
For those requiring antibiotic prophylaxis the dosing recommendations are as follows:
- Cephalexin, Cephradine, or Amoxicillin: two grams orally one hour prior to dental procedure
- If unable to take oral medications: Cefazolin one gram or Ampicillin two grams IM/IV one hour prior to the procedure
- If allergic to Penicillin: Clindamycin 600 MG orally one hour prior to procedure
- If allergic to Penicillin and unable to take oral medications: Clindamycin 600 MG IV one hour prior to procedure
Note: No second doses are recommended for any of the above regimens.
If you have any questions, contact:
Deb Jadczak, BS/RN
Nurse Coordinator
Joint Replacement Team
(603) 650-7557
