Systemic, oral characteristics and dental management of pediatric patient with Tetralogy of Fallot. A case report.

Abstract

Introduction: Tetralogy of Fallot is a congenital heart disease and the most common cyanotic heart defect in children. It is clinically characterized by a ventricular septal defect, pulmonary stenosis, overriding aorta over ventricular septal defect and right ventricular hypertrophy. There is little or no information about the oral manifestations in patients with this pathology. A report and discussion of a pediatric patient diagnosed with Tetralogy of Fallot, its clinical manifestations, oral findings and dental management are presented. Case Report: A four-year-old male patient diagnosed with Tetralogy of Fallot and epileptic attacks. The patient has deciduous teeth with many severe early childhood caries, stomatitis and cyanotic mucous membranes, root fragments, periapical abscess and noticeable enamel hypoplasia. Conclusions: In agreement with other authors, children with systemic diseases such as Tetralogy of Fallot have a higher rate of caries, poor oral hygiene, high susceptibility to other infections and bacterial endocarditis, cyanotic mucous membranes and enamel hypoplasia. Primary prevention is critical, proper dental hygiene, regular dental check-ups and the use of antibiotic prophylaxis are particularly important, especially in high-risk patients.

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

“…However, Franco et al ( 15 ) found no differences in decayed/missing/filled teeth (dmft) or Decayed/Missing/Filled Teeth (DMFT) between cardiac and control children aged 2–16 years. Ayala & Aguayo ( 8 ) mention that among patients with PA/VSD, those treated with Digoxin demonstrate a greater number of carious lesions. On the other hand, a consistent outcome found in the present scoping review was the higher degree of untreated caries, delayed treatment, and decreased level of dental care in patients with PA/VSD ( 1 , 11 , 15 , 26 , 29 ).…”

“…Maintaining oral health in children with PA/VSD is extremely important because the oral cavity is the chief entrance via for bacteria that may cause infective endocarditis, which increases the risk of additional damage to the heart condition ( 1 ). Chronic administration of liquid sucrose-sweetened oral drugs increases the incidence of dental caries and gingivitis, particularly in young children and in cases of developmental enamel defects ( 8 , 20 ). Additionally, administered diuretics may lead to impaired salivary secretion or xerostomia ( 16 , 19 ).…”

“…In severe cases, a right-to-left shunting through the foramen ovale is formed, which is manifested by cyanosis, acropachy, polycythemia, systemic hypoxia, anemia, bluish appearance, and clubbing of the fingers ( 4 , 6 ). The etiology of TF continues to remain unclear, but it has been related with defects occurring from week 3 to week 8of intrauterine life ( 7 , 8 ). Likewise, several associated conditions have been mentioned as follows: low birth weight; short gestational duration; rubella; maternal infections; smoking or alcoholism; drugs such as Thalido-mide, Warfarin, and Phenytoin, and, possibly, twinning ( 4 , 8 ).…”

“…The etiology of TF continues to remain unclear, but it has been related with defects occurring from week 3 to week 8of intrauterine life ( 7 , 8 ). Likewise, several associated conditions have been mentioned as follows: low birth weight; short gestational duration; rubella; maternal infections; smoking or alcoholism; drugs such as Thalido-mide, Warfarin, and Phenytoin, and, possibly, twinning ( 4 , 8 ). Gene mutations have been suggested in 4% of TF cases ( 9 ).…”

“…Therefore, it is necessary to conduct an early oral examination, followed by the promotion of individual hygiene measures and the implementation of therapeutic procedures in children affected by PSD/VSD ( 11 , 13 ). Despite recent medical progress, CHD are still a cause of high mortality in pre-school children, accounting for one half of deaths in this age group ( 8 ). In this context, the present article aims to present the main results of a scoping review on the dental management of patients with PSD/VSD performed over a period of the last 10 years.…”