The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 22 , ISSUE 12 ( December, 2021 ) > List of Articles

ORIGINAL RESEARCH

Prevention of Infective Endocarditis of Oral Origin in Children: A Call for Pediatric Dentists–Pediatric Cardiologists’ Collaboration in Egypt

Reham K Elghazawy, Khaled A Shams, Mariem O Wassel

Keywords : Cardiac surgeons, Cardiologists, Dentists, Infective endocarditis, Pediatric

Citation Information : Elghazawy RK, Shams KA, Wassel MO. Prevention of Infective Endocarditis of Oral Origin in Children: A Call for Pediatric Dentists–Pediatric Cardiologists’ Collaboration in Egypt. J Contemp Dent Pract 2021; 22 (12):1444-1450.

DOI: 10.5005/jp-journals-10024-3254

License: CC BY-NC 4.0

Published Online: 10-05-2022

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aim: To assess knowledge and practices of some Egyptian pediatric dentists and pediatric cardiologists/cardiac surgeons regarding prevention of infective endocarditis (IE) from oral origin in children. Materials and methods: Pediatric dentists or pediatric cardiologists/cardiac surgeons having their practice in Egypt were conveniently selected. An online questionnaire was constructed for each specialty practitioner in English using a web-based platform. Each survey tool collected data about demographics, knowledge, and practices concerning the prevention of IE of oral origin. Surveys were disseminated to potential respondents using direct messaging or posting surveys’ links on high-traffic areas (blogs, groups, or pages) of commonly known social media platforms. Results: Two-hundred and thirty-nine pediatric dentists and 71 pediatric cardiologists/cardiac surgeons’ responses were included in analysis. Some shortage in oral health knowledge and deviations in management protocol from known guidelines were evident in cardiologists’ responses, whereas 66.2 and 64.8% reported encountering IE of oral origin or canceling a cardiac surgery due to oral infection, respectively. Most pediatric dentists (65.7%) rely on physician referral before managing children at risk of IE despite following recognized guidelines for IE prevention which may reflect difficulty in understanding such guidelines. Ninety percent of children with heart diseases visit a dentist due to oral complaint and not for checkup. Conclusion: Identification of disparities and pitfalls in management of children with heart diseases, if appropriately addressed by pediatric dentists and cardiologists, may reduce the risk of IE from an oral origin. Clinical significance: Health education of both specialists and development of national guidelines based on national epidemiology and clinical experience of cardiologists are strongly needed to decrease oral disease burden, allow for a consensus of patient management, and minimize the need for cross-referral, thus facilitating dental management without undue delays.


PDF Share
  1. Johnson JA, Boyce TG, Cetta F, et al. Infective endocarditis in the pediatric patient: a 60-year single-institution review. Mayo Clin Proc 2012;87(7):629–635. DOI: 10.1016/j.mayocp.2012.02.023.
  2. Lockhart PB, Brennan MT, Thornhill M, et al. Poor oral hygiene as a risk factor for infective endocarditis-related bacteremia. J Am Dent Assoc 2009;140(10):1238–1244. DOI: 10.14219/jada.archive.2009.0046.
  3. Poveda-Roda R, Jiménez Y, Carbonell E, et al. Bacteremia originating in the oral cavity. A review. Med Oral Patol Oral Cir Bucal 2008;13(6): 355–362. PMID: 18521055.
  4. Mang-de la Rosa MR, Castellanos-Cosano L, Romero-Perez MJ, et al. The bacteremia of dental origin and its implications in the appearance of bacterial endocarditis. Med Oral Patol Oral Cir Bucal 2014;19(1):67–74. DOI: 10.4317/medoral.19562.
  5. Del Giudice C, Vaia E, Liccardo D, et al. Infective endocarditis: a focus on oral microbiota. Microorganisms 2021;9(6):1218. DOI: 10.3390/microorganisms9061218.
  6. Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007;116(15):1736–1754. DOI: 10.1161/CIRCULATIONAHA.106.183095.
  7. Habib G, Lancellotti P, Antunes MJ, et al. ESC Scientific Document Group. ESC guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J 2015;36(44):3075–3128. DOI: 10.1093/eurheartj/ehv319.
  8. Cahill TJ, Harrison JL, Jewell P, et al. Antibiotic prophylaxis for infective endocarditis: a systematic review and meta-analysis. Heart 2017;103(12):937–944. DOI: 10.1136/heartjnl-2015-309102.
  9. Olderog-Hermiston EJ, Nowak AJ, Kanellis MJ. Practices and attitudes concerning oral health in pediatric cardiology clinics to prevent infective endocarditis. Am J Cardiol 1998;81(12):1500–1502. DOI: 10.1016/s0002-9149(98)00207-0.
  10. Nakano K, Ooshima T. Common knowledge regarding prevention of infective endocarditis among general dentists in Japan. J Cardiol 2011;57(1):123–130. DOI: 10.1016/j.jjcc.2010.09.001.
  11. Oliver KJ, Casas MJ, Judd PL, et al. Oral health assessment practices and perceptions of North American paediatric cardiologists. Paediatr Child Health 2017;22(6):312–316. DOI: 10.1093/pch/pxx093.
  12. Coutinho AC, Maia LC, Castro GF. Knowledge and practices of pediatric cardiologists concerning the prevention of infective endocarditis of oral origin. Gen Dent 2008;56(1):29–34. PMID: 18254557.
  13. Pimentel EL, Azevedo VM, Castro Rde A, et al. Caries experience in young children with congenital heart disease in a developing country. Braz Oral Res 2013;27(2):103–108. DOI: 10.1590/s1806-83242013000100016.
  14. Pourmoghaddas Z, Meskin M, Sabri M, et al. Dental caries and gingival evaluation in children with congenital heart disease. Int J Prev Med 2018;9:52. DOI: 10.4103/ijpvm.IJPVM_401_15.
  15. Balmer R, Booras G, Parsons J. The oral health of children considered very high risk for infective endocarditis. Int J Paediatr Dent 2010;20(3):173–178. DOI: 10.1111/j.1365-263X.2010.01034.x.
  16. Hughes S, Balmer R, Moffat M, et al. The dental management of children with congenital heart disease following the publication of Paediatric Congenital Heart Disease Standards and Specifications. Br Dent J 2019;226(6):447–452. DOI: 10.1038/s41415-019-0094-0.
  17. FitzGerald K, Fleming P, Franklin O. Dental health and management for children with congenital heart disease. Prim Dent Care 2010;17(1):21–25. DOI: 10.1308/135576110790307690.
  18. Carinci F, Martinelli M, Contaldo M, et al. Focus on periodontal disease and development of endocarditis. J Biol Regul Homeost Agents 2018;32(2 Suppl. 1):143–147. PMID: 29460534.
  19. Nomura R, Matayoshi S, Otsugu M, et al. Contribution of severe dental caries induced by Streptococcus mutans to the pathogenicity of infective endocarditis. Infect Immun 2020;88(7):e00897–e00919. DOI: 10.1128/IAI.00897-19.
  20. American Academy of Pediatric Dentistry. Policy on the dental home. The reference manual of pediatric dentistry. Chicago, IL: American Academy of Pediatric Dentistry; 2020. p. 43–44.
  21. American Academy of Pediatric Dentistry. Policy on care for vulnerable populations in a dental setting. The reference manual of pediatric dentistry. Chicago, IL: American Academy of Pediatric Dentistry; 2020. p. 32–38.
  22. Liu Z, Yu D, Zhou L, et al. Counseling role of primary care physicians in preventing early childhood caries in children with congenital heart disease. Int J Environ Res Public Health 2014;11(12):12716–12725. DOI: 10.3390/ijerph111212716.
  23. Cotti E, Arrica M, Di Lenarda A, et al. The perioperative dental screening and management of patients undergoing cardiothoracic, vascular surgery and other cardiovascular invasive procedures: a systematic review. Eur J Prev Cardiol 2017;24(4):409–425. DOI: 10.1177/2047487316682348.
  24. Venugopal A, McVeigh K, Parmar S. Review of nature of cardiology referrals to OMFS for dental assessment/treatment. Br J Oral Maxillofac Surg 2011;49(1):s110. DOI: 10.1016/j.bjoms.2011.03.243.
  25. Nakatani S, Ohara T, Ashihara K, et al. Japanese Circulation Society Joint Working Group. JCS 2017 guideline on prevention and treatment of infective endocarditis. Circ J 2019;83(8):1767–1809. DOI: 10.1253/circj.CJ-19-0549.
  26. Centre for Clinical Practice at NICE (UK). Prophylaxis against infective endocarditis: antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures. London: National Institute for Health and Clinical Excellence (UK); 2016.
  27. Chen TT, Yeh YC, Chien KL, et al. Risk of infective endocarditis after invasive dental treatments: case-only study. Circulation 2018;138(4):356–363. DOI: 10.1161/CIRCULATIONAHA.117.033131.
  28. Lockhart PB, Brennan MT, Fox PC, et al. Decision-making on the use of antimicrobial prophylaxis for dental procedures: a survey of infectious disease consultants and review. Clin Infect Dis 2002;34(12):1621–1626. DOI: 10.1086/340619.
  29. Šutej I, Peroš K, Trkulja V, et al. The epidemiological and clinical features of odontogenic infective endocarditis. Eur J Clin Microbiol Infect Dis 2020;39(4):637–645. DOI: 10.1007/s10096-019-03766-x.
  30. Duval X, Millot S, Chirouze C, et al. Oral streptococcal endocarditis, oral hygiene habits, and recent dental procedures: a case-control study. Clin Infect Dis 2017;64(12):1678–1685. DOI: 10.1093/cid/cix237.
  31. Roberts GJ. Dentists are innocent! “Everyday” bacteremia is the real culprit: a review and assessment of the evidence that dental surgical procedures are a principal cause of bacterial endocarditis in children. Pediatr Cardiol 1999;20(5):317–325. DOI: 10.1007/s002469900477.
  32. Arslan F, Karagöz E, Arslan BY, et al. An unnoticed origin of fever: periapical tooth abscess. Three case reports and literature review. Infez Med 2016;24(1):67–70. PMID: 27031901.
  33. Katz J, Weinstein E, Barak S, et al. Dental disease in the differential diagnosis of fever of unknown origin. Ann Dent 1992;51(2):3–5. PMID: 1463314.
  34. Dunlop RM, Sanders BJ, Jones JE, et al. Pulp therapy in pediatric patients with congenital heart disease: survey of American Academy of Pediatric Dentistry members. J Dent Child 2013;80(3):139–144. PMID: 24351695.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.