Review Article
Volume 9 Issue 8 - 2020
Dental Perspective of Children with Cardiovascular Disease A Review
Nirmala SVSG1*, Saikrishna Degala2 and Ramasubbareddy C3
1Professor, Department of Pedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, India
2Professor and HOD, Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, Mysore, Karnataka, India
3Reader, Department of Pedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, India
*Corresponding Author: Nirmala SVSG, Professor, Department of Pedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, India.
Received: March 12, 2020; Published: July 09, 2020


Congenital heart disease is one of the most common developmental anomalies. While many such conditions are apparent in the neonate, a significant proportion do not come to light until the child is older, or even later on in adult life. Medical history is mandatory prior to the treatment. Children will have Low irregular fever, with sweating, malaise, anorexia, weight loss and arthralgia. Pulp therapy of the primary tooth is not recommended and extraction of the offending tooth is preferred. Distal shoe space maintainer not advocated. In permanent dentition, endodontic therapy may be undertaken, to reduce anxiety and minimize the risk oral sedation and nitrous oxide analgesia may be beneficial. Appointments should be scheduled in short times and in the mornings. Local anesthesia should be injected slowly and with recommended doses in each condition. Antibiotic Prophylaxis is recommended in all dental procedures involving the manipulation of gingival tissue, the periapical region of the teeth, or perforations of the oral mucosa, such as extractions, endodontic treatment surpassing the periapical limits, the placement of retraction sutures, biopsies, suture removal, the placement of brackets, or buccal cleaning operations, among other. Prophylaxis in turn is not recommended in the routine injection of anesthetic solutions in non-infected tissues, dental X-rays, the placement of removable dentures or orthodontic devices, loss of temporal teeth, or bleeding. Children who are in anticoagulant therapy hematological monitoring and cessation of therapy is important. This article discusses about etiology, clinical features and management of children with cardiovascular diseases.

Keywords: Bacterial Endocarditis; Children; Cardiovascular Disease; Dental Management; Rheumatic Fever


  1. Absi EG., et al. “The appropriateness of referral of medically compromised dental patients to hospital”. British Journal of Oral and Maxillofacial Surgery 35 (1997): 133-136.
  2. Hoffman JI and Kaplan S. “The incidence of congenital heart disease”. Journal of the American College of Cardiology 39 (2002): 1890-1900.
  3. Park K. “Park's textbook of Preventive and Social Medicine”. 23rd edition (2016).
  4. Jowett NI and Cabot LB. “Patients with cardiac disease: considerations for the dental practitioner”. British Dental Journal 6 (2000): 297-302.
  5. Steinhauer T., et al. “Risk stratification and dental management of the patient with cardiovascular diseases. Part I: Etiology, epidemiology and principles of medical management”. Quintessence International 36 (2005): 119-137.
  6. Lifshey FM. “Evaluation of and Treatment Considerations for the Dental Patient with Cardiac Disease”. The New York State Dental Journal 8 (2004): 16-19.
  7. Balmer R and Bu’Lock FA. “The experiences with oral health and dental prevention of children with congenital heart disease”. Cardiology in the Young 13 (2003): 439-443.
  8. Kahri J and Rapola J. “Cardiovascular disorders in dental practice”. Nor Tannlegeforen Tid 115 (2005): 84-90.
  9. Muzyka BC. “Atrial Fibrilation and its relationship to dental care”. American Dental Association 130 (1999): 1080-1085.
  10. American Academy of Pediatric Dentistry. Definition of dental home”. Reference Manual6 (2015).
  11. Friedlander AH., et al. “Atrial fibrillation: pathogenesis, medical-surgical management and dental implications”. Journal of the American Dental Association 140 (2009): 167-177.
  12. Ayala C and Aguayo L. “Oral and systemic manifestations, and dental management of a pediatric patient with Tetralogy of Fallot. A case report”. Journal of Oral Research 5 (2016): 87-91.
  13. Cruz-Pamplona M., et al. “Dental considerations in patients with heart disease”. Journal of Clinical and Experimental Dentistry 2 (2011): e97-e105.
  14. FitzGerald K., et al. “Dental health and management for children with congenital heart disease”. Primary Dental Care 1 (2010): 21-25.
  15. Tasiuola V., et al. “Dental health and treatment in a group of children with congenital heart disease”. The Pediatric Dental Journal 30 (2007): 323-328.
  16. Roberts GJ., et al. “Dental bacteremia in children”. Pediatric Cardiology 18 (1997): 24-27.
  17. Spivack E. “Tetralogy of Fallot: An overview, case report, and discussion of dental implications”. Special Care in Dentistry 21 (2001): 172-175.
  18. Hallet KB., et al. “Oral health of children with congenital cardiac diseases: A controlled study”. Pediatric Dentistry Journal 14 (1992): 224-230.
  19. Munroe CO and Lazarus TL. “Predisposing conditions of infective endocarditis”. The Journal of the American Dental Association 42 (1976): 483.
  20. Gómez-Moreno G., et al. “Pharmacological interactions of anti-inflammatory-analgesics in odontology”. Medicina Oral, Patologia Oral Y Cirugia Bucal 14 (2009): E81-E89.
  21. Jackson MA., et al. “Infective endocarditis in childhood: 2015 update: a scientific statement from the American Heart Association”. Circulation 132 (2015): 1487-1515.
  22. Blanco-Carrión A. “Bacterial endocarditis prophylaxis”. Medicina Oral, Patologia Oral y Cirugia Bucal 9 (2004): 37-43.
  23. Nosrati E., et al. “Gingival evaluation of the pediatric cardiac patient”. Pediatric Dental 35 (2013): 456-462.
  24. Friedlander AH., et al. “Atrial fibrillation: pathogenesis, medical-surgical management and dental implications”. Journal of the American Dental Association 140 (2009): 167-177.
  25. Li Y and Wang W. “Predicting caries in permanent teeth from caries in primary teeth: an eight-year cohort study”. Journal of Dental Research 81 (2002): 561-566.
  26. Stecksén-Blicks C., et al. “Dental caries experience in children with congenital heart disease: a case-control study”. International Journal of Paediatric Dentistry 14 (2004): 94-10.
  27. Pimentel EL., et al. “Caries experience in young children with congenital heart disease in a developing country”. Brazilian Oral Research 27 (2013): 103-108.
  28. Oliveira FS., et al. “Resin-modified glass ionomer cement and a resin based material as occlusal sealants: a longitudinal clinical performance”. Journal of Dentistry for Children 75 (2008): 134-143.
  29. Seale NS. “The use of stainless steel crowns”. The Pediatric Dental 24 (2002): 501-505.
  30. Kindelan SA., et al. “Stainless steel preformed crowns for primary molars”. International Journal of Paediatric Dentistry 1 (2008): 20-28.
  31. Mathu-Muju K and Wright JT. “Diagnosis and treatment of molar incisor hypomineralization”. Compendium of Continuing Education in Dentistry 27 (2006): 604-610.
  32. The Royal College of Surgeons of England. A Guideline for First Permanent Molar Extraction in Children. London: RCS (Eng) (2004).
  33. Dunlop RM., et al. “Pulp therapy in pediatric patients with congenital heart diseases: Survey of American Academy of Pediatric Dentistry members”. Pediatric Dentistry 80 (2013): 139-144.
  34. Jiménez-Beato G and Machuca-Portillo G. “Heart and periodontal diseases: Does evidence exist of association?” Medicina Oral Patologia Oral y Cirugia Bucal 10 (2005): 215-220.
  35. Smith GN and Pashley DH. “Periodontal ligament injection: evaluation of systematic effects”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 56 (1983): 571-574.
  36. Saini R., et al. “Periodontal diseases: a risk factor to cardiovascular disease”. Annals of Cardiac Anaesthesia 13 (2010): 159-161.
  37. Blinder D., et al. “Dental extractions in patients maintained on continued oral anticoagulant”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 88 (1999): 137-140.
  38. Khurana M and Mar tin MV. “Orthodontics and infective endocarditis”. British Journal of Orthodontics 26 (1999): 295-298.
  39. Bellinger DC., et al. “Developmental and neurologic status of children after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass”. The New England Journal of Medicine 332 (1995): 549-555.
  40. Limperopoulos C., et al. “Neurodevelopmental status of newborns and infants with congenital heart defects before and after open heart surgery”. Pediatrics 137 (2000): 638-645.
  41. Farbod F., et al. “Infective endocarditis and antibiotic prophylaxis prior to dental/oral procedures: latest revision to the guidelines by the American Heart Association published April 2007”. International Journal of Oral and Maxillofacial Surgery 38 (2009): 626-631.
  42. Gutiérrez JL., et al. “Consensus document on the use of antibiotic prophylaxis in dental surgery and procedures”. Medicina Oral Patologia Oral y Cirugia Bucal 11 (2006): 188-205.
  43. American Academy of Pediatric Dentistry (AAPD). “Reference Manual. Guideline on antibiotic prophylaxis for dental patients at risk for infection”. Pediatric Dentistry Journal 37 (2015): 292-297.
  44. Zavala-Cornejo KV., et al. “Manejo estomatológico del paciente pediátrico con cardiopatía con¬génita. Revisión de la literature”. Univ Odontologia 30 (2011): 57-66.
  45. Blanco-Carrión A. “Bacterial endocarditis prophylaxis”. Medicina Oral Patologia Oral y Cirugia Bucal 9 (2004): 37-43.
  46. Steinhauer T., et al. “Risk stratification and dental management of the patient with cardiovascular diseases. Part I: Etiology, epidemiology, and principles of medical management”. Quintessence International 36 (2005): 119-137.
Citation: Nirmala SVSG., et al. “Dental Perspective of Children with Cardiovascular Disease A Review”. EC Paediatrics 9.8 (2020): 47-59.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

January Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before February 10, 2023.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.