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Attitudes about dental care among parents whose children suffer from severe congenital heart disease: a case-control study
Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
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2006 (English)In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 16, no 4, 231-238 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To examine attitudes and experiences of parents whose children have complex congenital heart disease (CHD) with respect to dental health information and advice, dental care, and service and to compare the results with data from an age- and gender-matched control group without any medical problems.

SETTING: Faculty of Medicine (Paediatric Cardiology and Paediatric Dentistry), Umea University, Umea, Sweden.

SAMPLE AND METHOD: Each group comprised parents of 33 children; the children's mean age was 9.4 years. All the cases and the controls resided in the county of Vasterbotten, northern Sweden. Data were collected with a questionnaire with 20 joint questions to both groups and four additional questions to the CHD group.

RESULTS: Of the 20 joint questions, significant differences were displayed in the following areas: the professional group that provided the parents with dental health information and advice (P < 0.01), attitudes to reception at the dental clinic, and experience of sedation before operative dental treatment (P < 0.05). Parents to 11 children with CHD who were patients at a specialist clinic for paediatric dentistry scored the reception at the dental clinic as excellent in nine cases and satisfactory in two, compared to excellent (3), satisfactory (11), decent (4), and poor (4) among those who were patients in general dental practice (P < 0.01). No statistically significant differences in educational level or in parental experience of dental health were noted between the two groups (P > 0.05).

CONCLUSION: Children with CHD in northern Sweden mainly receive their dental health information from a physician or a dentist, and healthy children mainly receive information from a dental hygienist indicating that children with CHD are given priority in the dental care system. Parental attitudes to reception in the dental service differed, and parents of healthy children scored the reception at the dental clinic better than parents of children with CHD. It is suggested that children with severe CHD should receive dental care in clinics for paediatric dentistry, particularly at early ages.

Place, publisher, year, edition, pages
2006. Vol. 16, no 4, 231-238 p.
Keyword [en]
Odontology
National Category
Dentistry
Research subject
Odontology
Identifiers
URN: urn:nbn:se:umu:diva-12928DOI: 10.1111/j.1365-263X.2006.00736.xOAI: oai:DiVA.org:umu-12928DiVA: diva2:152599
Available from: 2008-06-24 Created: 2008-06-24 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Dental caries and background factors in children with heart disease
Open this publication in new window or tab >>Dental caries and background factors in children with heart disease
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Karies och bakgrundsfaktorer hos barn med hjärtfel
Abstract [en]

Congenital heart disease (CHD) is one of the most common congenital anomalies with an incidence of approximately 8–10 cases per 1000 live births. Technical development and continuing improvement in surgical methods have led to early interventions and an increased survival and consequently also a new group of patients in dentistry. The general aim of this thesis was to study the caries prevalence and some possible background factors in children with complex CHD.Paper I examined the caries prevalence in 41 children with complex CHD and 41 healthy age- and gender-matched controls. CHD children had higher dmfs-values 5.2 ± 7.0 vs. 2.2 ± 3.5 in the controls (p < 0.05). CHD children on digoxin medication had higher dmfs values 10.1 ± 8.5 vs. 3.7 ± 5.3 in the other CHD children (p < 0.05). CHD children had received more fluoride varnish treatments and fluoride tablets (p < 0.01).Paper II investigated attitudes and experiences of dental health information and advice, dental care, and service in 33 parents of children with complex CHD and 33 parents of age- and gender-matched controls. Differences were displayed in the professional group that provided the parents with dental health information and advice, attitudes to reception at the dental clinic, and experience of sedation before operative dental treatment (p < 0.05).Paper III examined 183 Swedish general dentists’ experiences of and attitudes to dental care for children with CHD. Eighteen % of the dentists had received special education or information to treat children with CHD, while almost half of the dentists had one or more patients with CHD and a majority of them stated that their CHD patients had a caries problem. The dentists had a different opinion regarding the provision of dental treatment for children with CHD compared to the current situation (p < 0.001).Paper IV studied salivary secretion, salivary buffering capacity, viable count of bacteria (TVC), mutans streptococci (MS) and lactobacilli (LBC), calcium, chloride, magnesium, potassium, sodium, and IgA in 24 children on heart failure medication and 24 healthy controls. Seven children (29 %) had stimulated secretions below 0.5 ml/min compared to no child among the controls (p < 0.01). TVC were 1.4 × 106 ± 1.2 × 107 in the cardiac group vs. 2.7 × 106 ± 2.9 × 107 in the control group (p < 0.05). MS ratio of TVC constituted 0.11 ± 0.35 % vs. 0.01 ± 0.02 % for the controls (p > 0.05).Paper V studied the endogenous pH and titratable acidity and dissolution of calcium and phosphate from dental hard tissues by 13 pharmaceutical preparations used in paediatric cardiology. Six of the preparations had an endogenous pH below the critical value for enamel dissolution.It is concluded that (i) children with complex CHD had a higher caries experience in the primary dentition than healthy matched controls, (ii) children on digoxin medication had a higher caries experience than other children with complex CHD, (iii) children with complex CHD had received more caries prevention than healthy controls, (iv) parents of children with complex CHD were less satisfied with the reception and care they received than parents of healthy children, (v) general dentists had a different opinion regarding the provision of dental treatment to children with CHD compared to the current situation (vi) children on heart failure medication can have a low saliva secretion, (vii) pharmaceutical preparations used on long-term basis in paediatric cardiology may pose a hazardous threat to dental hard tissues due to their acidity.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2011. 65 p.
Series
Umeå University odontological dissertations, ISSN 0345-7532 ; 115
Keyword
attitudes, caries, children, dental care, heart disease, medication, saliva
National Category
Dentistry
Research subject
Odontology
Identifiers
urn:nbn:se:umu:diva-39655 (URN)978-91-7459-139-2 (ISBN)
Public defence
2011-02-25, Sal B, Tandläkarhögskolan, Umeå universitet, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2011-02-07 Created: 2011-02-03 Last updated: 2011-02-07Bibliographically approved

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