More than one third of five-year-old children with congenital heart defects could be at increased risk of infective endocarditis because of poor oral health, according to Tine Birkeland Sivertsen’s PhD thesis.


  1. Endocarditis antibiotics are over-prescribed in children with congenital heart defects.
  2. More than one third of five-year-old children with congenital heart defects have caries.
  3. An early intervention program improves oral hygiene in children with congenital heart defects.


Thesis: Oral health in children with congenital heart defects. Current status and experiences from an intervention program
Candidate: Tine Birkeland Sivertsen
Time: May 9, 2019 at 11:15
Place: University of Bergen, Odontologibygget: Auditorium Cavum
Link to university website (in Norwegian)


(1) Dental workers of the Public Dental Service feel less confident when treating children with congenital heart disease than healthy children. They generally over-prescribe antibiotics to prevent endocarditis in these children. The study includes answers from 184 dentists and hygenists in three counties in Western Norway.

(2) 25 out of 67 five-year-olds with congenital heart defects had caries. Half of the children had erosion, and more than a third had caries and/or erosion at the dental level, indicative of increased infective endocarditis risk. The prevalence of poor oral health was higher compared to a control group of healthy children.

Only four of the children in the study had experienced fillings, indicating an unmet need for operative treatment. Neither birth-weight, parental education level, meal frequency or consumption of sugar-sweeted drinks were associated with oral health.

(3) An intensive oral health intervention program starting at infancy did not reduce the prevalence of caries or dental erosion among five-year-old children with congenital heart defects. However, the children had fewer teeth affected by caries, less dental plaque and less gingival bleeding compared to children with heart defects who didn’t receive the program. They also more often had their dentine caries treated, and their parents were more likely to brush the childrens’ teeth twice a day.


(1) Sivertsen, T. B., Åstrøm, A. N., Greve, G., Aßmus, J., & Skeie, M. S. (2013). Endocarditis prophylaxis and congenital heart defects in the Norwegian Public Dental Service. Acta Paediatrica102(1), 29-34.

(2) Sivertsen, T. B., Aßmus, J., Greve, G., Åstrøm, A. N., & Skeie, M. S. (2016). Oral health among children with congenital heart defects in Western NorwayEuropean Archives of Paediatric Dentistry17(5), 397-406.

(3) Sivertsen, T. B., Åstrøm, A. N., Greve, G., Aßmus, J., & Skeie, M. S. (2018). Effectiveness of an oral health intervention program for children with congenital heart defectsBMC oral health18(1), 50.

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