Stomatologiczna opieka nad dziećmi z wrodzonymi wadami serca – aktualne wytyczne profilaktyki infekcyjnego zapalenia wsierdzia i model interdyscyplinarnej opieki

Background. Congenital heart disease (CHD) is the most common congenital anomaly and one of the major predisposing factors for infective endocarditis (IE). Advances in pediatric cardiology and cardiac surgery have substantially improved long-term survival, increasing the importance of long-term prevention of complications. Maintaining good oral health and appropriate dental management are essential components of comprehensive care for children with CHD. Objective. To summarize current recommendations for infective endocarditis prophylaxis in children with congenital heart disease, discuss safe dental management, including patients with cardiovascular implantable electronic devices (CIED), and present an interdisciplinary model of care. Material and methods. A narrative review was conducted based on the latest American Heart Association (2021) and European Society of Cardiology (2023) guidelines, supplemented by recent literature on infective endocarditis prevention, pediatric dental care, and the safety of dental procedures in patients with CIED. Results. Current guidelines recommend antibiotic prophylaxis only for patients at the highest risk of infective endocarditis undergoing selected invasive dental procedures. Greater emphasis is placed on maintaining good oral hygiene, effective control of oral infectious foci, and regular preventive dental care. Piezoelectric ultrasonic scaling is considered safe in most patients with CIED when appropriate precautions are observed. Effective care requires close collaboration between pediatric cardiologists, dentists, and primary care physicians. Conclusions. Prevention of infective endocarditis in children with CHD should primarily rely on maintaining good oral health and individualized risk assessment. An interdisciplinary model of care and adherence to current guidelines enable safe dental treatment while minimizing the risk of infectious complications.