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Paediatric Dental Health

Dental Health in Children with Congenital Heart Disease

 Studies have found that children with congenital heart disease have similar or higher levels of tooth decay compared to those children without a cardiac defect and can have more untreated oral problems.

 Young children with heart defects may have developed enamel defects, namely enamel hypoplasia. This means the outermost layer of the tooth is thinner than normal and is more at risk of developing decay.

 Children with congenital heart disease are also more likely to have misaligned or crowded teeth than children without heart issues.

 Children who are prescribed high sugar formulas or supplements are at increased risk of developing cavities in their teeth.

 Some medications for heart disease can cause dry mouth which can increase the risk of tooth decay.

 The teeth and the heart share the same blood, meaning the same bacteria that can lead to cavities in teeth can travel to the heart and cause a dangerous infection called infective endocarditis.


What is infective endocarditis? 

 Infective endocarditis is a life-threatening condition which affects the heart valves. It may also occur around holes between the heart chambers, at the site of abnormalities in the walls of arteries or at the site of previous heart or arterial surgery.

 It is caused by bacteria entering the blood stream and settling in the heart, causing an infection.

 It can be very dangerous and children with congenital heart conditions are at an increased risk.



How can you reduce the risk of getting endocarditis?

 Everyone has bacteria in their mouth which are usually harmless.

 If the teeth or gums are unhealthy, bacteria can get into the blood stream, which increases the risk of infective endocarditis.

 Unhealthy teeth can either have decay caused by too much sugar and not enough tooth brushing or can be damaged by too much acid in the diet.



There are some simple ways to help keep your child’s teeth and gums healthy:

 Have a healthy, balanced diet and reduce the amount and frequency of sugar consumption in food and drinks.

 Ensure your child brushes at least twice a day for 2 minutes with a fluoride toothpaste with supervision from an adult until the age of at least 7-8 years old.

 Take your child for regular dental check-ups, ideally every 3 months and before any cardiac surgery.


What will happen at the clinic appointment?

 In cardiac outpatients, a visual examination of your child’s teeth and mouth will be performed by a dentist using a mirror.

 If needed, we will send your child for x-rays of their teeth and then inform you if any dental treatment is required.

 We can help advise you on when, how and where the dental treatment can be completed.

 All children should be dentally fit prior to planned elective cardiac surgery or intervention.

 We will give you advice and provide leaflets on helping keep your child’s teeth healthy and decay free and promoting good dietary habits.

 Please bring details of the general dental practice your child attends with you to this appointment. 

If you’re struggling to find a local dentist, please let a member of the cardiology team know and we can help assist you with this.


Who does the Dental Team see at the East Midlands Congenital Heart Centre?

 Children attending their pre-surgical screening visit prior to elective planned cardiac surgery or intervention for a dental screening visit. 

 2-year-old patients under the care of EMCHC are offered a dental screening visit.

 Referrals from cardiology doctors for children requiring a dental assessment.

 Referrals from dentists within the East Midlands for cardiac patients for advice and/or treatment within a Level 1 surgical centre.

 Dental treatment for cardiac patients under general anaesthetic.