Periodontal Associates, Inc.

10/16/2026

10/11/2026

Our PAI team at Medwish Medworks Medical and Dental Clinic at the convention center in Cleveland. The best 2-day free clinic. So wonderful to be together and serve our community.

09/10/2026

Severe periodontitis increased stroke risk by up to 4.19 times

Gum disease and stroke risk: A new Journal of Periodontology review makes the case for dentists and physicians to team up.

09/07/2026

This comes up on a daily basis in our office. Here's a summary of this ADA (American Dental Association) Council on Scientific Affairs (CSA) position statement:

**Main topic:** How dentists and orthopedic surgeons should coordinate care for patients with hip or knee replacements, responding to the 2024 AAOS-AAHKS (American Academy of Orthopedic Surgeons- American Association of Hip and Knee Surgeons) clinical practice guideline.

**Key points of agreement between ADA and AAOS-AAHKS:**
- **No routine antibiotic prophylaxis needed** — Based on studies of hundreds of thousands of arthroplasty patients, there's no evidence that dental procedures cause periprosthetic joint infection (PJI), or that antibiotics before dental work prevent it. This applies to immunocompetent patients.
- **No antiseptic mouthrinse required** before dental procedures for joint replacement patients.
- **No dental clearance needed** before hip/knee replacement surgery — pre-surgery dental screening doesn't reduce later PJI risk.
- **Delay arthroplasty after dental procedures** (not the reverse) — postsurgical joint sites may be more vulnerable in the weeks right after surgery, so orthopedic surgery should be timed after dental work, with confirmed healing.
- For genuinely **immunocompromised patients** (defined in a box — e.g., advanced AIDS, severe neutropenia, certain biologic drug users, transplant recipients), if the orthopedic team decides antibiotics are needed, the *orthopedic surgeon* should prescribe them.

**Where the ADA pushes back:**
- The AAOS-AAHKS recommends delaying **nonurgent invasive dental procedures for 3 months** after joint replacement. The CSA disagrees with this as a rigid rule.
- Their reasoning: bacteremia is common even from toothbrushing, flossing, and chewing — not just dental procedures — and most PJIs are caused by skin bacteria (staphylococci), not oral bacteria (streptococci). Delaying necessary dental care can also worsen oral health, which itself raises infection risk.
- Instead, the ADA calls for **individualized, shared decision-making** among dentist, orthopedic surgeon, and patient — weighing joint stability, mobility/pain after surgery, and long-term oral health — rather than applying a blanket 3-month waiting period.

JADA 157(6) http://jada.ada.org June 2026

08/29/2026

Our staff delivering needed dental care to the youth at the Juvenile Detention Center.

07/12/2026

https://youtu.be/WHZCWVpWeaY?is=fgZRd4NvLgEWGFUz

In this video i explore the link between oral health and heart health

05/17/2026

Proud to provide care for our community MedwishMedworks

05/12/2026

Congratulations to our Dr. Jason Streem who was honored with the Dr. Ervin P. Mason Distinguished Dentist Award by the Greater Cleveland Dental Society and President Dr. Britni Skoda