We found this new post by the ADA helpful and interesting
SHOULD I TAKE ANTIBIOTICS BEFORE MY DENTAL PROCEDURE?
You have an orthopedic implant (joint replacement, metal plates or rods, etc.) from a previous orthopaedic surgery.
• A potential complication of these implants is bacterial infection, which occurs in approximately 1-3% of patients. These infections require more surgery as well as antibiotic usage for an extended period of time. Most infections occur around the time of the procedure (within one year), but some have occurred much later.
• In theory, late implant infections are caused by the spread of the bacteria from the blood stream to the implant. Unfortunately, there is no clear scientific evidence to support this theory. We know that many patients with orthopedic implants frequently have bacteria in their blood that does not spread to their implants.
Dental procedures have long been considered a potential cause of implant infections even after the initial orthopedic postoperative period. This is because dental procedures can introduce bacteria from the mouth into the bloodstream. However, this fact should be considered in the context that eating and performing oral hygiene at home may also introduce oral bacteria into the blood.
• Traditionally, antibiotics have been provided prior to dental procedures in patients with orthopaedic implants to minimize the bacteria that get into the blood.
• Best evidence, however, does not show that antibiotics provided before oral care help prevent infections of orthopedic implants.
• The routine use of antibiotics in this manner has potential side-effects such as increased bacterial resistance, allergic reactions, diarrhea, and may even cause death.
Patients who have compromised immune systems might be at greater risk for implant infections;
• Diabetes, rheumatoid arthritis, cancer, chemotherapy, chronic steroid use are examples suggesting immunosuppression. Please discuss your potential for immunosuppression with your physician or dentist.
• Patients who are immune-compromised might wish to consider antibiotics before dental procedures because of their greater risk for infection.
• Decisions with regard to antibiotic premedication should be made by patients, dentists and physicians in a context of open communication and informed consent.