In recent healthcare news, an in-depth systematic review has emerged highlighting the importance of preoperative dental assessments in curtailing the incidence of infections following orthopedic surgeries. The pivotal study, published in the “Orthopaedics & traumatology, surgery & research (OTSR)” journal, aimed to unravel the relationship between conducting such assessments and the risk of orthopedic infections post-surgery.
The Link between Dental Health and Orthopedic Surgery Outcomes
Orthopedic surgeries, notably those involving joint prostheses, necessitate meticulous preoperative preparations to minimize postoperative complications. One aspect recently gaining prominence is the condition of a patient’s dental health prior to surgery. The study, led by Dr. Sophie Barrere and her interprofessional team, focuses on two pivotal questions: firstly, whether preoperative dental assessments are related to the incidence of orthopedic infections, and secondly, if the presence of dental risk factors and comorbidities escalates the likelihood of orthopedic infections.
The comprehensive review encompassed an analysis of various databases, including PubMed, the Cochrane Library databases, and Google Scholar, for articles published in English before November 2018. The selection criteria for inclusion in the study were based on the descriptions of infections related to joint prostheses, dental infections, and the potential dental origins of pathogenic infections. The review included twelve case series, four case-control studies, and twelve cohort studies.
Findings Shed Light on Preventive Measures
In one of the case-control studies examined, prosthesis infection was presumed to be associated with a dental abscess in approximately 2.9% (6 out of 224) of cases. Cohort studies suggested that the presence of an infectious complication was less frequent if a preoperative dental examination had been conducted. Types of dental treatments administered before surgery were predominantly scaling and polishing, extractions, and restorative work.
However, the researchers faced challenges due to significant heterogeneity among the included studies, making definitive conclusions elusive. Despite this variation, the overall inference leaned towards the advantageous nature of performing preoperative dental assessments. The significance of maintaining favorable oral hygiene to mitigate risk factors for postoperative infections was underscored.
Implications in Orthopedic Surgical Practice
As orthopedic procedures continue to be frequently performed with the advancement of surgical techniques and the increasing demands of an aging population, the potential implications of preoperative oral hygiene are becoming more pivotal. This research denotes a critical perspective on the interdisciplinary nature of patient care, advocating for collaboration among dental and orthopedic professionals.
Expert Opinions and Recommendations
Dr. Nicolas Reina, an orthopedic surgeon and contributing author, stated that this systematic review emphasizes a holistic approach to patient care. According to Reina, “assessing patients’ dental health can be a simple yet effective strategy to safeguard against postoperative complications.”
Dr. Ove A. Peters, a specialist in endodontics, reinforced the importance of dental hygiene, mentioning, “Our oral cavity is a gateway of diverse microbiota, some of which can be opportunistic pathogens. Ensuring that this environment is healthy before an invasive procedure like orthopedic surgery is a prudent preventive measure.”
Emphasizing the need for further research, Dr. Lucie Rapp, Dr. Jean-Noel Vergnes, and Dr. Delphine Maret, from the Dental Faculty at Paul-Sabatier University, collectively suggest, “Future studies should aim to produce more standardized data to strengthen the evidence concerning preoperative dental assessments and their role in preventing surgical infections.”
Conclusion
This systematic review has successfully cast light on the somewhat overlooked aspect of dental assessment as part of preoperative care for orthopedic surgeries. While the heterogeneity of the data prevents a formal recommendation, the study tilts towards the notion that such assessments should be encouraged as they potentially lead to a reduction in postoperative infections.
The implications of this research are widespread and invite a change in pre-surgical protocols to integrate comprehensive dental evaluations. As healthcare shifts towards a more preventive paradigm, the review’s findings could contribute to establishing new standards of care that fortify patient outcomes and reduce the burden of surgical complications.
DOI Information and References
DOI: 10.1016/j.otsr.2019.02.024
References
1. Barrere, S., Reina, N., Peters, O. A., Rapp, L., Vergnes, J. N., & Maret, D. (2019). Dental assessment prior to orthopedic surgery: A systematic review. Orthopaedics & traumatology, surgery & research: OTSR, 105(4), 761–772.
2. PubMed [Database online]. US National Library of Medicine. Available at: https://pubmed.ncbi.nlm.nih.gov/
3. The Cochrane Library [Database online]. Cochrane Collaboration. Available at: https://www.cochranelibrary.com/
4. Google Scholar [Database online]. Available at: https://scholar.google.com/
5. Elsevier Masson SAS. (2019). Copyright information.
Keywords
1. Preoperative Dental Assessment
2. Orthopedic Surgery Infections
3. Dental Health and Surgery
4. Oral Hygiene and Orthopedics
5. Preventive Care in Orthopedic Surgery