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Stecksén-Blicks C, Rydberg A et al. Int J Paediatr Dent 2004; 14: 94–100

Nearly 1% of children are born with heart problems, and management may lead to dental risks. Vomiting, night feeding, sucrose in medication and diuretics causing xerostomia may all contribute to caries. This study involved 95% of children born with specified complex heart disease, but no other serious medical problems, in one Swedish county over a 10 yr period. Matched healthy controls were selected from the population register, with 41 subjects in each group. Mean ages were 6.9 yrs (cardiac) and 6.5 yrs (controls).

Mean dmfs was 5.2 in the cardiac group and 2.1 in the controls (P < 0.05). Differences in DMFS (0.9 and 0.3) were NS. In the 2 groups, 16 and 22 children had caries-free primary teeth. In the cardiac group, 9 molars had been extracted. Children in the cardiac group had received a mean of 3.8 fluoride varnish applications, compared with 1.8 for controls. There were significant associations between dmfs and fluoride varnish, prophylaxis polishes, fluoride tablets and digoxin medication (containing sucrose). The authors conclude that better preventive efforts might reduce the dental problems of children with cardiac problems.