title: Oral microflora and dietary intake in infants with congenital heart disease: a case control study.
abstract: BACKGROUND
  Infants with moderate to severe congenital heart disease (CHD) are at a higher risk for growth failure and malnutrition due to increased metabolic demands and inadequate energy intake. This state requires meals that are more frequent and a special enriched diet, which may have negative implications on oral health.
  
  
  OBJECTIVE
  To examine the oral colonisation of some bacteria associated with caries development during infancy; mutans streptococci (MS) and lactobacilli (LCB) in infants with CHD and whether their dietary intake had an impact on the bacterial levels.
  
  
  METHODS
  This was a prospective case-control study. 11 infants with CHD and 22 healthy, age-matched infants were enrolled. Saliva samples and food diaries were collected at 6, 9, and 12 months of age. The total viable counts of MS and LCB in saliva were determined, and energy intake, meal frequency, intake of proteins, fat, carbohydrates and sucrose were calculated.
  
  
  RESULTS
  At 12 months of age, the MS count was higher in the CHD group than in the controls (p<0.01), and MS constituted a higher ratio of the total viable count of oral bacteria (p<0.01). Meal frequency was higher in the CHD group at 6 and 9 months of age than in the controls (p<0.05). The intake of sucrose did not differ between the groups, while the total carbohydrate intake was higher in the control group at 6 and 12 months of age (p<0.05). Compared with the control group, which had six courses of antibiotic administration, the CHD infants had 21 courses (p<0.05).
  
  
  CONCLUSIONS
  Infants with severe CHD have higher levels of MS at 12 months of age than the healthy controls. A higher meal frequency and use of diuretic medication and antibiotics may have influenced MS colonisation.
authors.affiliation: Department of Odontology, Umeå University, Umeå, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Hansson
authors.forename: A
authors.initials: A
authors.lastname: Rydberg
authors.forename: C
authors.initials: C
authors.lastname: Stecksén-Blicks
mesh_terms: D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D058491:Bacterial Load; D001835:Body Weight; D016022:Case-Control Studies; D003731:Dental Caries / Q000382:microbiology; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D019422:Dietary Sucrose / Q000008:administration & dosage; D004232:Diuretics / Q000627:therapeutic use; D002149:Energy Intake; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D007223:Infant; D007778:Lactobacillus / Q000254:growth & development*; D062407:Meals; D008499:Medical Records; D009055:Mouth / Q000382:microbiology*; D011446:Prospective Studies; D012463:Saliva / Q000382:microbiology; D013295:Streptococcus mutans / Q000254:growth & development*; D014099:Toothbrushing
chemical_list: D000900:Anti-Bacterial Agents; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D019422:Dietary Sucrose; D004232:Diuretics