Caring for hearts by caring for mouths
Karen HowardConsultant Paediatric DentistryRBHSC
Structure
• Link between teeth and hearts• Caring for teeth– Eating habits– Tooth brushing– Fluoride
• Regular dental care
Hearts and Teeth• Infective Endocarditis• Dental infection causes infection in heart– Gum disease– Tooth decay
• Potentially fatalAt risk• acquired valvular heart disease• valve replacement• structural congenital heart disease• hypertrophic cardiomyopathy• previous infective endocarditis
Hearts and Teeth
• Treating Dental decay– Visits to dentist– Time off school– Stress and anxiety?– General Anaesthetic
2008
• ‘the importance of maintaining good oral health’
• ‘Managing infection• Investigate and treat promptly any episodes
of infection in people at risk of infective endocarditis to reduce the risk of endocarditis developing.’
Caring for teeth
1. Eating habitsHow oftenWhat
2. Toothbrushing3. Fluoride
Structure
• Link between teeth and hearts• Caring for teeth– Eating habitsEating habits– Tooth brushing– Fluoride
• Regular dental care
How often do they eat?
• Sugars only eaten at meal times
• Sugars only eaten four times daily
Safer snacks
• Fresh vegetables• Toast• Savoury sandwiches• Cheese and crackers• Low sugar cereal• Seeds/nuts• Homemade soup• Natural popcorn• Fresh fruit
• Milk• Water
• Tea/coffee (no sugar)
Cariogenic Sugars
• Sucrose• Glucose• Dextrose• Fructose• Maltose• Galactose• Lactose
• Glucose Syrup• Hydrolysed Starch• Invert Sugar• Molasses• Treacle, honey
etc.
Reducing Amount
• Average Sugar Consumption per person per
annum in UK 44kg
– SUCROSE 36kg pppa
• Recommended 15kg pppa (Sheiham 1991)
– (10kg if no Fluoride used)
Lesser known problems
• Eating/ drinking at bedtime• Eating drinking during the night• Eating very slowly• Appetite• Supplements• Medicines
Structure
• Link between teeth and hearts• Caring for teeth– Eating habits– Tooth brushingTooth brushing– Fluoride
• Regular dental care
Toothbrushing
• Wx5 of toothbrushing
Who?
• Everyone as soon as teeth come through
• Helped by adult until 7(ish)
What toothpaste/brush?
Toothpaste• 0-3 years- Smear
1000ppm fluoride
• 3-6 years- Pea 1350-1500ppm fluoride
What toothpaste/brush?
Brush• Small head
• OR
• Oscillating power brush
Why?
• Removes plaqueplaque cause of – Tooth decay– Gum disease
• Fluoride application
When?
•Twice daily• Last thing at night • One other occasion
Where?
• All surfaces of teeth• Remember to do where teeth meet the gums• All areas of mouth
Structure
• Link between teeth and hearts• Caring for teeth– Eating habits– Tooth brushing– FluorideFluoride
• Regular dental care
Fluoride
• Toothpaste• Varnish• Mouthwash• Tablets• High fluoride toothpaste
• All available- discuss with your dentist
Structure
• Link between teeth and hearts• Caring for teeth– Eating habits– Tooth brushing– Fluoride
• Regular dental careRegular dental care
Dentist
• Regular check-ups• 6 monthly• Dentist made aware of cardiac diagnosis
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