title: Frequent Dental Scaling Is Associated with a Reduced Risk of Periprosthetic Infection following Total Knee Arthroplasty: A Nationwide Population-Based Nested Case-Control Study.
abstract: Oral bacteremia has been presumed to be an important risk factor for total knee arthroplasty (TKA) infection. We aimed to investigate whether dental scaling could reduce the risk of TKA infection. A nested case-control study was conducted to compare 1,291 TKA patients who underwent resection arthroplasty for infected TKA and 5,004 matched controls without infection in the TKA cohort of Taiwan's National Health Insurance Research Database (NHIRD). The frequency of dental scaling was analyzed. Multiple conditional logistic regression was used to assess the frequency of dental scaling and the risk of TKA infection. The percentage of patients who received dental scaling was higher in the control group than in the TKA infection group. The risk for TKA infection was 20% lower for patients who received dental scaling at least once within a 3-year period than for patients who never received dental scaling. Moreover, the risk of TKA infection was reduced by 31% among patients who underwent more frequent dental scaling (5-6 times within 3 years). Frequent and regular dental scaling is associated with a reduced risk of TKA infection.
authors.affiliation: Department of Orthopaedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Ta-Wei
authors.initials: TW
authors.lastname: Tai
authors.affiliation: Institute of Clinical Pharmacy and Pharmaceutical Sciences, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Tzu-Chieh
authors.initials: TC
authors.lastname: Lin
authors.affiliation: Joy Dental Clinic, Tainan, Taiwan.
authors.forename: Chia-Jung
authors.initials: CJ
authors.lastname: Ho
authors.affiliation: Institute of Clinical Pharmacy and Pharmaceutical Sciences, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Yea-Huei
authors.initials: YH
authors.lastname: Kao Yang
authors.affiliation: Department of Orthopaedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Chyun-Yu
authors.initials: CY
authors.lastname: Yang
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D016022:Case-Control Studies; D015897:Comorbidity; D012534:Dental Scaling / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000209:etiology*; D012306:Risk; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013624:Taiwan / Q000453:epidemiology