Surgical placement of prosthetic joints is commonly performed to treat the damage associated with degenerative joint disease (DJD)/osteoarthritis. Hip, knee and shoulder replacements are the more common procedures. These devices are made of artificial materials (metal and plastic copolymers) with lots of nooks and crannies in a warm, moist dark environment. This represents a perfect environment for bacteria to flourish. The surgical procedures are done in a sterile operating room environment so the risk of infection during the actual surgery is small to none. However, post operatively, there is a risk of secondary joint infection from bacteria of an external source, such as periodontal bacteria. In the event a joint replacement gets secondarily infected the corrective treatment is very complicated and risky. Usually, antibiotics are not very effective in treating this situation because of the lack of blood supply in an artificial joint. Antibiotics need a blood supply to reach the end target. So, the realistic goal is to PREVENT secondary infection of the prosthetic joint.
Example of a periodontal clearance form from orthopedic surgeon prior to joint replacement surgery. Names of surgeon and patient have been removed to protect privacy of patient and surgeon.
Frequently medical insurance companies require an orthopedic surgeon to refer a patient preoperatively to a periodontist/dentist for evaluation and treatment of dental inflammation/infection before they will pay the orthopedic surgeon to perform the joint replacement surgery. Medical insurance companies are aware that there are better surgical outcomes with fewer expensive complications if the joint replacement surgery is performed in an environment free of periodontal inflammation/infection.
At Britt Perio we have effective methods to prevent periodontal bacteria from infecting prosthetic joints and producing better surgical outcomes.