PREVALENCE OF DENTAL DECAY AND PERIODONTAL DISEASES AMONG CHILDREN SUFFERING FROM CONGENITAL HEART DISEASES. A LITERATURE REVIEW – PART III

Abstract

Dental decay is one of the most prevalent chronic and infectious diseases for mankind. It is defined as `a dynamic process, taking place in the tooth bacterial biofilm (plaque), which results in a disturbance of equilibrium between tooth substance and the surrounding plaque fluid and finally results in a loss of minerals from the tooth surface - demineralisation.` Fluoride plays an important role in dental decay prevention and stimulates self-healing of minor cavities by reducing the demineralisation process and promoting the remineralization process. Remineralisation occurs frequently, especially when the biofilm pH is restored by saliva, which acts as a buffer. The adequate salivary production is of great importance for maintaining a normal physiology in the oral cavity. It is known that children with congenital heart disease (CHD) frequently require regular long-term medication, but the knowledge of oral health effects caused by long-term medication in medically compromised children is sparse. Many medications used on a long-term basis may contain sugar, have a low pH or high acidity. There is a strong correlation between xerostomia and pharmacological treatment and a number of drugs have been listed as xerogenic. These drugs include ones with a directly damaging to salivary glands function, such as cytotoxic drugs, medications with anticholinergic activity, drugs which deplete fluid as diuretics, and drugs acting on the sympathetic system, like antihypertensive drugs. Only a few clinical studies have been carried out on the outcome of salivary function with antihypertensive drugs, and the outcome is not clear-cut. A number of studies have been carried out on the caries prevalence in children with CHD but only five of them were controlled. Children with CHD had higher mean values of dmft /DMFT indices than healthy children and only a few of them had experienced fillings, indicating an unmet need for operative treatment.