Oral Health Status of Paediatric Cardiac Patients: a Case-control Study

Dental care in children with cardiac disease is an important consideration from the time the first tooth erupts because of the risk of infective endocarditis (IE). Transient bacteraemia occurs frequently during dental procedures with instrumentation or even after routine oral activities. Objectives: To investigate the oral health of paediatric cardiac patients and the parental knowledge about their child’s oral health and infective endocarditis and to compare it with age and gendermatched children without cardiac disease. Materials and methods: A total of 66 children with heart diseases aged 2-12 years attending the paediatric cardiology clinic of the Tygerberg Hospital were examined for dental caries, developmental enamel defects, plaque and gingivitis. A case-matched control group of 66 children was also examined. The criteria used for dental examination were those of World Health Organization (WHO) Basic Oral health survey (1997). Parental oral health care and infective endocarditis knowledge was assessed by administrating a structured questionnaire. Results: No statistically significant differences were established in the study between the caries experience score for the two groups. However, the mean decayed component and total mean dmft and DMFT were slightly higher in the cardiac group, in both the primary and permanent dentitions. The prevalence of developmental dental anomalies was slightly higher in the cardiac group but not statistically significant. Gingival inflammation was significantly higher in the cardiac group as compared to the control group (p = 0.04). The parental knowledge of oral health care and infective endocarditis was not satisfactory in both groups. Conclusion: As these children are “at risk” from dental disease, the primary focus should be on oral hygiene instructions, dietary counseling, instructions on fluoride use and the awareness of infective endocarditis.