umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Dental caries and background factors in children with heart disease
Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
2011 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Karies och bakgrundsfaktorer hos barn med hjärtfel (Swedish)
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 [en]
attitudes, caries, children, dental care, heart disease, medication, saliva
National Category
Dentistry
Research subject
Odontology
Identifiers
URN: urn:nbn:se:umu:diva-39655ISBN: 978-91-7459-139-2 (print)OAI: oai:DiVA.org:umu-39655DiVA: diva2:394867
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
List of papers
1. Dental caries experience in children with congenital heart disease: a case-control study
Open this publication in new window or tab >>Dental caries experience in children with congenital heart disease: a case-control study
Show others...
2004 (English)In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 14, no 2, 94-100 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: To compare the dental health in a group of children with complex congenital heart disease with age and gender matched healthy controls.

Design: Case-control study.

Setting: Faculty of Medicine and Odontology/ Pediatric cardiology and Pedodontics, Umeå university, Sweden

Sample and Methods: All the cases and their controls lived in the county of Västerbotten in northern Sweden. Each group comprised 41 children with a mean age of 6.5 years. Data were collected from medical and dental records. All bitewing radiographs were read separately by one of the authors.

Results: Children with congenital heart disease had significantly more caries in their primary teeth than the control group. The mean dmfs-value was 5.2 + 7.0 in the cardiac group compared to 2.2 + 3.5 in the control group (p < 0.05). Twenty-six of the children had all four 6-year molars, and their mean DMFS-values were 0.9 + 1.9 in the cardiac group compared to 0.3 + 0.6 in the control group (p > 0.05). The children with congenital heart disease had received more caries prevention based on the use of fluorides than the control group. There was a significant correlation between the number of fluoride varnish treatments and the dmfs value of the child (r = 0.411, p < 0.01). Fifty-two per cent of the children in the cardiac group were prescribed fluoride tablets on one or more occasions compared to 17% in the control group (p < 0.01). Number of month on digoxin medication and the dmfs-value had a significant correlation (r = 0.368, p < 0.05). Ten of the children had been on digoxin medication between 6 and 87 months and they had a mean dmfs-value of 10.1 + 8.5.

Conclusion: Swedish children with complex congenital heart disease have poorer dental health than healthy age and gender matched controls in spite of intensified preventive efforts. In many cases, intervention had been given when caries were present. A closer cooperation between paediatric cardiology and paediatric dentistry is needed.

Identifiers
urn:nbn:se:umu:diva-13421 (URN)10.1111/j.1365-263X.2004.00531.x (DOI)15005697 (PubMedID)
Available from: 2008-01-31 Created: 2008-01-31 Last updated: 2011-02-07Bibliographically approved
2. Attitudes about dental care among parents whose children suffer from severe congenital heart disease: a case-control study
Open this publication in new window or tab >>Attitudes about dental care among parents whose children suffer from severe congenital heart disease: a case-control study
Show others...
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.

Keyword
Odontology
National Category
Dentistry
Research subject
Odontology
Identifiers
urn:nbn:se:umu:diva-12928 (URN)10.1111/j.1365-263X.2006.00736.x (DOI)
Available from: 2008-06-24 Created: 2008-06-24 Last updated: 2011-02-07Bibliographically approved
3. Experience of dental care for children with congenital heart disease among Swedish dentists
Open this publication in new window or tab >>Experience of dental care for children with congenital heart disease among Swedish dentists
2007 (English)In: Swedish Dental Journal, ISSN 0347-9994, Vol. 31, no 2, 85-90 p.Article in journal (Refereed) Published
Abstract [en]

This study was conducted in order to examine the experience of and attitudes to dental care for children with congenital heart disease (CHD) among Swedish general dentists. 183 general dentists employed in the Public Dental Health Service in the counties of Västerbotten and Uppsala, and private practitioners listed with dentistry for children in the county of Västerbotten, Sweden, were enrolled in the study. Data were collected with a questionnaire with 18 questions. Eighteen per cent of the dentists stated that they had received special education or information except the graduate training to treat children with CHD. Forty-eight per cent of the dentists had one or more patients with CHD. Seventy-two per cent of these stated that their CHD-patients had a caries problem. Statistically significant differences were displayed between answers on the questions "who in the dental team perform the major part of the dental care for children with CHD" and "what is your opinion on which personal category that should perform the major part of the dental care for this group of children" (p < 0.001). Among dentists whose clinical time mainly was used for dentistry for children, it was more common to treat children with CHD (p < 0.001) than for dentists with a lower degree of dentistry for children. The study showed that the Swedish dental care for children with CHD today mainly is performed by dental nurses, dental hygienists and general dentists. This strongly differs from the dentist's opinion on who should perform the major part of the dental care for this group of children. These findings taken together with the very low number of dentists that had received special education or information except the graduate training to treat children with CHD indicates that the Swedish dentists are unsettled and insecure in the dental treatment of children with heart defects. An early and close cooperation between specialists in pediatric dentistry, dentists with special training and general dentists is strongly desirable to support the dentists and facilitate the dental care for children with CHD.

National Category
Dentistry
Research subject
Odontology
Identifiers
urn:nbn:se:umu:diva-16320 (URN)17695053 (PubMedID)
Available from: 2007-09-10 Created: 2007-09-10 Last updated: 2011-02-07Bibliographically approved
4. Saliva profiles in children using heart failure medication: a pilot study
Open this publication in new window or tab >>Saliva profiles in children using heart failure medication: a pilot study
2010 (English)In: European Archives of Paediatric Dentistry, ISSN 1818-6300, E-ISSN 1996-9805, Vol. 11, no 4, 187-191 p.Article in journal (Refereed) Published
Abstract [en]

AIM: To study the saliva profiles in children with severe heart disease taking heart failure medication compared with the saliva from healthy age and gender matched controls.

STUDY DESIGN: Cross sectional case-control design.

METHODS: Twenty-four age and gender matched pairs of children, mean age 12.0 years participated. Stimulated saliva was collected in a standardized way before lunchtime and the subjects were asked to refrain from all eating, drinking and tooth brushing 90 mins before sampling. Stimulated salivary secretion rate, buffering capacity, total salivary viable count of bacteria, mutans streptococci and lactobacilli, calcium, chloride, magnesium, potassium, sodium and salivary IgA were determined.

RESULTS: There were 7 of the 24 children in the cardiac group who had secretions below 0.5 ml/min compared with no child in the control group (p<0.01). Lower [corrected] total viable counts of bacteria (TVC) were detected in the cardiac group 1.4x10⁶ ± 1.2x10⁷ vs. 2.7x10⁶ ± 2.9x10⁷ in the control group (p<0.05). Mutans streptococci (MS) in the cardiac group were 5.2x10⁴ ± 1.5x10⁵ vs. 8.1 x10³ ± 1.3x10⁴ in the control group, (p>0.05) and MS ratio of TVC constituted 0.11±0.35 per cent compared to 0.01±0.02 per cent for the control group (p>0.05).

STATISTICS: Continuous data were analysed by an analysis of variance (ANOVA) and categorical data by chi-square test.

CONCLUSION: Reduced salivary secretion could be a caries risk factor in children taking heart failure medication.

Keyword
children, heart failure, medication, saliva
Identifiers
urn:nbn:se:umu:diva-39662 (URN)20840829 (PubMedID)
Available from: 2011-02-03 Created: 2011-02-03 Last updated: 2017-12-11Bibliographically approved
5. Acidity and in vitro effects on dental hard tissues of pharmaceutical preparations used in paediatric cardiology
Open this publication in new window or tab >>Acidity and in vitro effects on dental hard tissues of pharmaceutical preparations used in paediatric cardiology
Show others...
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: The knowledge of oral health effects caused by long-term medication in medically compromised children is sparse. Besides the effects on salivary secretion, pharmacotherapy may also act directly on the dental hard tissues, with dental caries and/or erosive lesions as possible outcomes of their acid and fermentable sugar content.

Methods: Thirteen pharmaceutical preparations commonly used on a long-term basis in paediatric cardiology were selected. The endogenous pH of water solutions of tablets, capsules, and liquid medicines were measured with a pH meter. The titratable acidity and the dissolution of calcium and phosphate after immersion of tooth specimens were quantified for preparations with an endogenous pH below 5.5.

Results: The endogenous pH values varied between 3.03 and 9.02. Six of the 13 preparations (46%) had an endogenous pH below the critical value for enamel dissolution (pH 5.5). The captopril (12.5 mg) tablet water solution had the lowest pH while the propranolol hydrochloride mixture displayed the highest titratable acidity. The highest dissolved calcium and phosphate was displayed for captopril (12.5 mg) tablet water solution followed by acetylsalicylic acid (75 mg) tablet water solution.

Conclusion: It is concluded that some pharmaceutical preparations that are commonly used on a long-term basis in paediatric cardiology may pose a hazardous threat to dental hard tissues due to their acidity.

National Category
Pediatrics Dentistry
Identifiers
urn:nbn:se:umu:diva-39698 (URN)
Available from: 2011-02-04 Created: 2011-02-03 Last updated: 2017-01-30Bibliographically approved

Open Access in DiVA

fulltext(670 kB)3571 downloads
File information
File name FULLTEXT07.pdfFile size 670 kBChecksum SHA-512
4880e50b2b5c2150d691e4e7bb72e9df1301fc20823ce19a52744c24c0dbbcf09cf4f77e41cd7049d1850b58f22939b93712bd1b1445d1adce2c6c2baf20c52d
Type fulltextMimetype application/pdf

Authority records BETA

Rosén, Linda

Search in DiVA

By author/editor
Rosén, Linda
By organisation
Pediatric Dentistry
Dentistry

Search outside of DiVA

GoogleGoogle Scholar
Total: 3571 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 1740 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf