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Effectiveness of an oral health intervention program for children with congenital heart defects
Tine B Sivertsen1, Anne N Åstrøm2, Gottfried Greve3,4,5
1Department of Clinical Dentistry, University of Bergen, Årstadveien 19, NO-5020, Bergen, Norway. tine.sivertsen@uib.no.
Insights
An intensive oral health program for children with congenital heart defects (CHD) did not reduce caries or erosion prevalence. However, it improved oral hygiene, reduced gingival bleeding, and decreased untreated decay in children with CHD.
Area of Science:
- Pediatric Dentistry
- Cardiology
- Public Health
Background:
- Children with congenital heart defects (CHD) often exhibit poorer oral health than their healthy peers.
- Lifelong follow-up is common for individuals with CHD, highlighting the importance of integrated care.
- Oral health interventions are crucial for this vulnerable pediatric population.
Purpose of the Study:
- To assess the effectiveness of an intensive oral health program for children with CHD.
- To compare oral health outcomes at age 5 in children with CHD who received the intervention versus a control group.
- To evaluate the program's impact on caries, dental erosion, plaque, and gingival health.
Main Methods:
- A longitudinal study in western Norway involving 119 children with CHD.
- An intervention group received an oral health program from infancy to age 5.
- Outcomes measured included caries prevalence, dental erosion, plaque index, and gingival bleeding index, compared to a control group.
Main Results:
- No significant difference in caries prevalence (25.3% vs. 25.4%) or dental erosion (22.2% vs. 19.7%) was observed at age 5.
- The intervention group showed significantly better oral hygiene, with less plaque and gingival bleeding.
- Children in the intervention group had fewer decayed teeth and less untreated dentine caries, with parents more likely to brush twice daily.
Conclusions:
- The oral health program did not impact caries or erosion prevalence in children with CHD.
- The intervention led to improved oral hygiene and reduced signs of gum disease.
- Findings suggest benefits in reducing untreated decay and promoting better daily oral care practices.
Background:
Children with congenital heart defects (CHD) are reported to have poorer oral health compared with healthy children. The aim of the present study was to evaluate the effectiveness of an intensive oral health care program among children with CHD followed from infancy to the age of 5 years, by comparing their oral health status at 5 years with a control group of children with CHD who had not received the program.
Methods:
In this longitudinal study, children in western Norway with a need for lifelong follow-up due to congenital heart defects were invited to participate (n = 119). Children born in 2008-2011 were offered an oral health intervention program from infancy to the age of 5 years. The outcome measures for evaluating the intervention were dental caries prevalence, dental erosion, plaque index and gingival bleeding index. The data of the intervention group were compared with cross sectional oral health data of 5 year old controls with CHD born 2005-2007 (already published).
Results:
Early oral health intervention did not affect the prevalence of caries (25.3% versus 25.4%) or dental erosion (22.2% versus 19.7%) of children with CHD assessed at 5 years. Children in the intervention group were less likely than those in the control group to present with both dental plaque and gingival bleeding at age 5 years. In spite of no difference in caries prevalence between the groups, caries affected children (d1-5mft) in the intervention group had fewer teeth affected by caries than children in the control group (p = 0.06). The care index was reported to be higher in the intervention group compared with the control group, implying that fewer children in the intervention group suffered from untreated dentine caries. Parents in the intervention group were more likely to brush their children's teeth twice a day than parents of children in the control group.
Conclusion:
The oral health promotive program did not influence the prevalence of caries nor dental erosion. However, the findings indicated better oral hygiene, reduced gingival bleeding and less untreated dentine caries in the intervention compared with the control group.
Trial Registration:
ClinicalTrials.gov NCT03311438 . Registration date: October 17th 2017, retrospectively registered.
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