Oral Health and Cardiac Imaging in Children with Congenital Heart Disease: Evaluating the Parallel Contributions of Dental Care, Echocardiography, and Nuclear Medicine

Abstract

Children with congenital heart disease (CHD) face elevated risks of infective endocarditis (IE) due to structural cardiac vulnerabilities and poor oral health. This narrative review synthesizes evidence on the interplay between preventive dental care and advanced cardiac imaging modalities—echocardiography and nuclear medicine—in mitigating IE risk and improving outcomes. Dental interventions, including antibiotic prophylaxis and early hygiene education, are critical to reducing bacteremia, while echocardiography remains the cornerstone for diagnosing structural abnormalities and IE-related complications such as vegetations and valvular dysfunction. Emerging nuclear techniques, including 18F-FDG PET/CT and white blood cell scintigraphy, enhance diagnostic precision in complex cases, particularly for culture-negative IE or prosthetic device infections. Case studies illustrate how integrated care models combining dental and cardiac expertise prevent IE and guide timely interventions. Despite these advances, disparities in access to specialized care persist, underscoring the need for standardized protocols and multidisciplinary collaboration. This review advocates for proactive oral health strategies, tailored imaging protocols, and global initiatives to address socioeconomic barriers, ultimately aiming to reduce morbidity and mortality in pediatric CHD populations.