Dental Care for the Patient with Down Syndrome

Abstract

Approximately one out of every 800-1,100 births results in an extra chromosome of the twenty first group called Trisomy 21, or Down syndrome. Affecting over 250, 000 people in the U.S. alone, this population has progressed tremendously over recent years to be able to function in the mainstream of society. Inclusive school, work and community settings are now becoming the norm for persons with Down syndrome. This has resulted in a higher level of functioning for most of these individuals with resulting increases in selfesteem and self-image. The demand for dental care in persons with Down syndrome is increasing with this inclusive trend. Most dental treatment for persons with Down syndrome can take place in a general dental office with relatively minor adaptations. In undergraduate dental training there is usually little or no exposure to treating patients with disabilities, and general practitioners may be hesitant to treat these patients with confidence. This paper will attempt to summarise the unique characteristics associated with Down syndrome that influence the dental care and treatment of this population. Systemic factors influencing dental care Although 40 to 50% of babies with Down syndrome are born with some type of cardiac abnormality, most receive surgical correction within the first few years of life. There is however, an abnormally large percentage who develop mitral valve prolapse (MVP) by adulthood. The incidence of MVP in the normal population is between 5-15%. Approximately 50% of adults with Down syndrome have mitral valve prolapse requiring

A Paired Comparison among Siblings of Common Parents About Dental Care with and without Down Syndrome

“…The provision and/or supervision of be worse than that for non Down syndrome controls 4,5 and this is exacerbated if the individuals with Down syndrome are insti tuti onalized where very poor oral hygiene care has been reported 6 . The disabled form a substanti al secti on of the community and it is esti mated that worldwide there are about 500 million people with various disabiliti es 7 . Prevalence varies from country to country.…”

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

“…For lower grades the treatment must be tailored to the institutionalized case. There is no contraindication to local anesthesia in these children [41,42].…”

Down Syndrome: A Review for the Dental Professionals

“…Also, it is recommended to keep the appointment short and focusing on a specific treatment. [41,45,46]  Parents and caregivers oral health education: Motor functions are usually delayed in younger persons with DS, but coordination improves with age. Therefore, good oral hygiene may need to be responsibility of the primary caregiver until the individual can develop the necessary coordination to become selfsufficient.…”

“…The antibiotic prophylaxis against infective endocarditis is not recommended for people undergoing dental procedures. [44][45][46]  Cooperation: Children with DS have learning disability but exhibit a wide range of behavior in the dental setting, including cooperation, compliance, mild to moderate anxiety, phobia and complete lack of cooperation. For many patients, it is possible to carry out simple restorative treatment and preventive measures using standard behavioral management techniques such as tell-show-do, positive reinforcement, modelling, distraction and both verbal and nonverbal communication.…”