Dental management of a 6-year-old boy with ventricular septal defect and down syndrome under general anesthesia: A case report

Introduction: Down Syndrome (DS) is a genetic disorder caused by the presence of an extra copy of chromosome 21, characterized by physical and intellectual disabilities. DS has a significant risk factor for congenital heart diseases (CHD), which are abnormalities in the structure or function of the heart present from birth. Ventricular Septal Defect (VSD) is a septal defect in the ventricular wall, where small defects are usually asymptomatic and large defects can cause shortness of breath, feeding difficulties, and poor growth. Case History: A 6-year-old boy patient was referred to the Pediatric Dentistry Clinic at Dr. Saiful Anwar Regional General Hospital, Malang, by his pediatric cardiologist to investigate focal infection prior to heart surgery. The patient has been diagnosed with Ventricular Septal Defect (VSD) and Down Syndrome (DS). During intraoral examination, multiple caries and multiple gangrene radix were found. The patient was given prophylactic antibiotics previously and scheduled to undergo tooth fillings and extractions under general anesthesia. Discussion: Children with VSD have an increased risk of bacterial endocarditis. Dental procedures that cause trauma to soft tissue or bone may lead to bleeding, potentially leading to transient bacteremia. Prophylactic antibiotics are used in an attempt to prevent bacterial endocarditis. Due to these considerations, it was decided to undergo comprehensive dental management under general anesthesia (GA). With a comprehensive dental management approach under GA, all necessary procedures can be completed in a single visit. Conclusion: Dental management in children with VSD and DS under general anesthesia is a good option.