Monday, April 5, 2021

Oral Health in the Down Syndrome Community

We know that proper dental care should be a part of everyone’s healthcare routine, but often, extra attention needs to be paid in people with certain conditions. For people living with Down Syndrome, common symptoms include jaw, tongue, and teeth problems that can lead to a greater risk for oral complications.

With March 21 marking World Down Syndrome Day, we aim to shine a light on the specific oral health issues that can affect children and adults living with this condition.

What is Down Syndrome?

The genetic makeup of a child is formed by the chromosomes of their biological parents. Each of the parent’s 23 chromosomal pairs split apart and come together to create a new set of 23 pairs in the child.

Down syndrome occurs when the 21st chromosome of the one of the parents doesn’t separate properly, creating a full or partial extra copy of that chromosome in the child. This extra genetic material changes how the baby’s brain and body develop during pregnancy, causing mental and physical differences after birth.

According to a study cited by the Centers for Disease Control (CDC), Down syndrome occurs in about one in every 700 children, making it the most common genetic disorder in the United States. (For more information on the causes and risk factors of Down syndrome, visit the CDC website or the National Down Syndrome Society (NDSS).

Facial and Oral Signs of Down Syndrome

Many of the signs of Down syndrome usually include a combination of physical features in the face and mouth.

According to the NDSS, the following can impact dental health in people with Down Syndrome:

  • A large tongue
  • Late tooth growth
  • Short tooth roots
  • Small and missing teeth
  • Small bones in the nose
  • A small upper jaw

Common Oral Complications of Down Syndrome

It’s important to understand the potential oral health complications so that good daily routines can be established at home and treatment can be addressed early if needed.

Difficulty Chewing

Missing or irregular teeth and a misaligned jaw can cause difficulty chewing. This can also be a result of a symptom known as hypotonia, which is a lack of muscle tone that can affect the ability to chew and swallow. As the National Institute of Dental and Craniofacial Research (NIDCR) explains, improper chewing contributes to “inefficient natural cleansing action, which allow[s] food to remain on teeth after eating” and can lead to an increased risk for cavities.

Dry Mouth

Dry mouth (aka a lack of saliva) might occur in people with Down syndrome for a number of reasons: mouth breathing because of small nasal passages or a protruding tongue, chronic respiratory infections, or as a side effect of medication for hypertension. Dry mouth can result in trouble speaking, a burning sensation, or a constant sore throat. What’s more, without the proper amount of saliva to help clear away food, bacteria, and other disease-causing substances in the mouth, they’re more likely to suffer from tooth decay and gum disease.

Early Onset Periodontitis

The NIDCR calls periodontal disease “the most significant oral health problem in people with Down syndrome” — and it can happen much more quickly than to those without the condition. Several factors contribute to this including poor immunity, prolonged wound healing, short tooth roots, teeth grinding, and poor oral hygiene. When not addressed, this advanced form of gum disease can lead to visibly receding gums, lost teeth, and even certain cancers.

Overgrowth of Gums

Known as gingival hyperplasia, an overgrowth of gums can occur in people with Down syndrome who take medication for seizures. It can also simply be a side effect of poor oral hygiene. Left untreated, gingival hyperplasia can cause pain, visible gum growth over the teeth, teeth misalignment, and an increased risk for developing periodontal disease.

By keeping up with proper at-home care, scheduling preventative visits, and working with a dentist on an individualized plan, anyone with Down syndrome should be able to enjoy a happy, healthy smile for years to come.

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