Dentist asked whether I need antibiotics before a filling because of my shoulder replacement. Do I? And how long do they keep checking a new shoulder?

Two questions from the partial side, a bit over a year on from the ladder business now and the shoulder doing nicely.

First one: booked in for a filling and an extraction next month and the new dentist asked, on the form, whether I need antibiotic cover because of a joint replacement. I genuinely do not know. Nobody mentioned it when I was discharged. A friend with a new hip says he takes a couple of tablets before every dental visit and swears by it. Another friend says that went out years ago.

Second one, related: I had my one year check with an X-ray in September, all fine, and the surgeon said "see you in two years." Is that normal? I had sort of assumed one year and done. What are they actually looking for at these later ones, if I feel fine?

I was asked exactly the same thing by my dentist after my right one and I did not know either. My dentist rang the hospital in the end, took about a day to get an answer, and the answer was no antibiotics for me. But that was me, so I would let them check yours.

On the "see you in two years" thing, that is what I got too. I was a bit offended at first, like being told to go away, but my surgeon said they keep an eye on the X-rays for years because things like loosening can start without you feeling it. Mine is three years out now and the visits are a ten minute chat and a picture.

Your hip friend may have been told to by his own surgeon, which is a different thing from it being the rule. I take nothing for the dentist with either shoulder and was told not to.

onearm_gardener said:

the new dentist asked, on the form, whether I need antibiotic cover because of a joint replacement

Both good questions, and the answers are linked. General information only; your own team's advice comes first.

On the dentist: for most people, no. The American Dental Association's guideline says that, in general, people with prosthetic joint implants do not need prophylactic antibiotics before dental procedures to prevent joint infection, based on a review that found no association between dental procedures and joint infections. The practice your hip friend describes was common years ago and has largely been dropped. There are exceptions, for example someone with a previous infection or other complication of the joint, or conditions that lower resistance to infection, and in those cases the dentist, the orthopaedic team, and the patient decide together, with the orthopaedic surgeon generally recommending any antibiotic. Your dentist was right to ask; the right response is to tell them you have a replacement and, if in doubt, let them check with your surgical team, as Margaret's did. Many units give a standard answer in a sentence.

On the follow-up: "see you in two years" is entirely normal after a good first year. Infection and wound problems are mostly early issues, and by a year the shoulder has usually reached most of its result. The later X-rays look for things you will not feel at first: bone changes around the components that suggest loosening, wear, and, around a hemiarthroplasty, wear of your own socket where the metal ball sits against natural cartilage. Comparing films over time shows whether anything is changing. Between visits, the reasons to get in touch early are change in the shoulder: new pain once it has settled, a loss of movement or strength, a fall onto the arm, or redness, swelling, or fever. And an infection elsewhere, a tooth abscess included, is worth treating promptly rather than leaving, because bacteria in the bloodstream can reach a replacement even years later.

The site has just published a full piece on this, follow-up after shoulder replacement, covering the review schedule, the X-rays, and the dental guidance. What applies to your particular operation is something your own surgeon can confirm at the next visit.

Very clear, thank you. I had never thought about my own socket wearing on the partial, which explains why the surgeon squinted at that bit of the X-ray for so long.

Closing the loop. Dentist rang the fracture clinic, standard answer, no antibiotics needed for me. Filling done, extraction next week. And "see you in two years" is now on the calendar next to the apple tree pruning, which I am told I am allowed to do again, from the ground, with a long handled saw. No ladders. Point taken.