Efficacité de deux méthodes d’enseignement d’hygiène orale chez les enfants atteints de cardiopathies

Tooth brushing and food chewing are among the oral activities that can cause transient bacteremia. A transient bacteremia can initiate infective endocarditis in patients at risk. Risk factors for infective endocarditis in children include most congenital heart diseases and it has been shown that effective plaque control and good oral hygiene can reduce the risk for infective endocarditis initiated by bacteria of oral origin. The present research objectives were drawn up to evaluate the level of knowledge of parents of children with congenital heart disease on infective endocarditis and its relation to oral health. Our other research objective was to probe the oral hygiene habits of children with congenital heart disease. The efficacy of two oral hygiene instructional methods in children with congenital heart disease was also evaluated. The experimental procedure meant the involvement of all the parents of children with congenital heart disease, between 6 and 12 years old who were visiting the department of cardiology at the CHU Sainte-Justine. They were solicited to participate in the research project and were given an information and consent form. All parents who agreed to participate were given the questionnaire that was used to evaluate the knowledge of parents of children with congenital heart disease on infective endocarditis and its association with oral health. The questionnaire also aimed to know the personal and professional oral hygiene habits of children with congenital heart disease. A clinical exam performed on each child cited the Quigley & Hein, Turesky modified plaque index before and after the utilization of the assigned oral hygiene instructions. Each child was assigned to one of the two oral hygiene instruction groups through a randomization table. The method of oral hygiene instructions of group 1 corresponded to the instructions given by the cardiologist and the method of oral hygiene instructions of group 2 corresponded the to instructions given by an audio visual presentation.  Paired T-test and Chi-square analyses, as well as one-way ANOVA analysis and Pearson’s correlation analysis were produced to evaluate the data. The results demonstrated that the knowledge of the association between oral health and infective endocarditis was not superior in parents of children with higher risk of adverse effect from infective endocarditis than in parents of children with a lesser risk (p=0,104). Interestingly enough, parents of children with a congenital heart disease that are knowledgeable about the association will adopt preventive behaviors in order to promote their child’s oral heath and reduce their risk for infective endocarditis. The clinical exam also demonstrated that both oral hygiene instructions methods were effective for plaque control (p=0,000) but no significant statistical difference was found between the two methods (p=0,668). The parents of children with congenital heart disease that are aware of the association between oral health and infective endocarditis demonstrated preventive oral health behaviors to promote oral health in comparison with the parents who lacked the knowledge. The oral hygiene instructions methods given by way of the audio visual presentation was not superior to those given by the cardiologist.

Keyphrases: Oral health, Endocarditis, Congenital heart disease