Oliver Kelly J, Casas Michael J, Judd Peter L, Russell Jennifer L
The Hospital for Sick Children, Toronto, Ontario.
The Royal Children's Hospital, Melbourne, Victoria, Australia.
Paediatr Child Health. 2017 Sep;22(6):312-316. doi: 10.1093/pch/pxx093. Epub 2017 Jun 22.
Children with cardiac defects should have good oral health, particularly prior to cardiac surgery to minimize risks of infective endocarditis. The aim of the study was to examine the oral health assessment practices of North American cardiologists.
Online surveys were e-mailed to 1409 cardiologists. Cardiologists without paediatric patients or practicing in centres without cardiac surgical care were excluded. Surveys addressed oral health assessment practices for paediatric cardiac patients, and perceptions of the impact of oral health on cardiac care.
The centre response rate was 69%, individual response rate 20%. Most cardiologists (96%) reported oral health was assessed as part of cardiac care. The most common time for assessment was prior to cardiac surgery (44%), with a quarter assessing by age 1 (28%). While most oral assessments involved a dentist (59%), 17% of cardiologists performed the oral assessment without the aid of a dentist. Four-fifths of cardiologists (83%) reported cancellation of cardiac surgery due to oral disease. Cardiologists who deferred assessment until prior to surgery had the highest experience of cancellation (96%). Assessments were delayed despite the common belief (89%) that children on pre-surgical high-calorie diets are at increased risk of oral disease.
Assessments of oral health status were often deferred until immediately prior to cardiac surgery despite the cardiologist's perception that children with cardiac defects were at increased risk of oral disease and prior experience of surgical cancellation due to oral disease. Paediatricians may need to facilitate early oral assessment for these children.
患有心脏缺陷的儿童应保持良好的口腔健康，尤其是在心脏手术前，以尽量降低感染性心内膜炎的风险。本研究的目的是调查北美心脏病专家的口腔健康评估实践。
通过电子邮件向1409名心脏病专家发送在线调查问卷。不涉及儿科患者或在没有心脏外科护理的中心执业的心脏病专家被排除在外。调查问卷涉及儿科心脏病患者的口腔健康评估实践，以及对口腔健康对心脏护理影响的看法。
中心回复率为69%，个人回复率为20%。大多数心脏病专家（96%）报告称，口腔健康评估是心脏护理的一部分。最常见的评估时间是在心脏手术前（44%），四分之一的人在1岁时进行评估（28%）。虽然大多数口腔评估由牙医进行（59%），但17%的心脏病专家在没有牙医协助的情况下进行口腔评估。五分之四的心脏病专家（83%）报告称，由于口腔疾病，心脏手术被取消。将评估推迟到手术前的心脏病专家取消手术的经历最多（96%）。尽管普遍认为（89%）术前高热量饮食的儿童患口腔疾病的风险增加，但评估仍被推迟。
尽管心脏病专家认为患有心脏缺陷的儿童患口腔疾病的风险增加，且有因口腔疾病取消手术的既往经历，但口腔健康状况评估往往推迟到心脏手术即将进行时。儿科医生可能需要为这些儿童提供早期口腔评估。
