Oral infection and surgery

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6958.880d (Published 01 October 1994) Cite this as: BMJ 1994;309:880
  1. G Stansby,
  2. M Byrne,
  3. G Hamilton
  1. St Mary's Hospital Medical School, London W2 1NY Redhill, Surrey Royal Free Hospital, London NW3 2QG.

    EDITOR, - Christos A Bartzokas and colleagues report a relation between oral infection and haematogenous infection after total joint replacement operations.1 We recently reported a study of oral health in patients undergoing vascular surgery, which showed a high incidence of important periodontal disease in these patients; we postulated that this might be a cause for some cases of infection of vascular grafts.2 Like patients receiving joint replacements, patients having vascular surgery tend to be elderly.

    Patients with prosthetic heart valves have traditionally been given clear instructions relating to dental health and antibiotic prophylaxis for dental procedures. Patients undergoing equivalent vascular surgical procedures, however, like patients receiving joint replacements, are much less commonly given such advice. We suggest that Bartzokas and colleagues' recommendations concerning preoperative dental check ups and postoperative oral care in joint replacement surgery should be extended to include patients having vascular surgery. Since joint replacement operations and vascular grafting are carried out in most district general hospitals perhaps such hospitals should issue an advice card that patients could show to their dentist at check ups and that recommended appropriate antibiotic prophylaxis.


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