Children with congenital heart disease have poorer oral health compared with healthy children. Oral diseases, such as dental caries and gingivitis, are associated with the oral microbiome. The objective of this review was to find evidence of differences in the bacterial colonization of the oral cavity of children with congenital heart disease (CHD) versus healthy children. A literature review was conducted according to predetermined criteria, including the need for controlled clinical trials. Half of the 14 studies that met the inclusion criteria reported significant differences in bacterial colonization in children with congenital heart disease. A variety of influencing factors were discussed. There is some evidence for alterations in the oral microflora as a result of physiopathological and treatment-related factors in children with CHD, but additional research is required to validate these findings.

Purpose: The aim of this retrospective study was to analyse the dental and medical parameters, including peri- and postoperative management and complications, of patients with special healthcare needs receiving dental treatment in a tertiary care hospital setting. Methods: A total of 154 patients (mean age 7.8 ± 4.1 years) who received dental treatment under general anaesthesia or analgosedation at the Department of Paediatric Dentistry of the XXX University in XXXXXXX between 2021 and 2023 were divided into the following diseases: metabolic disease, nervous system disorder, congenital heart disease, tumour disease, gastroenterological disease, genetic syndrome, pulmonology disease and coagulopathy. Caries experience (dmf-t/DMF-T), type of anaesthesia and pre- and perioperative parameters were recorded. Results: Regardless of disease, all children showed higher caries experience in the primary dentition compared to permanent dentition (mean ± standard deviation; 6.44 ± 4.85/2.01 ± 3.87). Most of the children suffered from genetic syndrome, followed by congenital heart and metabolic disease. Dental treatment was mostly performed under general anaesthesia. 92.2% of those patients were intubated orotracheally and 66.9% received antiemetics. The complication rate was lower than 3%. Conclusions: Data show that special healthcare needs patients regardless of kind of disease are highly affected by caries and require dental treatment. Most dental restorations were performed under general anaesthesia. Regardless of disease and type of anaesthesia, the complication rate was low, which underlines the high clinical relevance of adequate dental care under general anaesthesia for this vulnerable patient group.

This study aimed to evaluate the administration of endocarditis prophylaxis (EP) in children and adolescents with cardiac findings requiring invasive dental therapy according to the newest European Society of Cardiology (ESC) guidelines from 2023. The research question focused on comparing EP protocols between chairside treatment (CS) and general anesthesia (GA) settings, given clinical protocol differences observed between these modalities. This retrospective analysis included 201 patients with cardiac findings who attended the Department of Pediatric Dentistry at Giessen University Hospital between 2018 and 2023 and underwent dental interventions with bacteremia risk. Patient data included cardiac findings, EP administration protocols, antibiotic agents used, treatment settings, and patient outcomes defined as infective endocarditis (IE) occurrence within three months post-intervention. EP indications were evaluated according to ESC guidelines. Fisher’s exact test was used to statistically test differences (GA vs. CS) regarding the outcome and the type of EP medication ( α = 0.05). Of all patients, 58.7% received treatment under GA and 41.3% chairside. According to ESC guidelines, EP indication existed in 36.4% of GA patients and 22.9% of CS patients. However, EP was administered in 84.7% of GA patients and 59.0% of CS patients. A significant correlation was found between the variables “treatment setting” and “antibiotic preparation EP” ( p < 0.001). No cases of IE occurred within 3 months, regardless of EP administration or indication status. Conclusion : Besides the limitations of our retrospective study, frequent EP over-administration beyond guideline recommendations was detected, and no IE cases occurred. This aspect could question whether EP indications should be more restrictively defined, particularly in children and adolescents with healthy dental status. What is Known: • The indication for antibiotic endocarditis prophylaxis (EP) during dental treatment is based on cardiac and dental risk factors. • In 2023, the European Society of Cardiology (ESC) published new guidelines for the prevention of infective endocarditis (IE) [1]. What is New: • This study highlights the difficulties in implementing guideline-adhering endocarditis prophylaxis and emphasizes the need for strict and comprehensible EP indication in children and adolescents.

Background: Dental higher education requires teaching of critical thinking and reflective skills. Both of which are strengthened by portfolio assignments. The aim of this study was to evaluate how the implementation of a portfolio assignment in a preclinical course of dental studies affected the students‘ understanding of course topics and their motivation to self-reflect. Methods: Students in a preclinical course focusing on the topic of ‘preventive dentistry’ in the third semester of dental studies were given a newly developed portfolio assignment that they were to work on throughout the semester in relation to the internship and lecture content. At the end of the semester, the success of the portfolio assignment implementation was measured using a validated evaluation form. The form included two dichotomous items, 14 Likert scale items and two free text fields regarding “portfolio assignment in the context of dental studies”, “structure and tasks”, “content and knowledge gain”, “requirements and scope” and “overall assessment”. Results: Students of two consecutive semesters (n _total = 64), in which the portfolio was implemented for the first time, participated in the portfolio assignment and evaluation process. The evaluation results showed that portfolio assignments and self-reflection tasks have been underrepresented in dental studies to date. In both semesters, the portfolio assignment was rated as good to very good in > 90% of cases. The structure and tasks, as well as the repetition of course content, scope and effort, were rated positively. More than 80% of the students also agreed that the reflection tasks contributed to an increase in engagement with the course content and an awareness of the knowledge gained over the duration of the semester. Conclusion: In conclusion, the implementation of a portfolio assignment, including self-reflective elements, into the curriculum revealed to be a promising teaching tool that is well received by students. At the same time, portfolio assignments illustrate not only to students but also to teachers that learning and optimisation is a dynamic process that should be constantly evaluated and adapted in all semesters.

Die Narkosebehandlung ermöglicht im Bereich der Kinderzahnmedizin für viele Patienten mit eingeschränkter Compliance und/oder mit besonderen Gesundheitsbedürfnissen (Co-Morbiditäten) überhaupt erst einen Zugang zu einer zahnmedizinischen Behandlung. Diese Patienten werden dabei in der Regel in spezialisierten Zentren behandelt. Der vorliegende Artikel stellt die Planung und Durchführung der Behandlung eines Patienten mit einem komplexen Herzfehler dar. Article published online: 16 July 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany