Dental treatment and late prosthetic joint infections.

Hospital and dental charts of 2,693 patients in whom total prosthetic joints had been placed at the Veterans Administration Hospitals of Ann Arbor and Allen Park, Michigan, as well as at The University of Michigan Hospital, were analyzed. Of the thirty (1.1%) late prosthetic joint infections (greater than 6 months after placement), only one (0.04%) could be temporally associated with dental treatment. A Fisher's exact test of the data reflected that dental treatment in this population did not increase the incidence of late prosthetic joint infections (p value is 0.0005). Nine of the thirty late infections occurred in insulin-dependent diabetic patients and patients on long-term immunosuppressive therapy. An analysis of the organisms isolated from the late infections shows that 54% where Staphylococcus epidermidis and Staphylococcus aureus. These data do not support the practice of prescribing prophylactic antibiotic coverage of prosthetic hip and knee joints prior to all dental therapy. Rather, use of antibiotics during dental treatment appears warranted only if a chronic bacteremia is anticipated or where a predisposing systemic condition may exist.

Bacterial endocarditis: a retrospective study.

A retrospective study was done on patients admitted to the University of Michigan Hospital from 1962 to 1972 with a diagnosis of bacterial endocarditis. The findings in the group studied indicate that Streptococcus viridans was the predominant causative organism, males were affected three times as often as females, erythromycin was effective against organisms of oral origin, dental procedures were not definitely established as responsible for the onset of the disease in any of the cases, and rheumatic heart disease and congenital heart disease were the predominant, but not the only, predisposing factors.