Do I need antibiotics before the dentist after a joint replacement?

“Do I need to take antibiotics before my dental cleaning?” is one of the most common calls our office gets from patients with a new knee or hip. For a long time, the answer was usually yes. Today, for most patients, it's no.

What changed

In June 2025, the American Academy of Orthopaedic Surgeons published updated guidance on antibiotics before dental procedures for patients with hip or knee replacements.¹ It found that:

• For routine, non-invasive dental work, antibiotics are rarely appropriate.
• For invasive dental work in patients with a normal immune system, antibiotics are also rarely appropriate.
• For invasive dental work in patients with a weakened immune system, antibiotics may be appropriate.

The American Dental Association reached a similar conclusion years earlier. It states that, in general, antibiotics are not recommended before dental procedures to prevent joint replacement infection.²

Who may still need them

Your situation may be different if you:

• Have a weakened immune system, for example from chemotherapy, certain rheumatoid arthritis medications, an organ transplant or poorly controlled diabetes.
• Have had a joint replacement infection in the past, or have had a revision surgery. The AAOS guidance doesn't cover these patients.
• Are having a major dental procedure soon after your surgery.

If any of these apply, check with me and your dentist before your appointment.

Why it matters

Antibiotics aren't harmless. They can cause allergic reactions and stomach problems, and overuse contributes to antibiotic resistance. Good dental health still matters, though. Keep up regular cleanings, and treat dental infections promptly.

The bottom line

Most patients with a knee or hip replacement don't need antibiotics before routine dental care. If you're unsure, call our office before your appointment.