Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-28T17:14:24.420Z Has data issue: false hasContentIssue false
  • English
  • Français

The experiences with oral health and dental prevention of children with congenital heart disease

Published online by Cambridge University Press:  24 May 2005

Richard Balmer  and
Frances A. Bu'Lock
Richard Balmer
Affiliation:
Division of Child Dental Health, Leeds Dental Institute, Leeds, UK
Frances A. Bu'Lock
Affiliation:
Department of Paediatric Cardiology, Glenfield General Hospital, Leicester, UK
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: To examine the degree to which children, considered to be at risk from infective endocarditis, had received professional education and preventive procedures in regard to dental health, and to evaluate the knowledge of their parents of the link between oral health and infective endocarditis. Materials and methods: Questionnaires were distributed to the families of 38 children under the care of paediatric cardiology. A short dental examination was carried out. Parents were asked if they knew why oral health was of particular importance in their child. Results: Of the children, 58% demonstrated evidence of previous or current dental disease, with 24% having had at least one filling, 13% with one or more teeth showing deficiency of enamel, and 39% with untreated dental caries. Only 79% of the children were registered with a dentist. According to Chi squared test, there was no difference in the dental health of registered and non registered children. Of the study group, 29% had received instruction in oral hygiene, 42% had received dietary advice, 13% had received advice regarding fluoride supplementation or had had fluoride professionally applied, and 8% had had fissure sealants. These percentages remained relatively low even if only registered children, or only registered children with previous or current dental disease, were considered. Only 64% of parents were aware of the link between the oral health of their children and infective endocarditis. Parents of children who were registered were more likely to be aware of this link than parents of children who were not registered. Conclusions: In spite of being registered with general dental practitioners, few children with congenital heart disease had received basic education in dental hygiene. Even children known to have had dental disease and, therefore, considered to be more vulnerable, were overlooked.

Keywords

Infective endocarditispaediatricscongenital cardiac malformations
Type
Original Article
Information
Cardiology in the Young , Volume 13 , Issue 5 , October 2003 , pp. 439 - 443
Copyright
© 2003 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Mollor JH, Hoffman JIE. Pediatric Cardiovascular Medicine. Churchill Livingstone, New York, 2000.
Behrman R, Kliegman R, Jenson H. Nelson Textbook of Pediatrics. W.B. Saunders Company, Philadelphia, 2000.
Soames J, Southam J. Oral Pathology, 2nd edn. Oxford Medical Publications, Oxford, 1993.
Fearne JM, Bryan EM, Eliman AM, Brook AH, Williams DM. Enamel defects in the primary dentition of children born weighing less than 2000 g. Br Dental J 1990; 168: 433–437.Google Scholar
Primosch RE. Tetracycline discoloration, enamel defects, and dental caries in patients with cystic fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1980; 50: 301–308.Google Scholar
Hallett KB, Radford DJ, Seow WK. Oral health of children with congenital cardiac diseases: a controlled study. Pediatr Dent 1992; 14: 224–230.Google Scholar
Hakala PE. Dental and oral changes in congenital heart disease. Suomen Hammaslaakariseuran Toimituksia 1967; 63: 284–324.Google Scholar
Berger EN. Attitudes and preventive dental health behaviour in children with congenital cardiac disease. Aust Dent J 1978; 23: 87–90.Google Scholar
Jalevik B, Klingberg G. Dental treatment, dental fear and behaviour management problems in children with severe hypomineralization of their permanent first molars. Int J Paed Dent 2002; 12: 24–32.Google Scholar
Pollard MA, Curzon ME. Dental health and salivary Streptococcus mutans levels in a group of children with heart defects. Int J Paed Dent 1992; 2: 81–85.Google Scholar
Franco E, Saunders CP, Roberts GJ, Suwanprasit A. Dental disease, caries related microflora and salivary IgA of children with severe congenital cardiac disease: an epidemiological and oral microbial survey. Pediatr Dent 1996; 18: 228–235.Google Scholar
Schwartz S, Salman I. The effects of oral surgery on the course of patients with diseases of the heart. Am J Orthodontics 1942; 28: 331–345.Google Scholar
van der Meer JT, Thompson J, Valkenberg HA, Michel MF. Epidemiology of bacterial endocarditis in The Netherlands. II. Antecedent procedures and use of prophylaxis. Arch Intern Med 1992; 152: 1869–1873.Google Scholar
van der Meer JT, Van Wijk W, Thompson J, Vandenbroucke JP, Valkenburg HA, Michel MF. Efficacy of antibiotic prophylaxis for prevention of native-valve endocarditis. Lancet 1992; 339: 135–139.Google Scholar
Lacassin F, Hoen B, Leport C, et al. Procedures associated with infective endocarditis in adults. A case control study. Eur Heart J 1995; 16: 1968–1974.Google Scholar
Strom BL, Abrutyn E, Berlin JA, et al. Dental and cardiac risk factors for infective endocarditis. A population-based, case-control study. Ann Intern Med 1998; 129: 761–769.Google Scholar
Roberts GJ, Holzel HS, Sury MR, Simmons NA, Gardner P, Longhurst P. Dental bacteremia in children. Pediatr Cardiol 1997; 18: 24–27.Google Scholar
Berger SA, Weitzman S, Edberg SC, Casey JI. Bacteremia after the use of an oral irrigation device. A controlled study in subjects with normal-appearing gingiva: comparison with use of toothbrush. Ann Intern Med 1974; 80: 510–511.Google Scholar
Guntheroth WG. How important are dental procedures as a cause of infective endocarditis? Am J Cardiol 1984; 54: 797–801.Google Scholar
Roberts GJ. Dentists are innocent! “Everyday” bacteremia is the real culprit: a review and assessment of the evidence that dental surgical procedures are a principal cause of bacterial endocarditis in children. Pediatr Cardiol 1999; 20: 317–325.Google Scholar
Drangsholt MT. A new causal model of dental diseases associated with endocarditis. Ann Periodontol 1998; 3: 184–196.Google Scholar
Lineberger LT, De Marco TJ. Evaluation of transient bacteremia following routine periodontal procedures. J Periodontol 1973; 44: 757–762.Google Scholar
Bor DH, Himmelstein DU. Endocarditis prophylaxis for patients with mitral valve prolapse. A quantitative analysis. Am J Med 1984; 76: 711–717.Google Scholar
Curzon ME, Roberts JF, Kennedy DB. Kennedy's Paediatric Operative Dentistry, 4th edn. Wright, London, 1996.
Saunders CP, Roberts GJ. Dental attitudes, knowledge, and health practices of parents of children with congenital heart disease. Arch Dis Child 1997; 76: 539–540.Google Scholar
Hayes PA, Fasules J. Dental Screening of Pediatric Cardiac Surgical Patients. Pediatr Res 1999; 45: 24A.Google Scholar
Cetta F, Bell TJ, Podlecki DD, Ros SP. Parental knowledge of bacterial endocarditis prophylaxis. Pediatr Cardiol 1993; 14: 220–222.Google Scholar
Seymour RA, Lowry R, Whitworth JM, Martin MV. Infective endocarditis, dentistry and antibiotic prophylaxis; time for a rethink? Br Dent J 2000; 189: 610–616.Google Scholar
Soble R. Sociologic and psychologic considerations in special patient care: the dentist, the patient and the family. Dent Clin North Am 1974; 18: 545–556.Google Scholar
Holzel A. The effect of medical conditions on the dental care of children. Working Party Report, 1978.
Shaw L. Prevention of Dental Caries in Children, in Paediatric Dentistry – UK. National Clinical Guidelines and Policy Documents. Dental Practice Board for England and Wales, 1999.
Murray J. The Prevention of Oral Disease, 3rd edn. Oxford University Press, Oxford, 1996.
Hinds K, Gregory J. National diet and Nutrition Survey: children aged 1.5 to 4.5 years, in Report of the dental survey. HMSO, London, 1995.
Tickle M, Milsom K, Kennedy A. Is it better to leave or restore carious deciduous molar teeth? A preliminary study. Primary Dental Care 1999; 6: 127–131.Google Scholar
Parry J, Khan F. Provision of dental care for medically compromised children in the UK by General Dental Practitioners. Int J Paediatr Dentistry 2000; 10: 322–327.Google Scholar
Dental Practice Board. Registrations: October–December 1997, England and Wales. GDS Quarterly Statistics, 1998.