Dental procedures and subsequent XXXX : findings from the Medicare Current Beneficiary Survey.

@entity1 @entity281 @entity950 @entity2720
BACKGROUND: The publication of the 2009 American Academy of Orthopedic Surgeons' (AAOS') guidelines for antibiotic prophylaxis after joint replacement (arthroplasty) has renewed debate concerning appropriate prophylaxis for dental @entity1 . The authors examined an administrative data set to assess whether dental procedures were associated with @entity281 ( @entity281 ). METHODS: Using data for the years 1997 through 2006 from the Medicare Current Beneficiary Survey (MCBS), the authors identified @entity1 who had undergone total joint arthroplasty and those who had experienced a @entity950 . They explored associations between dental procedures and subsequent @entity281 by using time-to-event analyses (N = 1,000). A nested case-control study included case @entity1 who had had @entity281 (n = 42) and matched control @entity1 who had had total arthroplasty but had no @entity281 (n = 126). The authors calculated hazard ratios (HRs) and odds ratios (ORs). RESULTS: Control @entity1 ( @entity1 without @entity281 ) were more likely than were case @entity1 (those with @entity281 ) to have undergone an invasive dental procedure, though this trend was not statistically significant in either the time-to-event analysis (HR = 0.78; 95 percent confidence interval [CI], 0.18-3.39) or the case-control analysis (OR = 0.56; 95 percent CI, 0.18-1.74). Only four of 42 case @entity1 had undergone an invasive dental procedure in the 90 days before the infection occurred. Consideration of all dental procedures yielded similar results. CONCLUSIONS: Dental procedures were not associated significantly with subsequent risk for @entity281 , although this study's power was somewhat low. The clinical importance of prophylactic antibiotics in dentistry for @entity1 who have undergone joint arthroplasty, therefore, may be questioned. CLINICAL IMPLICATIONS: These results support the view that the 2009 AAOS Information Statement on antibiotic prophylaxis for @entity1 with @entity2720 should be reconsidered for @entity1 in that population who are receiving oral health care.
