Pilotstudie zur Etablierung eines standardisierten Prophylaxeprogramms für kardial erkrankte Kinder
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Beschreibung
The experiences of the last years have reported poorer oral health among children with congenital heart diseases (CHD). The aim of the present pilot study was to evaluate the oral health status among children with CHD compared to healthy children. Furthermore, the effectiveness of an oral health care program for CHD children to prevent the incidence of dental caries as well as to improve their oral hygiene was assessed.
Methods: 107 (45♀, 62♂) children with CHD (after receiving minimum one cardiac surgery) from the Department for Paediatric Heart Surgery, Giessen (Germany) aged between 2 to 6 years (Øage: 4,63) participated in the intervention group (IG). At baseline, CHD children were compared to a control group (CG) of 101 (45♀, 56♂) healthy children from various kindergartens in and near Giessen (Øage: 4,4). All examinations were carried out before introducing the children to an optimal oral hygiene and practicing tooth brushing together. Subsequently, the dental status (dmf-t/-s), the number of teeth with developmental defects of enamel (DDE, Clarkson/O‘Mullane yes/no), plaque index (Quigley/Hein [QHI]), gingival index (Loe/Silness [GI]) and gingival hyperplasia index (Wetzel [GHI]) were determined. Starting with baseline (1. impulse [IMP]), the described procedure was repeated in the IG during two follow-ups (2./3. IMP). All analyses were performed using SPSS 25.0.
Results: Compared with controls, CHD children showed significantly (Mann-Whitney-U-test, p<0,05) increased mean dmf-t-values (1,2 vs. 0,3), higher appearance of DDE in primary dentition (1./2. IMP: 1,4; 3. IMP: 1,6) and a poorer oral hygiene (QHI: 2,6; GI: 0,3; GHI: 0,2). The oral health care program did not significantly affect the incidence of dental caries in the IG (Wilcoxon-test, p>0,05): 1. IMP (dmf-t: 1,2; d-t: 0,4); 2. IMP (dmf-t: 1,4; d-t: 0,5); 3. IMP (dmf-t: 1,5; d-t: 0,4). However, the rising care index implied less untreated caries: 1. IMP (m-t: 0,1; f-t: 0,6); 2. IMP (m-t: 0,1; f-t: 0,8); 3. IMP (m-t: 0,2; f-t: 0,9). All oral hygiene parameter (QHI, GI, GHI) in the IG could be improved significantly over the period of the preventive program (T-, Wilcoxon-test, p<0,05).
Conclusion: The findings showed a poorer oral health care status in children with congenital heart disease compared with healthy children, which indicates a special need for treatment and prevention. The oral health should be established in between the concept of the general disease to reduce the future risk for infective endocarditis.
Autor*in
Julia Camilla Bulski
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