Impact of dental clearance on total joint arthroplasty: A systematic review

Many orthopedic surgeons require that their patients obtain dental clearance before elective total joint arthroplasty (TJA). However, there is no consensus substantiating the practice. To this end, a systematic review on the prevalence of dental pathology in TJA patients, risk factors for failing dental screening, and impact of dental evaluations was performed. Literature was sourced from PubMed and Scopus databases. Six papers were sourced from the initial search, one study was extracted from the references of the original six manuscripts, and one new publication was retrieved from a second search conducted after the first. The prevalence of dental pathology ranged from 8.8% to 29.4% across studies. Two of four papers reported lower than average or improvements in post-operative infection with pre-operative dental evaluations while two found no such association. There is insufficient evidence to support universal dental clearance before TJA.