Dental Guideline for Total Joints
General Dental Timing Restrictions (All Providers)
Unless otherwise specified below, patients should:
- Avoid all elective dental procedures for three (3) weeks prior to surgery
- Avoid all elective dental procedures for three (3) months following surgery
This timing helps reduce oral bacterial load, minimizes the risk of perioperative bacteremia, and supports optimal wound healing.
Urgent or emergent dental care during these windows should be discussed directly with the treating surgeon.
High-Risk Patient Considerations
For surgeons who do not routinely recommend prophylaxis, antibiotics may still be considered on a case-by-case basis for patients with clearly defined high-risk conditions, including:
- Prior prosthetic joint infection
- Significant immunocompromise (e.g., uncontrolled diabetes, chronic high-dose steroid use, active malignancy, transplant status)
- Hemophilia, severe malnutrition, or other rare medical vulnerabilities
Surgeon-Specific Antibiotic Prophylaxis Recommendations
Dr. Timothy Crall, Dr. Brian Gilmer, Dr. Michael Karch
- No dental work 3 weeks prior to surgery or 3 months after surgery
- No prophylactic antibiotics are recommended for dental procedures following total joint replacement
Dr. Stephen Knecht
- No dental work 3 weeks prior to surgery or 3 months after surgery
- Lifetime prophylactic antibiotic therapy is required following:
Total Ankle Arthroplasty
Preferred regimen:
- Amoxicillin 2 grams orally, taken 30–60 minutes prior to the dental procedure
For patients with severe penicillin allergy:
- Azithromycin 500 mg orally, 30–60 minutes prior to the procedure
- Clarithromycin 500 mg orally, 30–60 minutes prior to the procedure
Dr. Tyler Williamson
- No dental work 3 weeks prior to surgery or 3 months after surgery
- Prophylactic antibiotic therapy is required for one (1) year following:
Preferred regimen:
- Amoxicillin 2 grams orally, taken 30–60 minutes prior to the dental procedure
For patients with severe penicillin allergy:
- Azithromycin 500 mg orally, 30–60 minutes prior to the procedure
- Clarithromycin 500 mg orally, 30–60 minutes prior to the procedure
If you have questions about a specific patient or would like to discuss individual circumstances, please do not hesitate to contact our office. We value your partnership in providing safe, coordinated care. If you would like to have your patients' surgical records on file, please use the fax and send it to the appropriate location and we will fill it out and fax it back.
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