The condition of oral health and chosen saliva parameters of pediatric patients after heart transplant: preliminary report

Introduction
The number of heart transplant in pediatric patients is constantly growing. Due to immuno¬suppressive therapy, there is an increased potential for oral lesions that may require special dental treatment. Decreased responses of the immune system can lead to a higher chance of odontogenic infection.

Objectives
The aim of the study was to evaluate dentition, condition of gingiva, mucous membrane, condition of saliva, and level of oral hygiene in children after heart transplant.

Material and methods
Heart transplant patients were examined extraorally and intraorally for pathological lesions. Decayed, missing, filled teeth (DMFT) and decayed, missing, filled surfaces (DMFS) indexes were used to assess the deciduous and permanent teeth. The periodontium was evaluated using gingival index (GI), modified sulcus bleeding index (mSBI), and gingival overgrowth index (GOI). Oral hygiene was evaluated with plaque index (Pl-I) and approximal plaque index (API). The saliva-check buffer by GC was used to measure the secretion speed (ml/min) to evaluate the pH and buffering abilities of the saliva.

Results
The condition of primary and secondary dentition was better in the research group than in the control group. In the extraoral and intraoral examination, no major pathological changes were found. In both groups, mean hygiene level (Pl-I) was at average level. However, level of hygiene in the interproximal spaces (API) was worse in the research group. No gingiva overgrowth or bleeding were noticed. Two children had mild gingivitis. All patients had normal stimulated saliva secretion (> 5.0 ml/min). Averaged saliva pH was 6.62.

Conclusions
Oral health is very important for heart recipients. All patients after heart transplantation should be provided with proper dental care. Due to permanent immunosuppression, all inflammatory changes in the oral cavity should be treated as soon possible.