Oral Health Strategies for Down Syndrome and Other Genetic Conditions

Information in this article was made available from a guide for parents and dental providers of children with special needs developed by the Oklahoma Dental Foundation in partnership with several funders.  The entire guide is available for download at: Oral Health Care For Children With Special Health Care Needs.

The following is an excerpt from page 16 of the guide.

Chromosomal conditions such as Down syndrome are lifelong genetic conditions that range in
complexity and severity. Children may have underlying medical conditions and a consultation
with their primary physician may be needed before beginning dental treatment.
Typical symptoms of Down and other genetic syndromes fall into many categories. This section
intends to cover only those issues that are unique to these disorders. Other conditions and/or
behaviors will be covered in other sections of this guide and the resource section.

Oral Effects
Oral ulcers and infections, ulcerative gingivitis
Increased periodontal disease and dental caries
Malocclusion and tooth anomalies

Physical/Behavioral Concerns Strategies for Care
Conical teeth, shallow roots

Malocclusion (crooked bite)

• Orthodontia should be carefully thought out
• Consult with an orthodontic specialist
Atlantoaxial instability • Use great care in moving the spine and neck
• Consult with primary physician
• Use pillows and/or pads for support
Periodontal disease

Dental caries

• Avoid sugar in foods, snacks and treats
• Frequent rinsing & twice daily home oral care
• Consider topical fluoride, fluoride varnish and sealants
• Frequent cleanings
• Consider Chlorhexidine
• Ensure home oral care is properly done
Gingival lesions, prolonged wound healing or bleeding • Consult with primary physician about the possibility of underling medical conditions
Cardiac disorders

Compromised immune system

• Antibiotics before appointments may be needed
• Consult with primary physician
• Treat infections aggressively
• Perform twice daily home oral care
Delayed eruption

Congenitally missing teeth

• Oral exams should begin by the first birthday
• Use panoramic X-rays to look for missing teeth
• Maintain primary teeth as long as possible
• Consider using spacers where teeth are missing