Dental Health in Children with Congenital Heart Defects

Published on: 08/10/2018

What are Congenital Heart Defects?

Children with congenital heart defects (CDH) present defects in the walls of the heart, valves of the heart and/or the blood vessels near the heart. The defects will be present at birth.

How does CHD affect the oral health of children?

Children with CDH may require special precautions before dental cleanings and treatment. Some of them could be more susceptible bacterial endocarditis and might require antibiotic prophylaxis.

Oral manifestations

  • Children with CDH have a higher rate of cavities due to intake of sweetened medications.
  • Children with CDH may have Microdontia (teeth that appear abnormally small).
  • Enamel Hypoplasia (softening of the outer-most layer of teeth) may occur in children

Dental Management and Prevention

Prevention is essential in managing the dental health of the child with CHD. Scheduling the child for early professional dental examinations is recommended.

Tips for Proper Dental Hygiene

  • Use sugar free medication.
  • You may use positive reinforcement/rewards for better results.
  • Apply topical fluoride and visit the dentist every 6 months.
  • Parents should begin brushing when the first baby tooth erupts and should assist their child in brushing until the child reaches 8 years of age.
  • Place emphasis on the brushing of teeth rather than the brushing technique.
  • Use fluoridated toothpaste; for children under 3 years old use a smear amount of fluoridated toothpaste and for children above 4 years old use a pea size amount.
  • Parents should monitor dietary practices (i.e. avoid prolonged use of bottle, reduce amounts of sugar consumed, reduce frequency of sugar consumed).

Preparing a child with CHD for a Dentist Appointment

Discuss the medications currently being taken with the child's dentist. The dentist might request a medical clearance from the cardiologist before treating the child. Some adjustments to the medications could be recommended if the child is on blood thinners. The risk for subacute bacterial endocarditis should be evaluated. Some children might require antibiotic prophylaxis before the dental cleaning or dental treatment.
 

Landon Sears, DMD - Nicklaus Children's Pediatric Dentistry Residency Program

References

American Heart Association. (2015, October 26). Retrieved August 21, 2017, from http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/About-Congenital-Heart-Defects_UCM_001217_Article.jsp#.WYMYx1hYqUk

Understand Your Risk for Congenital Heart Defects. (2015, October 26). Retrieved August 21, 2017, from http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/UnderstandYourRiskforCongenitalHeartDefects/Understand-Your-Risk-for-Congenital-Heart-Defects_UCM_001219_Article.jsp

Default - Stanford Children's Health. (n.d.). Retrieved August 21, 2017, from http://www.stanfordchildrens.org/en/topic/default?id=factors-contributing-to-congenital-heart-disease-90-P01788

Moursi and Truesdale. "Cardiovascular Disease. AAPD Oral Health Policies and Clinical Guidelines." American Academy of Pediatric Dentistry, 4th edition,. p. 234, 2011.

Weinrauch, L. A. (2015, October 22). Cyanotic heart disease. Retrieved August 21, 2017, from https://medlineplus.gov/ency/article/001104.htm

Tasioula, V, et al. "Dental Health and Treatment in a Group of Children with Congenital Heart Disease." Pediatric Dentistry Journal, July and August. 2008.

Gelb, B. D. (2001). Genetic basis of syndromes associated with congenital heart disease. Current Opinion in Cardiology, 16(3), 188-194. doi:10.1097/00001573-200105000-00006

Circulation. 2007;116:1736-1754. 2007, American Heart Association, Inc.

Anticoagulant and Antiplatelet Medications and Dental Procedures . (2015, October 22). Retrieved August 29, 2017, from http://www.ada.org/en/member-center/oral-health-topics/anticoagulant-antiplatelet-medications-and-dental-


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