Management of Dental Problems in a Case of Tetralogy of Fallot

Abstract Congenital heart disease (CHD) affects approximately 8 per 1000 live births globally. Tetralogy of Fallot (TOF) is one of the most common types of cyanotic CHD with four structural abnormalities of the heart. Children with CHD usually have poor oral health status (OHS). The dental evaluation and management of such patients with CHD is considered of utmost importance because it leads to the optimization of the OHS and elimination of the oral sources of focal infection before cardiac surgery to prevent infective endocarditis. The aim of this article is to present a case report describing about the effective dental care and management of a 5-year-old male patient with a diagnosis of CHD (TOF) before cardiac surgery. Extraoral examination findings were characteristic of cyanotic CHD (such as bluish-discolored lips and clubbing of digits). Intraoral examination revealed deciduous dentition with poor oral hygiene index, mobile, tender, and carious root stumps of teeth #54 and #64, and incipient caries in other multiple primary teeth. Appropriate dental treatment plan was made as per the patient’s dental and medical condition with interdisciplinary approach involving cardiologists/pediatricians and also considering the cooperative behavior of pediatric patient. Thus, necessary dental treatment and preventive procedures were effectively and successfully executed to address the dental problems. After successful cardiac surgery, follow-up evaluation demonstrated significant improvement in oral health. This article reflects the significance of a proper dental treatment plan to optimize the oral health condition in pediatric patient using nonpharmacological behavior management techniques in dental hospital/operatory. In addition, this article reviews and unveils the relevant literature.