Skip to main content
    • Aa
    • Aa

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

  • Richard Balmer (a1) and Frances A. Bu'Lock (a2)

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.

Corresponding author
Correspondence to: Richard Balmer, Leeds Dental Institute, Division of Child Dental Health, Clarendon Way, Leeds LS2 9LU, UK. Tel: 0113 2336329; Fax: 0113 343 6140; E-mail:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

FearneJM, BryanEM, ElimanAM, BrookAH, WilliamsDM. Enamel defects in the primary dentition of children born weighing less than 2000 g.Br Dental J1990; 168: 433437.

PrimoschRE. Tetracycline discoloration, enamel defects, and dental caries in patients with cystic fibrosis.Oral Surg Oral Med Oral Pathol Oral Radiol Endod1980; 50: 301308.

BergerEN. Attitudes and preventive dental health behaviour in children with congenital cardiac disease.Aust Dent J1978; 23: 8790.

JalevikB, KlingbergG. Dental treatment, dental fear and behaviour management problems in children with severe hypomineralization of their permanent first molars.Int J Paed Dent2002; 12: 2432.

PollardMA, CurzonME. Dental health and salivary Streptococcus mutans levels in a group of children with heart defects.Int J Paed Dent1992; 2: 8185.

SchwartzS, SalmanI. The effects of oral surgery on the course of patients with diseases of the heart.Am J Orthodontics1942; 28: 331345.

van der MeerJT, ThompsonJ, ValkenbergHA, MichelMF. Epidemiology of bacterial endocarditis in The Netherlands. II. Antecedent procedures and use of prophylaxis.Arch Intern Med1992; 152: 18691873.

van der MeerJT, Van WijkW, ThompsonJ, VandenbrouckeJP, ValkenburgHA, MichelMF. Efficacy of antibiotic prophylaxis for prevention of native-valve endocarditis.Lancet1992; 339: 135139.

LacassinF, HoenB, LeportC, et al. Procedures associated with infective endocarditis in adults. A case control study.Eur Heart J1995; 16: 19681974.

StromBL, AbrutynE, BerlinJA, et al. Dental and cardiac risk factors for infective endocarditis. A population-based, case-control study.Ann Intern Med1998; 129: 761769.

RobertsGJ, HolzelHS, SuryMR, SimmonsNA, GardnerP, LonghurstP. Dental bacteremia in children.Pediatr Cardiol1997; 18: 2427.

BergerSA, WeitzmanS, EdbergSC, CaseyJI. 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 Med1974; 80: 510511.

GuntherothWG. How important are dental procedures as a cause of infective endocarditis?Am J Cardiol1984; 54: 797801.

RobertsGJ. 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 Cardiol1999; 20: 317325.

DrangsholtMT. A new causal model of dental diseases associated with endocarditis.Ann Periodontol1998; 3: 184196.

LinebergerLT, De MarcoTJ. Evaluation of transient bacteremia following routine periodontal procedures.J Periodontol1973; 44: 757762.

BorDH, HimmelsteinDU. Endocarditis prophylaxis for patients with mitral valve prolapse. A quantitative analysis.Am J Med1984; 76: 711717.

SaundersCP, RobertsGJ. Dental attitudes, knowledge, and health practices of parents of children with congenital heart disease.Arch Dis Child1997; 76: 539540.

HayesPA, FasulesJ. Dental Screening of Pediatric Cardiac Surgical Patients.Pediatr Res1999; 45: 24A.

CettaF, BellTJ, PodleckiDD, RosSP. Parental knowledge of bacterial endocarditis prophylaxis.Pediatr Cardiol1993; 14: 220222.

SeymourRA, LowryR, WhitworthJM, MartinMV. Infective endocarditis, dentistry and antibiotic prophylaxis; time for a rethink?Br Dent J2000; 189: 610616.

ParryJ, KhanF. Provision of dental care for medically compromised children in the UK by General Dental Practitioners.Int J Paediatr Dentistry2000; 10: 322327.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Cardiology in the Young
  • ISSN: 1047-9511
  • EISSN: 1467-1107
  • URL: /core/journals/cardiology-in-the-young
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 2
Total number of PDF views: 28 *
Loading metrics...

Abstract views

Total abstract views: 327 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 23rd June 2017. This data will be updated every 24 hours.