I’ve got two conflicting opinions and I’m not sure which direction is the right one. I had a hip replacement about ten years ago. Now I need to get some dental implants. One dentist says I’ll have to pre-medicate with antibiotics; the other says that’s nonsense. Who’s right?

Beth

Dear Beth,

Oh…the medical community. Don’t you love them? They all claim to be experts and none of them agree with one another. That’s a lot of experts who see things differently. Here’s what is going on in your situation.

It used to be that the standard recommendation was any time someone with a hip replacement had anything invasive done, including a dental cleaning, they were to have antibiotics so there was no risk of any bacteria being introduced which could make its way to the replacement site.

However, that changed in 2012 when both the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA) released a new study which said recent studies showed there was no direct evidence to continue to make that recommendation.

That simply means it’s up to the dentist. It sounds like the dentist recommending the pre-medication likes to take every precaution possible. Which you do is up to you. There’s not a right or wrong answer. I would say if you’re a healthy person who doesn’t easily get sick it won’t matter. If you tend to catch things more easily, I’d pre-medicate.

Cosmetic Care and Dental Implants

I want to give you a heads up on a cosmetic issue that recently came up with a patient I know. She’d planned on getting dental implants and teeth whitening. Even though her dentist knew she wanted both procedures, he didn’t warn her that the teeth whitening needed to be done first.

The reason for that is the gel used to whiten teeth only works on natural tooth structure. While her natural teeth were getting whiter, her dental implants stayed the same color they were the day they were placed.

Only then did her dentist tell her to get her smile to match she’d have to replace her implant crowns. If he’d have advised her to get her whitening done first, she wouldn’t be in this situation having to spend unnecessary money. Her crown could have been made to match her new, white color from the beginning.

I don’t know if you were ever going to want teeth whitening, but as this just happened to someone I know, I thought I’d warn you just in case.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.