Must Pass Dental Exam Before New Total Joint Replacement?

Background: Many orthopedic surgeons request dental clearance for their patients before undergoing elective total joint arthroplasty (TJA). The premise is that active dental infections increase the incidence of prosthetic joint infections (PJIs), especially in the perioperative period. Objective: To evaluate the outcomes of requiring pre-arthroplasty dental examinations. Design: Prospective study. Participants: 511 patients with an average age of 60.2 ± 12.2 years evaluated between 2016 and 2017 at a university hospital in Iowa. Methods: Patients scheduled for an elective TJA were required to visit a dentist and have a standard dental screening form filled out. Fully edentulous patients were excluded. Patients with untreated caries or active infections had their pathology treated before the orthopedic procedure. Demographics and medical history were correlated with the examination outcomes and infection rate. Results: Of 511 patients enrolled, 94 (18.5%) "failed" their dental screeni more...