Poor dental health puts children with heart disease at risk

If oral bacteria enter the bloodstream, some children with heart disease may be susceptible to infective endocarditis, researchers say. Photo by Milenafoto/Wikimedia Commons

According to a new US government study, children with heart disease are more likely than their peers to have frequent cavities, toothaches or bleeding gums.

Researchers found that among American children and adolescents with heart disease, 10% had only “poor” to “fair” dental health, as rated by their parents. This was double the number of children without heart problems.

This is partly concerning, the researchers say, because if oral bacteria enter the bloodstream, some children with heart disease may be susceptible to infectious disease. endocarditis. The condition is rare, but it inflames the inner lining of the heart and can be life threatening.

According to Dr. Alene D’Alesio, chief of pediatric dentistry at Children’s Hospital of Pittsburgh, the larger issue, however, is that good oral health and sparing children pain and dental procedures are important. .

She says early preventive dental care is essential for young people born with heart defects.

“They should see a pediatric dentist no later than one year old,” said D’Alesio, who was not involved in the the study.

There are various reasons why children with heart disease may be more prone to cavities, according to study leader Karrie Downing, a researcher at the US Centers for Disease Control and Prevention.

On the one hand, Downing said, they may have surgeries or other procedures that make caring for teeth and gums more difficult, or put it lower on families’ priority list.

Beyond that, Downing said, children with heart disease typically have developmental or intellectual disabilities that can make dental care more difficult, whether at home or at the dentist.

Even heart medications can play a role, D’Alesio said: Some cause dry mouth, which can help feed cavities.

One simple way parents can help, D’Alesio said, is to make sure their children drink plenty of water — not juice or other sugary drinks.

The study – recently published in the CDC’s Morbidity and Mortality Weekly Report — drawn from data from an ongoing government survey of children’s health.

Between 2016 and 2019, nearly 120,000 American parents answered questions about their children’s oral health and dental care. This included nearly 3,000 parents of a child with heart disease.

Overall, these parents were twice as likely to rate their children’s dental health as poor to fair. And 1 in 6 said their child had suffered from frequent toothaches, bleeding gums or cavities in the past year.

Of all children with heart disease, about a quarter also had an intellectual or developmental disability. And this, according to the study, partly explains their poorer dental health.

There was no evidence that children with heart disease saw the dentist less often. In fact, about 83% had received preventive dental care in the past year, compared to 80% of children without heart problems.

But that still meant 17% had received none – a problem that disproportionately affected families without health insurance. Of all those children (with and without heart disease), 56% had seen a dentist for a checkup in the past year, according to the study.

Ideally, D’Alesio said, families should see a pediatric dentist rather than a dentist who treats adults. And young people with heart disease, she said, may need more frequent visits — perhaps a few times a year.

This can, of course, be easier said than done. Some families may even struggle to find a nearby pediatric dentist, D’Alesio noted.

At the same time, she says, there are many things parents of children with heart disease can do to help them maintain healthy teeth and gums.

“I don’t want anyone to think that heart disease equals cavities,” D’Alesio said.

She recommended that parents monitor their children’s brushing and flossing for a longer period of time – and possibly delay their “independence” until they are 8, 9 or 10 years old.

Downing also suggested some basic steps at home: Consider using flossing “aids” such as dental floss holders or toothpicks, and find a toothpaste and toothbrush your child likes. really. An electric toothbrush, Downing noted, could help simplify things.

More information

The American Academy of Pediatrics has more on dental care for children with heart disease.