Dental caries experience in children with congenital heart disease : a case-control study

• Objectives: To compare the dental health in a group of children with complex congenital heart disease with age and gender matched healthy controls. Design: Case-control study. Setting: Faculty of Medicine and Odontology/ Pediatric cardiology and Pedodontics, Umeå university, Sweden Sample and 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. 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 were prescribed fluoride tablets on one or more occasions compared to 17% in the control group (p < 0.01). Number of month 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 and they had a mean dmfs-value of 10.1 + 8.5. Conclusion: Swedish children with complex congenital heart disease have poorer dental health than healthy age and gender matched controls in spite of intensified preventive efforts. In many cases, intervention had been given when caries were present. A closer cooperation between paediatric cardiology and paediatric dentistry is needed.

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