The American heart Association recently issued new guidelines for those at risk of developing endocarditis--a bacterial infection of the heart..

In the past, many patients with congenital or other heart problems had to follow a strict regimen of antibiotics before undergoing certain dental procedures. The new guidelines may mean different antibiotics or different dosages for some patients or no premedication for others.

Under the guidelines, patients are divided into three categories: high risk, moderate risk, and low risk.

Those in high- and moderate-risk groups should follow the standard regimen of antibiotic dosage before having dental work. Low-risk patients may need a dosage one hour prior to the procedure or not medication at all.

If you have any kind of heart trouble, we talk to your family doctor or cardiologist before having dental procedures to find out which regimen is necessary for you. Bacterial endocarditis is serious. If you have any questions, call us. We can help you and your physician decide how to protect you from unnecessary illness.

How would you know if you needed to see us for restorative work? Here are a few problems you might watch for:

1. Your dental floss smells bad after you use it. This could be gum (periodontal) disease -- a leading cause of tooth loss. Other culprits are teeth shifting or food particles caught where the floss isn't reaching.

2. Pain when eating ice cream or other cold foods. Teeth that are continually sensitive to cold drinks and frozen confections may have decay deep in the tooth. Gum recession and tooth erosion can also cause this pain.

3. A hole in a tooth. A hole indicates decay and weakened external tooth structure. Left untreated, the enamel will break away, exposing the inner structure.

4. Sweets and even fruit cause a sharp pain in a back tooth. Sharp continuous pain when you eat anything containing sugar usually indicates decay close to the nerve of the tooth.

6. A filling falls out. A filling will generally last a long time, but new decay along the edge of a fillign can weaken it and cause it to eventually fall out.

7. Discoloration of your teeth. Gray, brown, or black spots may be a sign of decay; however, some foods and medications can also cause discoloration.

In any of these situations, prompt professional care is necessary. Delay may mean extensive treatment will be necessary to save your tooth.