Poor oral health in Sudanese children with congenital heart disease

Sudanese children born with heart defects have a higher presence of gingivitis and caries than heart healthy children. Lack of brushing and little knowledge about oral hygiene is probably part of the explanation.

Sudan have a scarcity of dentists, and children have limited access to dental services. The research of PhD candidate Hiba Mohamed Hassan Mohamedali at the University of Bergen shows that Sudanese children with congenital heart defects have poorer oral hygiene and oral health than children born without congenital heart defects. The findings are considered worrying, since poor oral health could potentially lead to infective endocarditis, an infection of the endocardial surface of the heart.

111 children with and 182 children without congenital heart disease were included. Almost all children had visible plaque on one or more teeth, but children with heart defects had more sites with plaque and more sites with gingivitis. They also had more caries, with a mean of 3.7 cavities each in the youngest children. None of the children with congenital heart disease had had their caries lesions treated, which was also very uncommon among children without congenital heart disease.

Furthermore, the researchers found a higher presence of bacteria that can cause cavities and gingivitis in children with congenital heart disease, including microbes that are known to cause infectious endocarditis and other systemic complications. The levels of several of these bacteria were significantly associated with more caries and more gingivitis.

Interviews with the children’s caregivers revealed that more than 20% of children with heart defects did not brush their teeth regularly. Among these children, the presence of caries were more than five times greater compared to children with congenital heart disease who did brush their teeth regularly. Children whose mothers had low education had poorer oral hygiene than children whose mothers had higher education. 80% of children with heart defects had never been to the dentist, and the knowledge of caries was lower among caregivers of children with than without heart defects.


Thesis: Oral Health in Sudanese Children with Congenital Heart Defects
 Hiba Mohamed Hassan Mohamedali
Time and place: February 3, 2017, University of Bergen


Ali, H. M., Mustafa, M., Hasabalrasol, S., Elshazali, O. H., Nasir, E. F., Ali, R. W., Berggren, E. & Skeie, M. S. (2016). Presence of plaque, gingivitis and caries in Sudanese children with congenital heart defects. Clinical oral investigations, 1-9.

Ali, H. M., Mustafa, M., Nasir, E. F., Lie, S. A., Hasabalrasol, S., Elshazali, O. H., Ali, R. W. & Skeie, M. S. (2016). Oral-health-related background factors and dental service utilisation among Sudanese children with and without a congenital heart defects. BMC Oral Health, 16(1), 123.

Mohamed Ali, H., Berggreen, E., Nguyen, D., Wahab Ali, R., Van Dyke, T. E., Hasturk, H., & Mustafa, M. (2017). Dental plaque microbial profiles of children from Khartoum, Sudan, with congenital heart defects. Journal of Oral Microbiology, 9(1), 1281556.

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