Q: I come to see you for my child’s heart condition, but you always ask about his teeth. Why?
A: As a pediatric cardiologist, it is very important for my patients to have healthy teeth. This entails brushing twice a day, flossing daily, replacing toothbrushes every 3 months, and routine visits to the dentist. Good dental health habits can start early in life. Parents are encouraged to clean a baby’s teeth with a washcloth. The use of a toothbrush can start early, as children will imitate other siblings and their parents’ brushing daily, creating a lifelong healthy habit.
When I was growing up, my siblings and I dreaded going to the dentist, as it often meant going to take care of a toothache. Later on, it also meant extensive cleaning, numbing, drilling, and filing gaps of broken teeth. Today, it is a more pleasant experience. Recommendations are that dental visits should be part of one’s regular preventive health care activities. I must say, I now, love my dentist and my dental hygienists. They do a good job keeping my teeth in good shape. After each visit to the dental office, I am reminded that they are caring for my teeth and my over all health.
The consequences of having bad teeth include gingivitis, gum disease, and tooth abscesses. It also often means lots of toothaches, missing school for many children and adolescents. Bad teeth are a setup for bacterial growth that can go to one’s blood stream and cause major blood infections that can seed the lining of the heart. Children and even adults with heart disease are more of a setup for these kinds of heart infection that we call endocarditis. Infection from a tooth abscess can also spread to the blood stream through blood vessels and lead to an infection of the brain or a brain abscess. So, I always remind my patients that healthy teeth help keep a healthy heart. In fact, healthy teeth are good for one’s overall health.
Unhealthy oral health contributes and complicates many chronic illnesses, making regular dental visits to the dentist also good for grown ups. Consequently, for children the goal is early prevention to avert numerous life long troubles. Gum disease is reported to be associated with increased cardiovascular risks. Having bad teeth may be as bad as having cholesterol problems in terms of increasing one’s risk for cardiovascular diseases and stroke. So, needless to say, having both gum disease and bad cholesterol is a double whammy and placed one’s at a higher risk for cardiovascular diseases compared with someone with healthy teeth and low healthy cholesterol levels.
Oral health is often an un-met need in many children and adolescents, because of several reasons, including increased sugar intake, nicotine initiation in adolescents, bad dental health habits (not brushing or flossing), and not having the opportunity to visit with a dentist. I learned recently that as many as 25% of children under 5 years of age have been reported to have dental caries. This is unfortunate. Access to a dentist is often difficult particularly for children in poor communities. Kids can take advantage of dental clinics through the school clinics or in nearby community dental clinics, but sometime those are not available. Parents should be reminded that the Children’s Health Insurance Program (CHIP) covers for both routine doctors visits and dental visits. Parents and doctors sometime have to find creative ways to find a dentist for a child.
As February is heart health month and gum disease awareness month, it is good to remind all of us of the benefits of good dental health. Pediatricians have a critical role in discussing with parents their kid’s dental health with every visit, highlighting the use of fluoride toothpaste as early as the first year of life, drinking fluorinated community water (as bottled water only contain no or just traces of fluoride), good dental care at home, and regular visit with the dentist.
Vernat Exil is a pediatric cardiologist at UNM. Please send your questions to him at firstname.lastname@example.org