Discussion

Discussion

Periodontal disease in patients with Down syndrome

Down syndrome (DS) is an autosomal dominant disorder associated with trisomy of chromosome 21. DS is the most common genetic birth defect, affecting approximately one in 700 live births. Patients with DS present with anatomical abnormalities, cognitive disabilities, and orofacial complications, including an increase in the prevalence of periodontal disease. Periodontal disease in patients with DS is severe, generalized, and has rapid progression; it is classified as a manifestation of systemic disease associated with the genetic disorder by the American Academy of Periodontology. Poor oral hygiene alone cannot explain the destruction and severity of periodontal disease in patients with DS. The severity of the condition is also manifested in reduced T and B cell counts, absence of normal lymphocyte expansion in infancy, suboptimal antibody responses to immunizations, decreased immunoglobulin A in saliva, and neutrophil chemotaxis. Preventive approaches and treatment modalities for periodontitis include removal of dental biofilm and surgical and nonsurgical therapy. Periodontal treatment basically consists of scaling and root planning (surgical and nonsurgical) in association with the use of local or systemic antibiotics.

Our appreciation is extended to Dr. Juan Yepes, Indiana University School of Dentistry Department of Pediatric Dentistry and Riley Hospital for Children, for contributing this case.

Reference

Ferreira R, Michel RC, Greghi SL, et al. Prevention and periodontal treatment in Down syndrome patients: A systematic review. PloS One. 2016;11(6):e0158339. doi: 10.1371/journal.pone.0158339. PMID: 27355338; PMCID: PMC4927059.