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Dentistry/gum disease and knee replacement


I am 68 years old and have a recurring problem with gum inflammation that clears up but always seems to return.  I need to have my knees replaced, but I hear that any bleeding in the mouth can cause infection of the prosthesis which may present a danger of eventual infection over the ong term if I have the knees replaced.  What is your opinion?

You have a good question.  In the 1980's there was some speculative studies that suggest there may be some association with joint infection and oral infection.  

However, based on 1997 Advisory Statement from the American Academy of Orthopedic Surgeons and the American Dental Association as well as the current research:  it seems there is a very slight chance that gingivitis will compromise the success of knee replacement.

There isn't evidence from the research linking infected joint prosthesis to oral bacteria.  There was a case series done with only 4 patients with massive oral infections who had infected prosthetic joints.  

I would practice meticulous home care (brushing 2x daily and flossing at least once a day) before, during, and after the surgery.  If the gum bleeding appears to be increasing or excessive, I would advise you to alert your orthopedic surgeon and seek a consult from a good general dentist.  They may suggest an antibiotic depending on your case, but I wouldn't be worried about a little gum bleeding, as long as that's what it is.

Best of Luck,
Ketan Amin, DMD
Austin Center for Endodontics (Root Canal Specialists)
Austin Center for Endodontics


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Ketan Amin, DMD


Graduating from Harvard School of Dental Medicine, I received a broad understanding of both medicine and dentistry. I continued my training at New York University, as a dental specialist in endodontics, which concerns root canal therapy, related surgeries, as well as diagnosing and managing various forms of pain occurring in the head and neck


Dentistry; Specialist in Endodontics (Root Canal Therapy).

American Association of Endodontics American Dental Association American Academy of OroFacial Pain

Harvard School of Dental Medicine-Doctorate in Dental Medicine (DMD) New York University College of Dentistry-Certificate, Endodontics

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