Oral Health Status in Children with Congenital Heart Disease: A Cross-sectional Comparative Study

Abstract

Background: Children with congenital heart disease (CHD) are considered to be at increased risk of poor oral health, which may have implications for general health and the prevention of infective endocarditis. This cross-sectional comparative study assessed the oral health status of children with CHD in comparison with age- and gender-matched healthy controls. Methods: A total of 102 children aged 3-6 years were examined, comprising 51 children with CHD (Group A) and 51 healthy controls (Group B). A single calibrated examiner assessed oral health using the decayed-missing-filled teeth (dmft) index, the Modified Oral Hygiene Index-Simplified (OHI-S), and the Modified Gingival Index (GI). Group differences were analysed using the chi-square test, Fisher's exact test, and the Mann-Whitney U test, with significance set at p < 0.05. Results: The mean age was 4.17±1.19 years in Group A and 4.21±1.14 years in Group B. Early childhood caries (ECC) was more prevalent in Group A (98.0%) than in Group B (60.8%), and the median dmft score was significantly higher in Group A [4.00 (IQR: 2.00-6.00)] than in Group B [2.00 (IQR: 0.00-3.00)] (p < 0.001). Severe ECC (dmft ≥ 5) was present in 39.2% of Group A children, compared with 1.9% of Group B children. Oral hygiene and gingival health were also poorer in Group A, with higher median OHI-S and GI scores than in Group B (p < 0.001 for both). No filled or missing teeth attributable to caries were recorded in Group A, indicating substantial unmet dental treatment needs. Conclusion: Children with CHD in this cohort showed a higher burden of dental caries, poorer oral hygiene, and greater gingival inflammation than healthy controls. These findings support the integration of early preventive dental care, timely referral, and parental oral health education into multidisciplinary CHD management.