Treat Gum Disease to Reduce Risk of Surgical Infections

Do you need more convincing that gum disease has a significant impact on your overall health? If so, consider this: about 13% of all infections following knee replacement surgery are caused by oral bacteria.

That’s right, oral bacteria are responsible for about one in seven infections following knee replacement surgery. Knee replacement–it’s hard to get much further from your mouth than your knee, so if your knee gets infected because of your mouth, it’s likely your entire body is at risk.

Fortunately, new research shows that treating gum disease with regular preventive visits can help reduce these risks.

Gum disease can increase the risk of infection following knee replacement surgery

Revisions Due to Infection

To determine the risk and benefit related to gum disease bacteria, researchers looked the records of nearly 1300 individuals who had to have their knee replacement redone because it became infected. They then compared these records to those of over 5000 matched controls who had knee replacement but no infection. The primary variable they wanted to evaluate was the effectiveness of scaling in preventing infection.

Scaling is the procedure you likely get as part of your normal hygiene and checkup visits. It’s when your hygienist scrapes away the hardened deposits on your teeth, called tartar or dental calculus. Removing these hard deposits is important because they shelter oral bacteria and can also trap food particles near the gums, contributing to bleeding gums and other gum disease complications.

Comparing the study group with the control group, they found that those who had received one scaling treatment in the three years before their knee surgery had a 20% lower risk of knee infection. The benefits are even greater if you make your regular dental visit every six months or so (5-6 scaling appointments in the three years prior to surgery): a 31% drop in infection risk. That’s reducing risk by nearly a third, just for making regular dental checkups.

How can gum disease treatment reduce risk by 31% when only 13% of infections are related to oral bacteria? There are many reasons. First, it could be that we’re actually underestimating the number of infections related to oral bacteria, which could be 30% or higher. More likely, though, it’s related to the lowering of your body’s overall infection burden. When your body is constantly fighting a chronic infection like gum disease, it reduces the resources your body has to fight other infections, such as those around a replacement knee. Thus, the benefit is not just removing oral bacteria, it’s improving your overall health to make it easier to fight off infection.

The Infection Prevention Debate

This research gives us important information about how to stop surgical infections related to gum disease, which is a controversial subject. In the past, the primary recommendation was that people with knee replacements or other artificial joints, limbs, or implants, should take an antibiotic prior to any dental procedure that might release oral bacteria in into the blood, called bacteremia.

This recommendation has a couple problems. First, the repeated exposures to antibiotics as a preventive measure can contribute significantly to antibiotic-resistant bacteria, which can lead to more serious, even life-threatening infections.

Second, these periodic treatments with antibiotics doesn’t address the fact that oral bacteria enters your blood all the time, not just when you have a dental procedure. Brushing, flossing, even eating can all release oral bacteria into your bloodstream. The combined exposure from these daily bacteremias far exceeds the exposure related to dental treatments.

That’s why the American Dental Association (ADA) no longer recommends antibiotics with dental procedures if you have an artificial joint or implant, although many doctors and orthopedic surgeons still do.

This new research shows there a better way: regular preventive visits to your dentist. Just keeping gum disease under control can lower your infection risk without need for antibiotics.

Protect Your Body from Infection

Gum disease is a chronic infection whose effects go far beyond your mouth. When your body is fighting off gum disease infection, it is more vulnerable to other infections, including postsurgical infections, but likely also everything from colds to acne.

If you are looking to preserve your overall health through preventive dentistry, please call 201-343-4044 today for an appointment with a River Edge dentist at the River Edge Dental Center for General & Cosmetic Dentistry.