If oral bacteria get into the bloodstream, some children with heart disease may be susceptible to infective endocarditis, researchers say. Photo by Milenafoto/Wikimedia Commons
Kids with heart conditions are more likely than their peers to have frequent cavities, toothaches or bleeding gums, a new U.S. government study finds.
Researchers found that of U.S. children and teenagers with heart conditions, 10% had only “poor” to “fair” dental health, as rated by their parents. That was twice the figure of kids without heart problems.
It’s a concern in part, the researchers say, because if oral bacteria get into the bloodstream, some children with heart disease may be susceptible to infective endocarditis. The condition is rare, but it inflames the inner lining of the heart and can be life-threatening.
The wider issue, though, is that good oral health, and sparing kids pain and dental procedures, is important, according to Dr. Alene D’Alesio, chief of pediatric dentistry at Children’s Hospital of Pittsburgh.
“They should see a pediatric dentist no later than the age of 1,” said D’Alesio, who was not involved in the study.
There are various reasons children with heart conditions can be more prone to cavities, according to study leader Karrie Downing, a researcher with the U.S. Centers for Disease Control and Prevention.
For one, Downing said, they may undergo surgeries or other procedures that make it harder to care for teeth and gums, or put it lower on families’ list of priorities.
Beyond that, Downing said, children with heart conditions commonly have developmental or intellectual disabilities that can make dental care more challenging — whether at home or the dentist’s office.
Even heart medications can play a role, D’Alesio said: Some cause dry mouth, which can help feed cavities.
One simple way for parents to help, D’Alesio said, is to make sure their kids drink plenty of water — and not juices or other sweetened drinks.
The study — recently published in the CDC’s Morbidity and Mortality Weekly Report — pulled data from an ongoing government survey on child health.
Between 2016 and 2019, nearly 120,000 U.S. parents answered questions about their kids’ oral health and dental care. That included almost 3,000 parents of a child with a heart condition.
Overall, those parents were twice as likely to rate their kids’ dental health as poor to fair. And 1 in 6 said their child had frequently suffered toothaches, bleeding gums or cavities in the past year.
Of all kids with a heart condition, about one-quarter also had an intellectual or developmental disability. And that, the study found, partly accounted for their poorer dental health.
There was no evidence children with heart disease saw the dentist less often. In fact, about 83% had received preventive dental care in the past year, versus 80% of kids without heart conditions.
But that still meant 17% had received none — a problem that disproportionately affected families without health insurance. Of all those kids (with and without heart disease), 56% had seen a dentist for a checkup in the past year, the study found.
Ideally, D’Alesio said, families should see a pediatric dentist, rather than a dentist who treats adults. And youngsters with heart disease, she said, may need more frequent visits — possibly a few times per year.
That can, of course, be easier said than done. Some families may have a hard time even finding a pediatric dentist nearby, D’Alesio noted.
At the same time, she said, there are plenty of things parents of kids with heart disease can do to help them maintain healthy teeth and gums.
“I don’t want anyone to think that heart disease equals cavities,” D’Alesio said.
She recommended that parents monitor their kids’ brushing and flossing for a longer stretch — and possibly delay their “independence” until the ages of 8, 9 or 10.
Downing also suggested some basic steps at home: Consider using flossing “aids,” such as floss holders or floss picks, and find a toothpaste and toothbrush your child actually likes. An electric toothbrush, Downing noted, might help simplify things.
The American Academy of Pediatrics has more on dental care for kids with heart conditions.
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