Abstract 4366943: Oral Health in Children and Adolescents With and Without Heart Disease in the United States 2022-2023

Background: Children and adolescents with heart disease (HD) represent a vulnerable population with an increased risk for dental caries and periodontal issues resulting in poor oral health. If left untreated, it can lead to severe complications such as infective endocarditis and impact overall health. Research Questions: To compare oral health indicators between children and adolescents with and without HD, and to examine risk factors for poor oral health in children with HD. Methods: Data was analyzed from the 2022-2023 National Survey of Children’s Health, an annual cross-sectional survey of parents and caregivers. Chi-square tests were used to compare physical and dental health of children ages 1 to 17 years with (n = 2771) and without (n = 102,421) HD. Multivariate logistic regression was used to identify predictors of poor oral health in the HD group. Results: Children and adolescents with HD were more likely to have public insurance (34.6% vs 29.5%), be in the 12 to 17 year old age group (44.4% vs 37.4%), have difficulty meeting basic needs sometimes or very often (17.3% vs 14.1%), have an intellectual (7.6% vs 1.1%) or developmental (19.0% vs 5.5%) disability (DD), have special health care needs (50.2% vs 20.9%), and have worse overall health (6.3% fair or poor vs 1.3%) compared to non-HD group. There were no significant differences between groups in receipt of preventative dental care in the previous year, including dental check-up, cleaning, oral care instruction, fluoride treatment, or sealant application, although children with HD were more likely to miss dental visits. Despite this, the HD group had significantly worse oral health, including teeth in fair or poor condition (p <0.001), toothache (p <0.001), bleeding gums (p <0.001), and dental decay (p = 0.002) compared to the non-HD group. Predictors of teeth in fair or poor condition in the HD group included poverty (p = 0.033), lack of nutritious food (p=0.015), and DD (p<0.001). Conclusion: Children with HD experience worse dental health than children without HD, despite similar preventative dental care. This may reflect the intrinsic impact of HD on tooth formation related to known enamel defects. DDs can affect the child’s ability to perform daily dental hygiene and limited access to healthy food and beverages can impact oral health. Clinicians should screen children with HD for risk factors and encourage caregivers of children with DD to assist with oral hygiene to optimize oral health.