Link Shown Between Oral Bacteria and Joint Infection

STKT-PER-286Doctors and scientists have long been concerned about a link between oral bacteria and joint health. In 2012, researchers studied a small group of participants who suffered from periodontal disease and joint disease, some of whom had joint replacements. Case Western Reserve University School of Dental Medicine questioned the DNA of bacteria from the lubricant fluid in hip and knee joints, which is called synovial fluid. Then, the dental plaque of the patients with periodontal disease was also examined.

Case Western study
In the study “Identification of Oral Bacterial DNA in Synovial Fluid of Patients with Arthritis with Native and Failed Prosthetic Joints,” researchers examined 36 participants, five of whom had a direct link between the DNA of his or her dental plaque and the bacteria in the joints. Eleven of the participants had rheumatoid arthritis (RA) and 25 were diagnosed with osteoarthritis (OA) during the time of the study. Of these participants, eight with OA and one with RA had failed prosthetics. Bacterial DNA was detected in five patients with failed prosthetic or native joints, and two of those individuals were identified to have gum disease and identical bacterial clones between the joint and mouth. This study showed a possible link between gum disease and failed joints; however, the findings were not substantial enough to make definitive claims.

The dental plaque that was tracked during the study is the cause of inflammation in the mouth, which, once in the bloodstream, can cause kidney and heart disease, cancer or even premature births or fetal deaths.

Mount Sinai Medical Center study
A study released in the April 17 issue of the Journal of Bone and Joint Health, found that patients who are prescribed antibiotics during dental procedures are likely to decrease the risk of joint infection. However, the issue becomes of more concern with patients who are not able to have routine dental procedures and keep up with their oral health because of insurance.

Patients who are undergoing dental surgery are put at higher risk of periprosthetic joint infection, but authors were unable to come up with a conclusive recommendation for practitioners to continue or discontinue the use of topical oral antimicrobials.

“The risk associated with not going to the dentist on a regular basis is likely higher than the risk associated with not giving prophylactic antibiotics on a regular basis,” coauthor Calin S. Moucha, told Medscape Medical News. “Maintaining good oral health by brushing teeth on a regular basis, using oral antiseptics, and seeing a dentist on a regular basis to evaluate potential problems is critical. The biggest challenge that I’ve seen is that a large majority of patients do not have dental insurance, and a large number of dentists in [New York City] do not participate in most plans. This makes it difficult for most patients to pay for good dental healthcare.”

Conclusions
There are many links between oral hygiene and one’s overall health and doctors are continually making efforts to ensure people are aware of the importance of keeping a healthy mouth. By using natural mouthwash and toothpaste and flossing on a regular basis, individuals, even those without health insurance, can decrease their risk of a hip infection. To steer clear of any issues, patients are always recommended to alert their doctor of a hip replacement.

Matthew Messina, a dentist in private practice in Cleveland who was not involved in either study told Medscape that premedication, or the use of antibiotics during a dental procedure, may be the best method to use until further research can solidify a solution.

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