Dental Concerns of Children with Down’s Syndrome - An Overview

Abstract

Down's syndrome is a condition known to be associated with a chromosomal abnormality. This is usually in the form of three in place of a pair of chromosomes 21, hence the name 'trisomy 21' the incidence of Down's syndrome in the population has been variably estimated between 1 and 4 per 1000 and which occurs in all races. These children are mentally retarded to some degree, they are generally smaller than average in height for their age, Midface dysplasia, flat broad bridge of the nose, "lop" ears, epicanthal folds with slanting almond-shaped eyes which was responsible for the term mongoloid. The majority of the children exhibit brachycephaly (broad, short head) and lack of supraorbital ridges and hypotelerism, Absence of frontal sinuses and absent or reduced maxillary sinuses, nasal septum or nasal conchl deviations are often observed which can produce a partially obstructed or narrow air passage and can contribute to the problem of mouth breathing, prone to infections especially upper respiratory tract infections. They have congenitally missing lateral incisors, the morphology of the teeth may also be affected. Teeth are smaller than normal, peg shaped and tend to be rounded or bulbous, roots of the incisors are short and most of the children are having tongue thrusting habit with lack of lip seal and high frenal attachment. They have a remarkable resistance to dental caries and at least half of them are caries free, preventive procedures along with chlorhexidine mouth wash may be beneficial and they suffer from a moderate to severe degree of periodontal disease. Down's syndrome children with congenital heart disease extractions and deep scaling should be done under antibiotic coverage and pulp treatment in primary teeth is contraindicated in patients with cardiac problems because of the risk of bacteremia whereas in permanent teeth it can be considered if an adequate apical seal can be obtained. Both orthodontic and prosthodontics appliances are usually contraindicated. Nitrous oxide analgesia or Tell show do in mildly apprehensive patients can be used, general anesthesia in severe resistance to dental treatment. This article discusses about etiological factors, clinical features and management aspects.

Protocolo de atención odontológica en pacientes pediatricos con sindrome de down

“…Aparecen las alteraciones menstruales y se manifiestan de forma más evidente los síntomas característicos del síndrome climatérico: alteraciones neurovegetativas con síntomas vasomotores de sofocos, cambios de humor, sudación e insomnio, pueden presentarse síntomas a nivel genitourinario, como atrofia y sequedad vaginal, cambios en su sexualidad, así como pueden aparecer algunas patologías que se deben prevenir, las más frecuentes son la osteoporosis y la enfermedad cardiovascular (20) Aquellas que experimentan otros síntomas, como sofocos e insomnio, parecen encontrarse especialmente en riesgo de presentar depresión durante este período. Además, las pacientes con antecedentes de depresión, en particular durante episodios relacionados con la reproducción, también parecen tener mayor riesgo de depresión durante el período en estudio (21).…”

“…Hábitos orales más frecuentes en niños con síndrome de Down En el gráfico 4 se observan que los hábitos más comunes dentro la cavidad bucal del niño con síndrome de Down en un 88% se encuentra la respiración bucal, seguido por un 60% de masticación inadecuada, y un 41,46% de bruxismo (10,11,19,21,…”

Dental and Oral Care Treatment Needs in Children with Down Syndrome in Surabaya

“…As shown in this study, most of samples (58.82%) had def-t and DMF-T score below 10. Down Syndrome patient with caries development show far less number of cavities than would be expected in a normal child which can be due to dental anomalies 15 . Dental anomalies in primary and permanent teeth are very common, and has incidence five times greater in people with Down Syndrome when compared to general population.…”

“…Caries treatment need for this study samples were restoration using Glass Ionomer Cement (61,76%) then Preventive Resin Restoration and Stainless Steell Crown for about almost 6% of the sample, pulp treatment for more than 10% samples, and extraction about 55.88%. It is critical to maintain the primary dentition as long as possible with the delayed emergence of the permanent teeth and the high number of missing teeth 15 . Poor periodontal tissue health conditions in people with Down Syndrome can cause permanent teeth to be removed in their teens which had been reported of more cases in loss of lower anterior permanent teeth before 8 years of age 7,14 .…”

“…Method about how to maintain the dental health of children with special needs is very important to be taught to parents and caregivers early on and it is important to be repeated adjusted to the child's growth and development. Oral Health Instruction should ideally be carried out on the first visit to the dentist and oral hygiene control is carried out at each regular visit every 3 months or more often for some children 7,15 . Using leaflet or module print or non print as media that can be re-learned at home by parents or caregivers still an option.…”