Oral health needs and barriers to care in children with congenital heart disease

Background: The rising number of children with congenital heart disease (CHD) in Malaysia presents significant challenges for pediatric oral health. Global research shows that children with CHD have more dental problems and poorer oral health than healthy children. This study aimed to evaluate the oral health needs, barriers to dental care, and oral health status of Malaysian children with CHD compared to a healthy control group. Methods: A cross-sectional study was conducted at the Faculty of Dentistry Universiti Malaya (FoDUM) and Universiti Malaya Medical Centre (UMMC), involving 134 children aged 3 to 12 years, divided equally into the CHD group (67 children) and the control group (67 children). Data were collected through a parent-completed questionnaire assessing oral health needs and barriers to care for their children. Clinical oral examinations were carried out on the CHD children using the Lobene Modified Gingival Index Score, and their dental status was evaluated using the decayed, missing, and filled teeth (dmft/DMFT) index. Statistical analyses included Chi-square and Fisher’s Exact tests to identify significant associations using SPSS version 29.0. Results: There was a significant association between children with CHD and never visiting a dentist (p = 0.002). The perceived need for dental check-ups was also significantly higher in children with CHD (p = 0.049). Children with CHD had significantly higher gingivitis scores (p < 0.001). A significant number of children with CHD were more afraid of the dentist (p < 0.001), anxious (p = 0.005), uncooperative during dental treatment (p < 0.001); additionally, their parents lacked knowledge about where to seek dental treatment (p = 0.005) and faced time constraints in bringing their child to the dental clinic (p = 0.014). Conclusions: Children with CHD have significant oral health needs and face considerable barriers to accessing dental care, highlighting the necessity for targeted interventions to improve their outcomes.

Congenital heart disease (CHD); Oral health needs; Oral health status; Oral health; Barriers

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