Prevention and Periodontal Treatment in Down Syndrome Patients: A Systematic Review

Abstract

The aim of this systematic literature review was to evaluate which type of periodontal preventive and therapeutic approaches presents superior outcomes in patients with Down syndrome (DS). Studies reporting different methods of periodontal care from DS patients were considered eligible. Included clinical studies should indicate at least two periodontal parameters in different periods of assessment. Screening of the articles, data extraction and quality assessment were conducted independently and in duplicate. Electronic search according to the PICO search, with both Key-words and MESH terms were conducted in MEDLINE, EMBASE and CENTRAL databases until March 2016. Manual search was conducted in four journals, namely Journal of Periodontology, Journal of Clinical Periodontology, Journal of Periodontal Research and Special Care in Dentistry and their electronic databases were searched. Electronic and manual search resulted in 763 papers, and of them 744 were excluded after title/abstract assessment. The full text of 19 potentially eligible publications was screened and 9 studies met inclusion criteria. The results demonstrated the importance to introduce youngest DS patients in preventive programs, as well as participation of parents, caregivers or institutional attendants in supervising/performing oral hygiene. In studies with higher frequency of attendance, all age groups presented superior preventive and therapeutic results, irrespective of the therapeutic approach used (surgical/nonsurgical/periodontal care program). The important factors for reducing periodontal parameters were the frequency of the appointments and association with chlorhexidine/plaque disclosing agents as adjuvant treatment. This systematic review demonstrated that early introduction in periodontal care, participation of parents/caregivers/institutional attendants, frequency of attendance and association with chemical adjuvants (independently of the periodontal treatment adopted) seems to improve periodontal outcomes in preventive and periodontal treatment of DS patients. Registration number (Prospero): CRD42016038433.

Periodontal status of individuals with Down syndrome: sociodemographic, behavioural and family perception influence

“…Chemical adjuvants seem to improve periodontal outcomes in the preventive and periodontal treatment of patients with Down syndrome (Ferreira et al . ).…”

“…The participation of the parents in supervising/performing oral hygiene is essential for prevention and control of periodontal disease in this population (Ferreira et al . ). However, very few attempts within the medical scientific literature have been made to describe and understand parents' perception of periodontal disease and its contribution to maintaining the oral hygiene of their children (Kaye et al .…”

Periodontal disease in Down's syndrome patients. A retrospective study

“…After all, not all treatment sessions involved periodontal treatments. However, the frequency of attendance seems to improve periodontal outcomes of treatment of DS patients …”

“…As the treatability is reduced, the relative strain caused by the same periodontal therapy increases. Also, early introduction of periodontal care, participation of parents/caregivers/institutional attendants, and frequency of attendance seem to improve periodontal outcomes in preventive of periodontal treatment of DS patients …”

“…Also, early introduction of periodontal care, participation of parents/caregivers/institutional attendants, and frequency of attendance seem to improve periodontal outcomes in preventive of periodontal treatment of DS patients. 20 The purpose of this research is to identify the risk factors for the development of periodontitis, with the aim of describing a risk profile for people with DS. On the basis of such a profile, the dentist in a Centre for Special Care Dentistry (CBT) and/or general practice is in a better position to identify the DS patient with a high risk of developing periodontal dysfunction and to provide adequate treatment for that patient.…”