From the Research
No, shoulder surgery or shoulder conditions are not indications for prophylactic dental antibiotics. Prophylactic antibiotics before dental procedures are only recommended for specific high-risk cardiac conditions such as prosthetic heart valves, previous infective endocarditis, certain congenital heart defects, and cardiac transplants with valve regurgitation. Even patients with prosthetic joints, including shoulder replacements, no longer routinely require antibiotic prophylaxis for dental procedures according to current guidelines 1. The rationale behind this recommendation is that there is insufficient evidence linking dental procedures to prosthetic joint infections, and the risks of antibiotic use (including adverse reactions and antimicrobial resistance) outweigh the potential benefits.
Key Points to Consider
- The transient bacteremia that occurs during dental procedures is similar to that which occurs during daily activities like brushing teeth, and the body's immune system typically handles this effectively 1.
- A recent study found no significant positive association between invasive dental procedures and late periprosthetic joint infections, further supporting the notion that antibiotic prophylaxis is not necessary for patients with prosthetic joints undergoing dental procedures 1.
- The American Dental Association and other professional organizations have guidelines that do not recommend routine antibiotic prophylaxis for patients with prosthetic joints undergoing dental procedures, unless there are specific individual risk factors that may warrant consideration of prophylaxis in special circumstances 2.
Recommendations for Patients with Shoulder Replacements
- If you have a shoulder replacement and are concerned about the need for antibiotic prophylaxis before dental procedures, discuss your specific situation with your orthopedic surgeon and dentist 1.
- Maintaining good oral hygiene is crucial for overall health, and patients with prosthetic joints should focus on regular dental care rather than relying on antibiotic prophylaxis 1.