Dental management of pediatric patients affected by pulmonary atresia with ventricular septal defect: A scoping review

Abstract

BackgroundCongenital Heart Diseases (CHD) involves a wide range of pathological conditions, such as Pulmonary Atresia with Ventricle Septal Defect (PA/VSD). This disorder leads to the systemic circulation of oxygen-poor blood (cyanosis), with associated features and consequences in the oral cavity.Material and MethodsUsing scoping review methodology for screening and article selection, the primary objectives of this paper were as follows: first, to pose a research question; second, to identify relevant studies in order to answer the research question; third, to select and retrieve the studies; fourth, to chart the critical data, and finally, to collate, summarize, and report the results from the most important articles on the dental management of children affected with PA/VSD. Relevant articles (Randomized Controlled Trials [RCT], reviews, observational studies, and clinical case reports) published over a 10-year period were identified and retrieved from four Internet databases: PubMed; Embase/Ovid; Cochrane Library, and Google Scholar.ResultsBy title and abstract screening and after removing duplicates, 24 articles were finally included in the present scoping review. According to the extracted data, the following are the most important clinical issues to be considered when treating children with PA/VSD in the dental setting: prevalence of dental caries; prevention of dental disease (oral hygiene and diet); bacteremia and infective endocarditis risk, and child behavior control and treatment under general anesthesia.ConclusionsPediatric Dentists should bear in mind that early diagnosis and treatment, together a long-term follow-up of children with PA/VSD, continue to be the best approaches for achieving enhanced patient psychological well-being and, in consequence, their good quality of life. Key words:Pulmonary atresia, congenital heart diseases, ventricle septal defect, scoping review, dental management.

Prevalence of Dental Decay and Periodontal Diseases Among Children Suffering From Congenital Heart Diseases. A Literature Review – Part Iii

“…Again, given the use of different indices, caution is also required when comparing results for plaque and gingivitis among different reports. In the present study, gingivitis and plaque were found to be highly prevalent among children with CHDs, and the percentages were much higher than in previous studies (1). Fifteen of the cases in the present study were found to have gingival hyperplasia.…”

“…As a result of progress in medical procedures and the use of prosthetic materials for correction of CHDs, the prognosis for these patients has improved. Children with CHDs now have a greater life expectancy, and many of them reach adulthood (1,27). Nevertheless, these children remain at a higher risk than healthy children of developing serious and potentially fatal heart-related infections, such as infective endocarditis (1,27).…”

“…Children with CHDs now have a greater life expectancy, and many of them reach adulthood (1,27). Nevertheless, these children remain at a higher risk than healthy children of developing serious and potentially fatal heart-related infections, such as infective endocarditis (1,27). Infective endocarditis of oral origin was thought to be associated only with invasive dental procedures, through the entry of oral bacteria into the systemic circulation (for example, Streptococcus viridans, S. sanguinus, and S. mutans) (1,13).…”

“…In another recent study in Sudan, a significantly higher prevalence of caries and gingivitis among children aged 3-12 years with a CHD than among those without a CHD, was found (16). The role of the caregiver of a child with a CHD, in terms of practicing daily oral health activities and possessing oral health knowledge, has been recognized to be a risk factor of great importance (1,16,25).…”

“…Retarded eruption of teeth, orthodontic anomalies, enamel hypoplasias and poor oral hygiene due to distraction, caused by the cardiac disease, are common clinical findings among patients with congenital heart disease (CHD) (1). A recent study finds that enamel and dentin of primary teeth of children with CHD have lower amounts of calcium and phosphate in their compound than the average expected in healthy children (2,3).…”