This has been discussed extensively in the patient community for years. When I started my post-op dental care, my dentist insisted on prophylactic antibiotics prior to treatment. I still go to the same dentist and she still requires 1 dose of antibiotics 1-2 hours prior to treatment.
6 years ago, all of the spine surgeons I asked recommended antibiotics prior to dental work. Now, some of them have revised their recommendations and don't require it for ADR. I don't believe that is true for other spine surgeries... I believe the criteria has to do with the location of the metal vs. blood supply???
Note that one of my mengitis from myelogram clients had a ton of hardware in his back from multiple posterior fusions. The theory is that without symptoms, the metal can provide a site for low grade infection and the access to the spinal canal can carry some of that bacteria in. Also note that my other meningitis from myelogram clients had 2-level lumbar ADR. I have no idea about technique for myelogram or other potential sources for the ADR client. I was present for the fusion guy's myelo. I used to work in sterile manufacturing, so I'm kind of hyper-aware of sterile technique and I did not see anything suspect.
Sorry for wandering, but it's all related. Back to antibiotics... I still get them. I would not if the dentist did not insist on them. As with all things spine, there is no clear path. I'd recommend that you tell your dentist... she may insist on them or defer to what your surgeon recommends. Know what your surgeon recommends BEFORE you go to the dentist and let your dentist know as well. That will give you the opportunity to get the antibiotics before you go in.
Mark
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