Children with Down’s syndrome have poorer oral health

Dental Tribune International

Fri. 31. January 2020

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DUBAI, UAE: Improved medical care has led to a higher life expectancy for individuals with Down’s syndrome, resulting in an increased need for dental care among this patient group. With reported incidences of one in 319 live births among UAE children compared with one in 602 live births among expatriate children, Dubai shows the highest prevalence of Down’s syndrome in the Middle East and North Africa region. Hence, researchers from Hamdan Bin Mohammed College of Dental Medicine at Mohammed Bin Rashid University of Medicine and Health Sciences in Dubai have assessed the oral health status of Down’s syndrome children in Dubai in order to provide proper care for them. They found that these children generally have a poorer dental health status than their peers.

For the evaluation, 106 Down’s syndrome children and 125 children in the control group, aged between 4 and 18, were recruited from special needs centres and private and public schools in Dubai. A dental examination to record decayed, missing and filled teeth (DMF index) in primary and permanent dentition, as well as a simplified oral hygiene index and calculus index, was carried out. In addition, occlusal, dentofacial and soft-tissue abnormalities, and erosion were assessed.

“The number of teeth missing, decayed or filled [in Down’s syndrome children] was significantly higher than in healthy children in our sample,” co-author Dr Mawlood Kowash, associate professor of paediatric dentistry at the university, told the newspaper The National. Overall, the mean DMF index in the permanent dentition was 3.32 for the Down’s syndrome children, compared with 2.16 for the controls.

Regarding oral hygiene status, the researchers did not find a considerable difference between the two groups, whereas the calculus index was significantly higher among children with Down’s syndrome. In addition, these children showed a significantly higher proportion of open bite (60.0% compared with 11.2%) and other occlusal problems and a higher prevalence of tooth erosion (34.0% compared with 15.3%) than the control group.

“People with Down’s syndrome can have a lot of health problems, and the parents or guardians can become overwhelmed with that. Teeth can come at the bottom of the list,” said Kowash. According to him, the discipline of special care dentistry to treat patients with intellectual disabilities has not yet evolved in the UAE to the extent that it has elsewhere.

“So we have to raise awareness, we have to educate parents but also our medical colleagues, so these patients can be referred to us and we can treat them before cavities and other problems develop. Awareness is very, very important,” continued Kowash.

Despite the high caries rate among Down’s syndrome patients, they had received more restorations and dental treatment compared with the control group, suggesting that Down’s syndrome children had better access to dental care. Therefore, the research team recommends establishing “proper prevention and community oral healthcare programmes that target special needs children in Dubai” and conducting further research in this field in order to gain a better understanding of the patients’ oral health and treatment needs.

The study, titled “Oral health status among children with Down syndrome in Dubai, United Arab Emirates”, was published in the May/June 2019 issue of the Journal of International Society of Preventive and Community Dentistry.

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