Pulp therapy in pediatric patients with congenital heart disease: survey of American Academy of Pediatric Dentistry members.

PURPOSE: The purpose of this study was to identify treatment options recommended by American Academy of Pediatric Dentistry (AAPD) members concerning pulp treatment in primary teeth in pediatric patients with congenital heart disease (CHD).

METHODS

A web-based survey was sent to all active members of the AAPD. The survey contained radiographs of pulpally involved primary teeth, a description of associated signs/symptoms, and a medical history of the patient who was positive for a type of CHD. Pediatric dentists were requested to report treatment recommendations.

RESULTS

Of the 6,590 surveys sent, 1,493 surveys (23%) were completed. Most respondents preferred to extract the tooth with the clinical presentation of irreversible pulpitis followed by distal shoe space maintenance when the patient presented with a negative medical history. By contrast, approximately half of the respondents elected to extract this tooth without space maintenance for all of the cardiac conditions. By contrast, most respondents elected to perform a pulpotomy in the case of reversible pulpitis regardless of the medical history. Indirect or direct pulp therapy were the least chosen options for both presentations.

CONCLUSIONS

The presence of CHD affects treatment decisions in teeth exhibiting irreversible pulpitis with symptomatic apical periodontitis but not in teeth displaying reversible pulpitis with a normal periodontal status.