Dental management and preventive strategies in pediatric patients with congenital or acquired heart disease: a systematic review
Authors
Lucia Giannini, Antonino Manti, Sabrina Ardizzone, Paolo Cressoni, Luca Esposito, Andrea Palermo, Francesca Calò, Lucia Memè
Abstract
Background: Children with congenital or acquired heart disease are medically fragile patients in whom poor oral health can contribute to systemic complications, including infective endocarditis (IE). However, evidence on how their oral health is managed in clinical practice remains fragmented.
Aim: To systematically review the literature on oral health status, dental management, and preventive strategies in pediatric patients with cardiac or cardiovascular diseases.
Methods: A comprehensive search of PubMed, Scopus, and Embase (January 2000–October 2025) identified studies involving patients aged ≤18 years with congenital or acquired cardiovascular disease and reporting data on oral health, dental care, or preventive interventions. After removal of duplicates, titles/abstracts and full texts were screened according to predefined criteria following PRISMA 2020 principles. Data were synthesized narratively.
Results: The search yielded 409 records; 347 were screened, and 54 full-text articles were assessed. Twelve studies met all inclusion criteria. Overall, children with cardiac disease showed higher caries experience, more plaque and gingival inflammation, poorer oral hygiene habits, and less regular dental attendance than healthy peers. Only a few structured preventive or educational programs were reported, with short-term improvements in knowledge and behaviors but limited long-term follow-up.
Conclusions: Pediatric cardiac patients represent a high-risk, underserved group from an oral health perspective. Early dental involvement, standardized preventive protocols, and close collaboration between pediatric cardiology and dentistry are essential. Further well-designed longitudinal and interventional studies are needed to clarify the long-term impact of integrated oral health care in this vulnerable population.
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