Dental caries experience in children with congenital heart disease: a case-control study.
OBJECTIVE
To compare the dental health of a group of children with complex congenital heart disease with that of age and gender matched healthy controls.


METHODS
Case-control study.


METHODS
Faculty of Medicine and Odontology/Pediatric cardiology and Pedodontics, Umeå University, Sweden.


METHODS
All the cases and their controls lived in the county of Västerbotten in northern Sweden. Each group comprised 41 children with a mean age of 6.5 years. Data were collected from medical and dental records while all bitewing radiographs were read separately by one of the authors.


RESULTS
Children with congenital heart disease had significantly more caries in their primary teeth than the control group. The mean dmfs-value was 5.2 +/- 7.0 in the cardiac group compared to 2.2 +/- 3.5 in the control group (P < 0.05). Twenty-six of the children had all four 6-year-molars, and their mean DMFS-values were 0.9 +/- 1.9 in the cardiac group compared to 0.3 +/- 0.6 in the control group (P > 0.05). The children with congenital heart disease had received more caries prevention based on the use of fluorides than the control group. There was a significant correlation between the number of fluoride varnish treatments and the dmfs value of the child (r = 0.411, P < 0.01). Fifty-two per cent of the children in the cardiac group had been prescribed fluoride tablets on one or more occasions compared to 17% in the control group (P < 0.01). Number of months on digoxin medication and the dmfs-value had a significant correlation (r = 0.368, P < 0.05). Ten of the children had been on digoxin medication between 6 and 87 months; this subgroup had a mean dmfs-value of 10.1 +/- 8.5.


CONCLUSIONS
Swedish children with complex congenital heart disease have poorer dental health than healthy age and gender matched controls in spite of intensive preventive efforts. In many cases, intervention had been given when caries were present. A closer cooperation between paediatric cardiology and paediatric dentistry is needed.
Pediatric Dentistry, Faculty of Medicine and Odontology, Umeå University, S-901 85 Umeå, Sweden. christina.stecksen@vll.se
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Stecksén-Blicks
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Rydberg
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Nyman
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Asplund
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Svanberg
D002316:Cardiotonic Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004245:DMF Index; D003731:Dental Caries / Q000209:etiology* / Q000517:prevention & control; D004077:Digoxin / Q000627:therapeutic use; D005260:Female; D005460:Fluorides, Topical / Q000008:administration & dosage; D006330:Heart Defects, Congenital / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D013548:Sweden
D002316:Cardiotonic Agents; D005460:Fluorides, Topical; D004077:Digoxin