We are unable to recommend for or against the use of topical oral antimicrobials in patients with prosthetic joint implants or other orthopaedic implants undergoing dental procedures.

Rationale
There is high quality evidence that demonstrates the occurrence of bacteremias with dental procedures. However, there is no evidence to demonstrate a direct link between dental procedure associated bacteremia and infection of prosthetic joints or other orthopaedic implants.

There is conflicting evidence regarding the effect of antimicrobial mouth rinse on the incidence of bacteremia associated dental procedures. One high quality study reports no difference in the incidence of bacteremia following antimicrobial mouth rinsing in patients undergoing dental extractions. Conversely, numerous studies suggest that topical antimicrobial prophylaxis decreases the incidence of dental procedure associated bacteremia. However, there is no evidence that application of antimicrobial mouth rinses before dental procedures prevents infection of prosthetic joints or other orthopaedic implants.