European Archives of Paediatric Dentistry

, Volume 11, Issue 4, pp 187–191 | Cite as

Saliva profiles in children using heart failure medication: a pilot study

  • Linda RosénEmail author
  • A. Rydberg
  • I. Sjöström
  • C. Stecksén-Blicks


AIM: To study the saliva profiles in children with severe heart disease taking heart failure medication compared with the saliva from healthy age and gender matched controls. STUDY DESIGN: Cross sectional case-control design. METHODS: Twenty-four age and gender matched pairs of children, mean age 12.0 years participated. Stimulated saliva was collected in a standardized way before lunchtime and the subjects were asked to refrain from all eating, drinking and tooth brushing 90 mins before sampling. Stimulated salivary secretion rate, buffering capacity, total salivary viable count of bacteria, mutans streptococci and lactobacilli, calcium, chloride, magnesium, potassium, sodium and salivary IgA were determined. RESULTS: There were 7 of the 24 children in the cardiac group who had secretions below 0.5 ml/min compared with no child in the control group (p<0.01). Lower than 106 total viable counts of bacteria (TVC) were detected in the cardiac group 1.4×106 ± 1.2×107 vs. 2.7×106 ± 2.9×107 in the control group (p<0.05). Mutans streptococci (MS) in the cardiac group were 5.2×104 ± 1.5×105 vs. 8.1 ×103 ± 1.3×104 in the control group, (p>0.05) and MS ratio of TVC constituted 0.11±0.35 per cent compared to 0.01±0.02 per cent for the control group (p>0.05). STATISTICS: Continuous data were analysed by an analysis of variance (ANOVA) and categorical data by chi-square test. CONCLUSION: Reduced salivary secretion could be a caries risk factor in children taking heart failure medication.

Key words

children heart failure medication saliva 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Bhat AH, Sahn, DJ. Congenital heart disease never goes away, even when it has been ‘treated’: the adult with congenital heart disease. Curr Opin Pediatr2004;16:500–507.PubMedCrossRefGoogle Scholar
  2. Bradshaw DJ, Marsh, PD. Analysis of pH-driven disruption of oral microbial communities in vitro. Caries Res 1998;32:456–462PubMedCrossRefGoogle Scholar
  3. da Fonseca M, Teske, EMD, Thikkurissy, S, Amini, H. The impact of oral health on the quality of life of young patients with congenital cardiac disease. Cardiol Young 2009;19:252–256PubMedCrossRefGoogle Scholar
  4. Dasanayake AP, Roseman, JM, Caufield, PW, Butts, JT. Distribution and determinants of mutans streptococci among African-American children and association with selected variables. Pediatr Dent 1995;17:192–198PubMedGoogle Scholar
  5. Edgar WM. Saliva and dental health. Clinical implications of saliva: report of a consensus meeting. Brit Dent J 1990;169:96–98Google Scholar
  6. Franco E, Roberts, RG. Dental disease, caries related microflora and salivary Ig A of children with severe congenital cardiac disease: an epidemiological and oral microbial survey. Pediatr Dent 1996;18:228–235PubMedGoogle Scholar
  7. Grahn K, Wikstrom, S, Nyman, L, Rydberg, A, Stecksen-Blicks, C. Attitudes about dental care among parents whose children suffer from severe congenital heart disease: a case-control study. Int J Paediatr Dent 2006;16:231–238PubMedCrossRefGoogle Scholar
  8. Hayes PA, Fasules, J. Dental screening of paediatric cardiac surgical patients. J Dent Child 2001;68:255–258Google Scholar
  9. Herrera JL, Lyons, MF, Johnson, LF. Saliva: its role in health and disease. J Clin Gastroenterol 1988;10:569–578PubMedCrossRefGoogle Scholar
  10. Koch G, Poulsen S, Twetman S. Caries prevention. In: Koch G, Poulsen S, (eds) Paediatric dentistry-a clinical approach. 2.ed. Copenhagen: Wiley-Blackwell, 2009; p. 107.Google Scholar
  11. Marsh PD. Dental plaque as a biofilm and a microbial community-implications for health and disease. BMC Oral Health 2006;15:6Google Scholar
  12. Nederfors T, Dahlöf, C. Effects on salivary flow rate and composition of withdrawal of and reexposure to the 1-selective antagonist metoprolol in a hypertensive patient population. Eur J□Oral Sci 1996;104:262–268CrossRefGoogle Scholar
  13. Nederfors T, Dahlöf, C, Ericsson, T, Twetman, S. Effects of the antihypertensive drug captopril on human salivary secretion rate and composition. Eur J Oral Sci 1995;103:351–354PubMedCrossRefGoogle Scholar
  14. Nederfors T, Dahlöf, C, Twetman, S. Effects of the beta-adrenoceptor antagonists atenolol and propranolol on human unstimulated whole saliva flow rate and protein composition. Scand J Dent Res 1994;102:235–237PubMedGoogle Scholar
  15. Nederfors T, Twetman, S, Dahlöf, C. Effects of the thiazide diuretic bendro-flumethiazide on salivary flow rate and composition. Scand J Dent Res 1989;97:520–527PubMedGoogle Scholar
  16. Reybrouck T, Vangesselen, S, Gewillig, M. Impaired chronotropic response to exercise in children with repaired cyanotic congenital heart disease. Acta Cardiol 2009;64:723–7.PubMedCrossRefGoogle Scholar
  17. Richardson P, McKenna, W, Bristow, et al. Report of the 1995 WHO/International Society & Federation of Cardiology Task Force. Definition and Classification of Cardiomyopathies. Circulation 1996;93:841–842PubMedCrossRefGoogle Scholar
  18. Rosén L, Stecksén-Blicks, C. Experience of dental care for children with CHD among Swedish dentists. Swed Dent J 2007;31:85–90PubMedGoogle Scholar
  19. Scully C, Felix, D. Oral Medicine — update for the dental practioner: dry mouth and disorders of salivation. Br Dent J 2005;199:423–427PubMedCrossRefGoogle Scholar
  20. Selwitz RH, Ismael, AI, Pitts, NP. Dental Caries. Lancet 2007;369:51–59PubMedCrossRefGoogle Scholar
  21. Sreebny L, Schwartz, S. A reference guide to drugs and dry mouth. Gerodon-tology 1986;5:75–99CrossRefGoogle Scholar
  22. Stecksén-Blicks C, Rydberg, A, Nyman, L, Asplund, S, Svanberg, C. Dental caries experience in children with congenital heart disease: a case-control study. Int J Paediatr Dent 2004;14:94–100PubMedCrossRefGoogle Scholar
  23. Streckfus C. Salivary function and hypertension: a review of the litterature and a case report. J Am Dent Assoc 1995;126:1012–1017PubMedGoogle Scholar
  24. Torres MC, Ramos, ME, Coelho, TL, Harari, S. Salivary Streptococcus mutans and Lactobacillus sp levels in cardiac children. J Clin Pediatr Dent 2001;26:103–109PubMedGoogle Scholar

Copyright information

© Adis International 2010

Authors and Affiliations

  • Linda Rosén
    • 1
    Email author
  • A. Rydberg
    • 2
  • I. Sjöström
    • 1
  • C. Stecksén-Blicks
    • 1
  1. 1.Depts. of OdontologyPaediatric DentistryUmeåSweden
  2. 2.Clinical Sciences, Faculty of MedicineUmeå UniversityUmeåSweden

Personalised recommendations