Oral and systemic manifestations, and dental management of a pediatric patient with Tetralogy of Fallot. A case report.

Carmen de la Luz Ayala, Lizbeth Aguayo


Introduction. Tetralogy of Fallot is a congenital heart disease and the most common cyanotic heart defect in children. It is clinically characterized by a ventricular septal defect, pulmonary stenosis, overriding aorta over ventricular septal defect and right ventricular hypertrophy. There is little or no information about the oral manifestations in patients with this pathology. A report and discussion of a pediatric patient diagnosed with Tetralogy of Fallot, its clinical manifestations, oral findings and dental management are presented. Case Report. A four-year-old male patient diagnosed with Tetralogy of Fallot and epileptic attacks. The patient has deciduous teeth with many severe early childhood caries, stomatitis and cyanotic mucous, radicular remains, periapical abscess and noticeable enamel hypoplasia. Conclusions. In agreement with other authors, children with systemic diseases such as Tetralogy of Fallot have a higher rate of caries, poor oral hygiene, high susceptibility to other infections and bacterial endocarditis, cyanotic mucous membranes and enamel hypoplasia. Primary prevention is critical, proper dental hygiene, regular dental check-ups and the use of antibiotic prophylaxis are particularly important, especially in high-risk patients.


Tetralogy of Fallot; Dental Caries; Heart Disease; Antibiotic Prophylaxis.


Silverman NH, The essential echocardiographic features of tetralogy of Fallot. Cardiol Young 2013; 23(6): 871-82.

Loukas M, Cesmebasi A, Le D, Etienne D, Tubbs RS, Anderson RH. Etienne Arthur Louis Fallot and his tetralogy. Clin Anat 2014; 27(7): 958-63.

Swamy P, Bharadwaj A, Varadarajan P, Pai, R. G. (2015). Echocardiographic evaluation of tetralogy of Fallot. Echocardiography 2015; 32(S2): 40-48.

Sawardekar KP. Profile of major congenital malformations at Nizwa Hospital, Oman: 10-year review. J Paediatr Child Health 2005; 41(7):323- 30.

Cornejo KBZ, Brener IV, Bouchan DR. Manejo estomatológico del paciente pediátrico con cardiopatía congénita. Revisión de la literatura.Univ Odontol 2011; 30(64): 57-66.

Ajitha N, Chunawalla Y, Morawala A. Dental considerations and management of a pediatric patient with tetralogy of Fallot. Guident 2014; 8(1):74-6.

Montero J, Moreno E, Rubio I, Vallejo S. Intranasal Midazolam for the Emergency Management of Hypercyanotic Spells in Tetralogy of Fallot. Pediatr Emerg Care 2015; 31(4): 269-71.

Nosrati E, Eckert GJ, Kowolik MJ, Ho JG, Schamberger MS, Kowolik JE. Gingival Evaluation of the Pediatric Cardiac Patient. Pediatr Dent 2013; 35(5): 456-62.

Cruvinel V, Gravina DB, Azevedo ND. Prevalence of enamel defects and associated risk factors in both dentitions in preterm and full term born children. J. Appl Oral Sci. 2012; 20(3):310-17.

Alva C. Tetralogía de Fallot: Actualización del diagnóstico y tratamiento. Rev Mex Cardiol 2013; 24(2): 87-93.

Kato T, Yorifuji T, Yamakawa M, Inoue S, Saito K, Doi H, Kawachi I. Association of breast feeding with early childhood dental caries: Japanese population-based study. BMJ open 2015; 5(3): e006982.

Breibart RE, Fyler RE. Tetralogy of Fallot. In Keane JF, Lock JE, Fyler DC (Eds.), Keane: Nadas’ Pediatric Cardiology, 2º ed.; Saunders, Philadelphia; 2006, pp. 559-579.

Babaji P. Tetralogy of Fallot: a case report and dental considerations; Tetralogia de Fallot: relato de caso com considerações dentárias. Rev Clín Pesq Odontol 2009; 5(3): 289-92.

Correa-Faria P, Martins-Junior PA, Vieira-Andrade RG, Marques LS, Ramos-Jorge, ML. Perinatal factors associated with developmental defects of enamel in primary teeth: a case-control study. Braz. Oral Res 2013; 27(4): 363-68.

Denysova E, Sokolova I. Caries and enamel hypoplasia temporary teeth at children of early age: prevention and treatment / Elena Denysova, Irina Journal of Health Sciences 2014; 4(11): 284–92.

Seow WK, Wright J. Developmental defects of enamel and dentine: challenges for basic science research and clinical management. Aust Dent J 2014; 59 (Suppl 1):143-54.

Paolucci, M. Microbiological and epidemiological characterization of the oral cavity microbiota using cultural and molecular techniques., [Dissertation thesis], Alma Mater Studiorum Università di Bologna. Dottorato di ricerca in Scienze mediche generali e scienze dei servizi; 2014.

Gutiérrez JL, Vicente Bagán J, Bascones A, Llamas R, Llena J, Morales A, Noguerol B, Planell B, Prieto J, Salmerón JI. Documento de consenso sobre la utilización de profilaxis antibiótica en cirugía y procedimientos dentales. Rev Esp Cirug Oral y Maxilofac 2006; 28(3): 151-81

Roberts GJ, Holzel HS, Sury MRJ, Simmons NA, Gardner P, Longhurst P. Dental bacteremia in children. Pediatr Cardiol 1997; 18:24-27.

Falces C, Miró JM. Prevención de la endocarditis infecciosa: entre el avance en los conocimientos científicos y la falta de ensayos aleatorizados. Rev Esp Cardiol. 2012; 65:1072–74.

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