Dentofacial and Cranial Changes in Down Syndrome

Abstract

ObjectivesThis study aimed to determine the prevalence of certain oral characteristics usually associated with Down syndrome and to determine the oral health status of these patients.MethodsThe cross-sectional study was conducted among patients attending a special education program at Faculty of Dentistry, Jamia Millia Islamia, Delhi, India. The study design consisted of closed-ended questions on demographic characteristics (age, sex, and education and income of parents), dietary habits, and oral hygiene habits. Clinical examination included assessment of oral hygiene according to Simplified Oral Hygiene Index (OHI-S), dental caries according to decayed, missing, and filled teeth (DMFT) index, periodontal status according to the Community Periodontal Index of Treatment Needs (CPITN), and malocclusion according to Angles classification of malocclusion. Examinations were carried out using a using a CPI probe and a mouth mirror in accordance with World Health Organization criteria and methods. Craniometric measurements, including maximum head length and head breadth were measured for each participant using Martin spreading calipers centered on standard anthropological methods.ResultsThe majority of the patients were males (n = 63; 82%) with age ranging from 6–40 years. The Intelligence Quotient (IQ) score of the patients indicated that 31% had moderate mental disability and 52% had mild mental disability. 22% exhibited hearing and speech problems.12% had missing teeth and 15% had retained deciduous teeth in adult population. The overall prevalence of dental caries in the study population was 78%. DMFT, CPITN and OHI scores of the study group were 3.8 ± 2.52, 2.10 ± 1.14 and 1.92 ± 0.63 respectively. The vast majority of patients required treatment (90%), primarily of scaling, root planing, and oral hygiene education. 16% of patients reported CPITN scores of 4 (deep pockets) requiring complex periodontal care. The prevalence of malocclusion was 97% predominantly of Class III malocclusions. Further 14% presented with fractured anterior teeth primarily central incisor. The percentage means of cephalic index was 84.6% in the study population. The brachycephalic and hyperbrachycephalic type of head shape was dominant in the Down syndrome individuals (90%).ConclusionThe most common dentofacial anomaly seen in these individuals was fissured tongue followed by macroglossia.

Oral Health Status of Institutionalized Individuals with Intellectual Disabilities in Lebanon

“…The relatively high DMFT scores described in our sample of children, adolescents and adults, averaging a value of almost 6 teeth, are similar to reports on intellectually disabled persons in several other populations [6,21-25]. The high caries activity noted in our sample may be attributed to their difficulty in maintaining oral hygiene, poor muscular co-ordination, and muscle weakness interfering with routine oral hygiene procedures [26].…”

Down syndrome—A narrative review with a focus on anatomical features

“…In general, the oral dysmorphic features common among people with DS are a fissured tongue and a high arched palate (Shukla et al, ; Rahul et al, ). In addition to these two traits (each with a prevalence of 79%), a recent epidemiological survey of children with DS ( n = 70) in India noted other oral manifestations such as macroglossia (83%), marginal gingivitis (93%), microdontia (63%), hypodontia (41%), an anterior open bite (23%) and periodontitis (11.5%) (Rahul et al, ).…”

Psychoprophylaxis for oral conscious sedation for dental care in Down syndrome adults with behavioral disorder

“…Dentofacial and cranial changes, such as V‐shaped palate, incomplete development of mid‐face, soft palate insufficiency, or cleft of lip/palate, may also be present. In addition, wide and dry lips, protruding tongue, and macroglossia may occur …”

“…In addition, wide and dry lips, protruding tongue, and macroglossia may occur. 8 Improved medical care over the last decades has markedly increased life expectancy of patients with DS from 10 years to approximately 60 years 9 DS is thus one of the intellectual disabilities dentists are most likely to encounter in their dental practice. Motivation is one of the keys to building the relationship between physician/dentist and patient and obtaining patient compliance, in the conviction that the oral health of these patients depends on regular follow-up.…”