Is a visit to the dentist necessary before knee prosthesis surgery?

Yes, absolutely! Potential centres of infection should be treated before any major surgery. We have a lot of bacteria in our mouths that do not normally cause any problems. However, if the mucous membrane is injured or if there are bad teeth (decayed teeth) that develop into a pus tooth, oral bacteria can enter the bloodstream. On the one hand, these weaken the immune system and the body, which is not conducive to a major operation. On the other hand, the bacteria can be deposited in the artificial knee joint postoperatively and multiply. This can trigger an infection in the new artificial knee joint. An infection of the artificial knee joint caused in this way is rare, but can result in serious complications for the person affected. The infected artificial joint must be operated on again and supported by a long course of antibiotics. If the treatment does not work, the artificial knee joint must be completely removed and a new knee prosthesis fitted at a later date once the joint infection has healed. This is very stressful for the psyche and the body. In addition, the result of such an artificial joint is usually worse, with more pain and less mobility.

Recommendation: Dental check-up before every major operation

We therefore recommend having your teeth checked and, if necessary, restored by a dentist before major joint replacement surgery. Dental hygiene (DH) is also recommended before the operation. After the operation, you should not go to the dentist or to the DH for at least 3 months in order to avoid possible infections.

In case of emergency, antibiotic prophylaxis should be considered for the treatment, depending on the patient's condition (immunosuppression, diabetes mellitus, etc.) and the type and duration of the dental procedure. The dentist should be informed that you have an artificial joint. No further precautions need to be taken for subsequent treatments. However, if the dentist detects an infection in the mouth area, the dentist will treat it with antibiotics.

It is also important to maintain very good dental and oral hygiene and to have this checked regularly by means of preventive dental check-ups.

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Dr Andreas L. Oberholzer is a recognised expert in knee problems and has extensive experience in the field of artificial knee joints and alternative treatment methods.

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