Tetralogy of Fallot: an overview, case report, and discussion of dental implications


  • Evan Spivack DDS

    1. Attending Dentist and Clinical Associate Professor, Center for Treatment of the Handicapped, Department of Pediatric Dentistry, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, 110 Bergen Street, Newark, NJ 07103; spivacev@umdnj.edu; paper written when the author was Director, Special Dental Services, Department of Dentistry, St. Joseph's Hospital and Medical Center, 703 Main Street, Paterson, NJ 07503
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Tetralogy of Fallot (TOF) is the most common cause of cyanotic heart disease. The anatomic defects comprising TOF lead to the systemic circulation of oxygen-poor (desaturated) blood, resulting in symptoms of cyanosis, polycythemia, and hypoxia. Untreated, most patients with this disorder die during childhood. Surgical treatment aimed at correcting the defects is currently recommended for infants. Long-term studies have reported good results with this approach. The case history of a four-year-old male with uncorrected tetralogy of Fallot is presented. The patient required extensive dental treatment prior to scheduled cardiac catheterization. The dental findings and plan of care for this patient are detailed, and attention is given to the role of the medical work-up, preoperative antibiotics, and sedatives. It is stressed that the dental treatment plan for patients with tetralogy of Fallot must take into account the patients' medical status both prior to and following corrective surgical procedures.