Journal article
Dental Screening in Elective Total Joint Arthroplasty: Risk Factors for Failure
The Journal of arthroplasty, Vol.36(5), pp.1548-1550
05/01/2021
DOI: 10.1016/j.arth.2020.12.026
PMID: 33478892
Abstract
Background: Active dental infection at the time of total joint arthroplasty (TJA) or in the acute postoperative period following TJA is thought to increase the risk of periprosthetic joint infection (PJI). Many surgeons recommend preoperative dental screening. This study aimed to identify how many elective TJA patients failed preoperative dental screening and what patient risk factors were associated with failure.
Methods: A consecutive series of elective, primary TJA was reviewed from 8/1/2016 to 8/1/2017. We studied 511 operations in 511 patients. All patients were referred for preoperative dental screening per protocol. Dental screening failure was defined as required dental intervention by the dentist. Screening failure rate was calculated for and logistic regression was used to evaluate the relationship between odds of screening failure and patient demographic data.
Results: In 94 of the 511 total cases (18.5%), patients failed dental screening and required dental procedures prior to TJA. Reasons for failure included tooth extractions, root canals, abscess drainage, and carious lesions requiring filling. Patient characteristics associated with failed dental screening included male gender (odds ratio 1.56, 95% confidence interval 1.0006-2.468, P=.047) and current smoker (odds ratio 3.6, 95% confidence interval 1.650-7.927, P=.001).
Conclusion: Universal dental screening prior to primary TJA resulted in 18.5% of patients needing an invasive dental intervention. Universal dental screening results in extra cost and time for patients and providers. Although male gender and active smoking were associated with increased odds of requiring an invasive dental procedure, more work is needed to develop targeted screening to improve perioperative workflow and limit unnecessary dental evaluations for patients. (C) 2020 Elsevier Inc. All rights reserved.
Details
- Title: Subtitle
- Dental Screening in Elective Total Joint Arthroplasty: Risk Factors for Failure
- Creators
- James G. Kohler - Univ Iowa Hosp & Clin, Dept Orthoped & Rehabil, 200 Hawkins Dr, Iowa City, IA 52240 USAAndrew J. Holte - University of Iowa Hospitals and ClinicsNatalie A. Glass - University of IowaNicholas A. Bedard - University of IowaTimothy S. Brown - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of arthroplasty, Vol.36(5), pp.1548-1550
- Publisher
- Elsevier
- DOI
- 10.1016/j.arth.2020.12.026
- PMID
- 33478892
- ISSN
- 0883-5403
- eISSN
- 1532-8406
- Number of pages
- 3
- Language
- English
- Date published
- 05/01/2021
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984548857302771
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