Effectiveness of an oral health intervention program for children with congenital heart defects

Tine B Sivertsen, Anne N Åstrøm, Gottfried Greve, Jörg Aßmus, Marit S Skeie, Tine B Sivertsen, Anne N Åstrøm, Gottfried Greve, Jörg Aßmus, Marit S Skeie

Abstract

Background: Children with congenital heart defects (CHD) are reported to have poorer oral health compared with healthy children. The aim of the present study was to evaluate the effectiveness of an intensive oral health care program among children with CHD followed from infancy to the age of 5 years, by comparing their oral health status at 5 years with a control group of children with CHD who had not received the program.

Methods: In this longitudinal study, children in western Norway with a need for lifelong follow-up due to congenital heart defects were invited to participate (n = 119). Children born in 2008-2011 were offered an oral health intervention program from infancy to the age of 5 years. The outcome measures for evaluating the intervention were dental caries prevalence, dental erosion, plaque index and gingival bleeding index. The data of the intervention group were compared with cross sectional oral health data of 5 year old controls with CHD born 2005-2007 (already published).

Results: Early oral health intervention did not affect the prevalence of caries (25.3% versus 25.4%) or dental erosion (22.2% versus 19.7%) of children with CHD assessed at 5 years. Children in the intervention group were less likely than those in the control group to present with both dental plaque and gingival bleeding at age 5 years. In spite of no difference in caries prevalence between the groups, caries affected children (d1-5mft) in the intervention group had fewer teeth affected by caries than children in the control group (p = 0.06). The care index was reported to be higher in the intervention group compared with the control group, implying that fewer children in the intervention group suffered from untreated dentine caries. Parents in the intervention group were more likely to brush their children's teeth twice a day than parents of children in the control group.

Conclusion: The oral health promotive program did not influence the prevalence of caries nor dental erosion. However, the findings indicated better oral hygiene, reduced gingival bleeding and less untreated dentine caries in the intervention compared with the control group.

Trial registration: ClinicalTrials.gov NCT03311438 . Registration date: October 17th 2017, retrospectively registered.

Keywords: Childhood oral health; Congenital heart defect; Dental care for children; Special care for children.

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Regional Committee for Medical Research Ethics, western Norway in 2009 (2009/2264). Consent to participate was given by parents signing an informed consent approved by the Regional Committee for Medical Research Ethics, western Norway in 2009.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests. The authors alone are responsible for the content and writing of the paper.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of enrollment in intervention and control group of children with CHD
Fig. 2
Fig. 2
The red line illustrates the caries prevalence (d3–5mft) among 5-year-olds with CHD (the control group from 2010 to 2012 and intervention group from 2013 to 2016. The perimeter marked by a dotted line) and the blue line the general population of 5-year-olds in the selected counties in western Norway from 2010 to 2016

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