There are about one million hip and knee joint replacements annually in the US. New guidelines established by a working committee of the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA) have clarified the issue of antibiotic premedication prior to invasive dental procedures: Antibiotic premedication is not recommended. Research involving large groups of joint replacement subjects has shown no evidence of joint infection, with or without antibiotic premedication, related to invasive dental procedures. The working committee also recommended the maintenance of thorough oral hygiene practices, in order to limit body exposure to oral bacteria.