Oral health for children with a heart condition

A good oral health routine is important for people of all ages, but especially during childhood. Regular oral hygiene prevents tooth decay, dental infection and gum disease.

Children with heart conditions are at a higher risk of these dental diseases, which can lead to re-admissions to hospital for dental surgery or a prolonged stay in hospital for treatment. Good oral hygiene in childhood means that children will form healthy habits for their teeth for life and avoid unnecessary hospital stays. 

When to see the dentist

Your GP will check your child’s mouth as a part of their six month checkup. Children usually have their first teeth coming through at this time and your GP will check their teeth and talk about oral hygiene with you. At around 12 months of age we recommend the first visit to the dentist. It is important to check at this time that your child’s teeth are coming through and look for any signs of early decay. Your doctor or dentist will tell you how often to go back for a dental check-up. Generally we recommend visiting a dentist once or twice each year. If your child is older than 1 year and has not yet been to the dentist we recommend visiting one as soon as possible. Even if your child has no obvious issues with their teeth it is important to start an ongoing relationship with a dentist and discuss your child’s medical history and strategies for good oral hygiene.

What is good oral hygiene?

Children’s teeth should be cleaned twice a day for two minutes with a small toothbrush and a small amount of toothpaste. If your child doesn’t like toothpaste, brushing only with water is also effective. There are also un-flavoured toothpastes available.

Avoid putting your child to bed with a bottle unless it contains only water. Many liquids including milk and formula contain sugars which when left on the teeth overnight, lead to tooth decay.

Limiting the amount of soft drinks and sugar in a child’s diet should also be an important part of day-to-day care of your child’s oral health.

Cleaning babies’ teeth (0 – 2 years old)

• A popular method for cleaning babies’ teeth is to use a clean gauze/cloth to firmly wipe the teeth and gums, in the morning and at bedtime. After your baby develops their first back teeth around the age of 1 year old, you can start using a small toothbrush with a smear of regular toothpaste to clean their teeth. Perhaps, start off by giving your baby a small toothbrush as a toy in the bath.

Cleaning toddler’s teeth (2 – 5 years old)

• At this age, brushing should be done twice a day, with a small toothbrush and a swipe of regular toothpaste. Parents still need to brush their child’s teeth at this age, to ensure good cleaning.

Cleaning older children’s teeth (6+ years old)

• Children in this age group should still be brushing their teeth twice a day. This is especially important as their adult teeth start to arrive in the mouth. Children will need to be supervised when brushing their teeth until at least 8 years of age to ensure their technique is correct.

Infective Endocarditis

Infective endocarditis is another reason good oral health is especially important for children who have a heart condition. Infective endocarditis is an infection of the lining and vessels of the heart. It requires hospitalisation and prolonged antibiotic treatment and may lead to further heart surgery.

Infective endocarditis can be caused by poor oral health and certain dental procedures, as these may let oral bacteria enter the bloodstream and cause an infection inside the heart. The best way to maintain good oral health is to keep a good oral hygiene routine; this includes daily brushing, regular visits to the dentist, avoiding sugary food/drinks and drinking plenty of water. Routine checks with the dentist do not put your child at increased risk of infective endocarditis; in fact they decrease the risk.

Children who have heart conditions may need to take some special precautions or take preventative antibiotics for any dental procedures or before certain surgeries. Make sure you get a letter from your Cardiologist and also tell your dentist and GP about your child’s health history beforethey begin any procedures. 

What about medications?

Children that have a heart condition are often on regular medications that can impact the health of your child’s teeth. Speak to your pharmacist, dentist or GP if you have questions about any of the medications you are giving your child. You may also wish to read our factsheet titled “Oral Health and Medications for Children with Heart Conditions”.

General tips to prevent oral disease

• Brush twice a day – after breakfast and before bed. If your child is unwilling to use toothpaste brush with water alone.

• Rinse mouth with water after taking medications.

• Have regular dental checkups.

• Drink tap water every day rather than bottled water. Tap water in Australia has added fluoride, which is good for teeth.

• Watch for any brown or white spots that don’t brush off. These are early signs of tooth decay.

• Avoid eating sugary, sticky food, sweet drinks and juices, especially between meals.

• Avoid putting your child to bed with a bottle. Make sure feeding has finished and their teeth are brushed or mouth rinsed before your child goes to sleep, to avoid tooth decay.

• Avoid honey or anything else on dummies to get your child to sleep or to settle.

Where to find a dentist:

• Speak to your dentist and discuss if they are happy to care for your child. It may be more appropriate to refer your child to a children’s dentist.

• For appointments/advice from CHW Dental Department phone: 9845 2582. Our dentists may be able to refer you to someone more local.

Medicare subsidies:

• All children under 18 who are eligible for Medicare can access public dental services in NSW. Some children may be eligible for the Commonwealth’s Child Dental Benefits Schedule. This program gives children and teenagers access to up to $1000 in benefits for dental services over two calendar years. For more information speak to your child’s dentist or visit:

  http://www.health.nsw.gov.au/oralhealth/Pages/child-dental-benefits-schedule.aspx 

  For your closest public dentist: https://www.health.nsw.gov.au/oralhealth/Pages/contacts.aspx