The impact of oral health on the quality of life of young patients with congenital cardiac disease

Abstract

The purposes of our study were, first, to determine the prevalence of dental caries in young patients with congenital cardiac disease, second, to determine the effect of oral health in their quality of life, third, to examine parental knowledge about associations between oral health and cardiac health, and fourth, to examine parental perceptions regarding access to dental care. A standardized questionnaire was given to a convenience sample of parents of 43 children with cardiac disease and 43 healthy controls from 12 to 71 months of age. In every patient, we performed a dental examination. Descriptive statistics, the two-tailed t-test, and Fisher's exact test were used for statistical analysis. Of the children with cardiac disease, 17% had caries, compared to 13% of the control group. Almost half of those with cardiac disease had never seen a dentist, compared to 35% of the control subjects. Of the parents of those with cardiac disease, one-fifth did not know whether oral health was important for the heart, compared to one-tenth of controls. Insurance and access to care were not barriers to obtain dental treatment. Statistically significant differences were, first, parents of children with congenitally malformed hearts felt more guilt about their child's oral health than control parents (p = 0.026), second, they were more upset about the dental problems and/or treatments of their children (p = 0.012), and third, they thought that dental problems and/or dental treatment made their children more irritable (p = 0.012). Our findings indicate that it is of paramount importance that cardiologists and their associated staff educate patients and families about oral health and other issues associated with congenital cardiac disease.

Caries experience in young children with congenital heart disease in a developing country

“…Another recent study reported a low caries index and no statistical difference when comparing young congenital heart disease patients with healthy controls. 6 The data from this study group showed that the test group had a reduced oral health-related quality of life in some specific domains, including family stress and psychological impact on the child. 6 Current evidence from animal models suggests that bacteremia leading to infective endocarditis may be induced by routine situations, such as oral hygiene and chewing.…”

“…Fonseca et al concluded that the most significant barrier to good oral health is often the lack of knowledge. 6 The population comprising our study was essentially a surgical group, reflecting our hospital's profile (tertiary care, reference cardiology hospital). This aspect could also have contributed to the process of caries development, since the complexity of the underlying cardiac disease may lead parents to underestimate the importance of oral hygiene.…”

“…On the other hand, this could only reflect a negative behavior regarding toothbrushing, or invasive dental procedures resulting from a more complex cardiac condition. 4,6,8 Unfortunately, most of the children are taken to the dentist when oral disease has already reached a critical point.…”

“…2,5 Dental disease may lead to dental extractions in young children, possibly requiring general anesthesia, thus compounding the problem with additional financial, emotional and physical burdens. 6 Hallet et al 2 compared the oral health of children suffering from congenital heart disease with that of children from healthy controls, and found that the incidence of caries lesions was significantly higher in the former group. Moreover, parents of these children were not often aware of the need to prevent dental infections.…”

Association between parental guilt and oral health problems in preschool children

“…Another study, which focused mainly on the quality of life of children with heart disease, observed that parents of special care children felt more guilty than parents of healthy children. 20 This relationship between parental guilt and oral problems could be due to the impact that ECC has on the child, the family and the community. 21 "Guilt" is a feeling that occurs when one assesses one's specific action as a failure or, especially, when the particular action has led to failure.…”