Over the past couple of weeks, dentistry has shown up in the headlines of the news with some exciting new developments. One of these has to do with medicine and dentistry, and the other has to do with a study that was published looking at incidence of caries on baby teeth. The first will require close interaction with our medical colleagues since it has to do with commonly prescribed medications. The third hopefully will be information and proof enough to have some parents take better control of their child's dietary choices.

For many years now, the American Heart Association has recommended that anyone with a compromised heart be given an antibiotic before any dental work that may cause bleeding is done. By a compromised heart I am referring to anyone with a heart murmur, a heart valve replacement and sometimes a stent placed in heart arteries.

Let's take a minute and look at why antibiotics may be needed. When having a dental cleaning, a filling below the gum line, periodontal scaling, an extraction or any other dental procedure that may cause bleeding, bacteria can enter the bloodstream. This is not a big deal in a person who has no heart defects. The body's immune system kills off the bacteria and the person remains healthy. In the person that has a heart defect, the bacteria can potentially land and grow on these compromised areas since the blood flow isn't as rapid.

There are two reasons why the American Heart Association changed its recommendations. The first is that scientists examined the potential for a bacterial infection and found that taking antibiotics doesn't really lessen that risk. In fact, the person with a heart defect may be introducing bacteria into their blood every day just through proper brushing and flossing. The second reason is that scientists determined that the risk of having a reaction to the antibiotic, however extremely rare that is, outweighed the benefits.

Also, repeated exposure of a person to antibiotics can make them susceptible to antibiotic resistant strains of bacteria.

It is important if you have previously taken antibiotics before dental work that you ask your physician if these changes apply to you. Once you have the answer to this, it is also very important that the physician communicate their decision to your dentist. The AHA may publish guidelines, but the physicians in the area establish the standard of care.

One more point on this topic is that the new guidelines don't talk at all about orthopedics and artificial joints. Sometimes the orthopedic surgeon will tell the patient to take antibiotics before dental visits. It is just important that this is communicated to the dentist.

The second new study was one that was publicized on television lately. The important point is that children's diet is largely to blame for the incidence of decay in baby teeth.

This study showed an increase in the amount of decay in teeth in children ages 2 to 5. The reasons cited for the increase in decay were the poor diet that these children were being exposed to and the subsequent lack of fluoridated water.

These 2- to 5-year-old children were being given sugary fruit juices and soda instead of water to drink. The good part of the study was that once children began getting their adult teeth there was a decrease in the incidence of dental decay on adult teeth. This was attributed to the placement of sealants on those adult teeth as soon as possible when they erupt in the mouth.

On a local note, Cayuga County has a federally funded sealant program for some of the area schools. I urge parents to take a look at what they are giving their children to eat and drink and to see if perhaps another choice would be better for that child both for their dental health and overall health.

Dr. Michael K. Keating, DDS, is a dentist in Auburn and can be reached at 252-7278 or e-mail him at DrMike@FingerLakesSmiles.com