Gingivitis in Children with Down Syndrome: Review of Local and Systemic Factors

Abstract

Background. When compared to healthy children, children with Down Syndrome (DS) have a higher prevalence of gingivitis (46.7%). Individuals with DS have anatomical abnormalities, and mental and orofacial problems. They also have a weakened immune system, resulting in a decrease in the number of T lymphocyte cells, making children with DS more susceptible to infection. This includes an increased prevalence of periodontal diseases, one of which is gingivitis. This systematic review discusses the existing local and systemic factors that may become the etiology of gingivitis in children with DS.Objective. To describe various local and systemic factors as the cause of gingivitis and to find out the main etiological factors of gingivitis in children with DS Methods. We searched PubMed and Google Scholar for Indonesian and English references either in the form of textbook, research results, reviews, and internet articles on the topic. We screened and selected the relevant articles for inclusion into the review. Results.In children with DS, apart from poor oral hygiene, the increasing incidence of gingivitis is caused by changes in other local factors related to systemic factors, such as oral dysfunction, dental and gingival abnormalities, changes in the oral microbial profile, and salivary characteristics. Furthermore, systemic immunodeficiency, changes in inflammatory mediators and proteolytic enzymes, and intellectual subnormality are considered as systemic factors. Conclusion.There is no main etiological factor of gingivitis in children with DS since various local and systemic factors are interrelated with each other causing gingivitis. The severity of gingivitis in children with DS presumably were caused by the systemic factors. Furthermore, good oral hygiene habits and the dentist's intervention in periodontal health can significantly reduce gingivitis in DS patients.

Efektivitas Sikat Gigi Listrik sebagai Kontrol Plak Penderita Sindrom Down

“…Selain itu, terdapat gangguan pada sistem imunologi sindrom Down, dimana sel T dan sel B terdapat dalam jumlah yang sedikit. Kondisi ini menyebabkan mudahnya terbentuknya plak karena penurunan mediator anti inflamasi, respon antibodi, dan imunoglobulin A (Huggard, Doherty, & Molloy, 2020;Octafianto, Saskianti, & Wahluyo, 2023). Kondisi ini selanjutnya juga dibarengi dengan ditemukannya jumlah sel TNFalpha yang tinggi sebagai mediator proinflamasi (Albandar, Susin, & Hughes, 2018;Octafianto et al, 2023).…”

“…Kondisi ini menyebabkan mudahnya terbentuknya plak karena penurunan mediator anti inflamasi, respon antibodi, dan imunoglobulin A (Huggard, Doherty, & Molloy, 2020;Octafianto, Saskianti, & Wahluyo, 2023). Kondisi ini selanjutnya juga dibarengi dengan ditemukannya jumlah sel TNFalpha yang tinggi sebagai mediator proinflamasi (Albandar, Susin, & Hughes, 2018;Octafianto et al, 2023). Tingginya kadar mediator pro inflamasi dan rendahnya kadar mediator anti inflamasi dapat mempengaruhi respon biologis dan respon imun anak down syndrome, sehingga skor indeks plak pasien down syndrome cenderung lebih besar jika dibandingkan dengan anak normal (Council, 2019).…”