A Parent’s Guide to Dental Care for Children with Heart Disease
(Congenital Heart Defects)
A clean and healthy mouth will reduce the risk for heart infection (endocarditis) in a child with heart disease.
Children with heart disease need to see a pediatric dentist regularly.
A child should have his/ her first dental visit no later than 12 months of age.
Early and frequent dental check-ups will allow your child to get treatment such as fluoride and sealants to help prevent cavities so that your child’s dental experience remains medically safe.
Your child’s dentist will work in consultation with your child’s heart specialist to make sure that your child gets the medicine he/she needs before the dental treatment.
Questions to ask your child’s dentist:
Why has my child’s heart specialist asked the cavities to be filled before my child’s heart surgery?
Cavities are sources of infection in the mouth and should be treated before heart surgery. This reduces the amount of bacteria from the mouth that reach the heart through blood circulation and helps the heart heal from surgery in an infection-free environment. Bacteria from the mouth can cause infections in the heart of children who have heart defects or have had surgery to correct the heart defect.
Will my child need antibiotics before dental treatment?
Maybe. Your child’s heart specialist will make this recommendation based on your child’s heart condition as well as the type of dental treatment needed. Not all dental procedures need antibiotic coverage.
What should I do if I forgot to give my child’s antibiotic before the dental appointment?
Tell the dentist. The appointment may have to be rescheduled. Some dentists may have the antibiotic in their office and can give it to your child. If the antibiotic dose was missed and dental treatment was still done, the antibiotic should be taken within 2 hours.
Should I stop my child’s Asprin® before the dental appointment?
No. Please do not stop or change your child’s medicines without instructions from your child’s heart specialist. The dentist with consult with your child’s heart specialist; the heart specialist will decide if the Asprin® needs to be stopped based on the dental procedure and the risk of bleeding. If this is the case, you will receive instruction on how many days before the dental procedure the Asprin® should be stopped, and when it should be restarted.
Should I brush my child’s teeth even though his/her gums bleed?
Yes. Brushing is very important to keep a clean mouth and healthy gums. If your child does not brush, plaque will build up along the gum margins and continue to cause bleeding. Always use a soft-bristled toothbrush. Having a clean mouth helps reduce the chances of an infection in the heart (endocarditis).
Should I floss my child’s teeth?
Yes. Flossing cleans the plaque between teeth. It is important to use the dental floss in an upward and downward motion, making a C-shape around the tooth. Flossing in a sawing motion can cause damage to the gums. Having a clean mouth helps reduce the chances of an infection in the heart (endocarditis).
Can my child have braces (orthodontic treatment) in the future?
Maybe. Braces increase the plaque build-up on teeth and increase the risk for developing cavities. As long as your child keeps their teeth and gums healthy and has a healthy diet, it should be ok to get braces. Your child may not need antibiotics for orthodontic treatment.
My teenager has been asking for a piercing in the mouth. Should I let him/ her get it?
No. Piercings in the mouth are objects where bacteria can grow. They are difficult to clean and cause infection and swelling. A child who has a heart defect can get an infection in the heart (endocarditis) from the bacteria on and around a piercing.
Does my child need prescription fluoride products?
The dentist may prescribe these based on the dental examination and x-rays.
Can my child get the laughing gas to stay relaxed during dental treatment?
Maybe. Your child can get the laughing gas to relax him/ her and reduce stress during dental treatment if the heart specialist has cleared your child for dental treatment. This is not an option if your child’s heart specialist has not cleared your child for dental treatment.
How can I prevent cavities and gum disease in my child?
Brush your child’s teeth every morning and night.
Use toothpaste with fluoride in it and has the ADA seal of approval.
Floss after brushing at night. Flossing cleans between the teeth where the bristles of a toothbrush cannot reach.
Drink fluoridated water.
Stay away from foods that have added sugar. In-between meal snacks should not be sweet treats.
Do not drink juices, sodas, or sports drinks often.
Questions your child’s dentist might ask you:
Who are your child’s doctors and how can I get in touch with them?
What medicine does your child take? What are the dosages? How does your child take the medicine (Are they liquid, pills, or injections)?
Has your child had heart surgery? When? Who was the surgeon?
Does your child need heart surgeries in the future?
Does your child have any drug and food allergies?
Has your child’s heart specialist told you that your child needs antibiotics before dental treatment?
Does your child take Asprin®?
What is your child’s blood oxygen level in room air?
What does your child eat for meals and snacks, and what do they drink?
Has your child had any complications or problems when having dental work done in the past?
Is your child afraid of the dentist?
Questions you should ask your child’s pediatrician:
Does my child need any extra protection while receiving dental care?
Is there anything the dentist should do differently for my child?
Does my child need antibiotics before dental treatment?
When should my child see a dentist?
A child should see a dentist within 6 months of the first tooth coming in or by the first birthday- which ever happens first. It is never too late to start taking your child to the dentist.
How often should my child see the dentist?
Most children should see the dentist every 6 months. However, if your child is at high risk for dental caries, the dentist may recommend more frequent visits, such as every 3 or 4 month.
Children with heart disease can get cavities, just like children who do not have heart disease.
Dental cavities are preventable by ensuring a healthy, low-sugar diet and regular brushing and flossing.
How to find a pediatric dentist:
American Academy of Pediatric Dentistry: www.aapd.org
American Board of Pediatric Dentistry: www.abpd.org
Additional Information on Congenital Heart Defects:
Note: The information you see describes general oral health information for children with heart conditions, but it does not apply to everyone. This information is not medical advice. Please contact a healthcare provider if your child has a medical problem. If you think your child may have a medical emergency, please call your child’s doctor or an emergency number immediately.
Text by Priyanshi Ritwik, DDS, MS
Edited by Julie Schiavo, MLIS, AHIP