Children, Down Syndrome, and Oral Health 101

Down syndrome (DS) is a chromosomal condition seen in 1 in 700 births in the United States, making it one of the most common genetic disorders. The condition, characterized by an extra chromosome 21, can lead to various physical and intellectual challenges. While scientists give much attention to addressing Down syndrome’s cognitive and developmental aspects, loved ones and caregivers must prioritize overall well-being, including oral health and wellness.

Maintaining healthy teeth and gums is critical for all, but it holds particular importance for those with DS. The unique challenges (physical, sensory, behavioral, and communication) associated with the condition can increase the risk of dental problems and oral health issues, making it vital to provide tailored care and support.

In this article, Kyrene Family Dentistry explores the link between dental problems and Down syndrome. We also touch on oral care tips and the importance of early intervention, highlighting the role of caregivers and dentists in ensuring optimal oral health for young boys and girls with this chromosomal disorder. We aim to provide a valuable resource for families, caregivers, healthcare professionals, and individuals with DS to maintain brilliant smiles.


Dental Problems in Children with Down Syndrome

Kids with Down syndrome are more prone to oral health challenges than the general population, mainly due to the physical and developmental characteristics associated with DS. 

Here are the top three common dental problems in Down syndrome-afflicted individuals:


1. Malocclusion and Orthodontic Problems

Severe malocclusion, or misalignment of the teeth and jaws, is common in children with Down syndrome.

In a 2021 study involving 23 children aged 10 to 14 with DS, the researchers found that 81.9% needed orthodontic treatments for underbites, overbites, crossbites, and crowding. Of them, 59.1% had Class III Malocclusion, and 36.4% had Class I.

According to a paper presented at the 6th World Congress on Down Syndrome in Madrid, Spain, in October 1997, the prevalence of malocclusion in Down syndrome children may be due to one of the following: 

  • An enlarged and forwardly positioned tongue
  • An underdeveloped maxilla (bone forming the upper jaw)
  • A large and prognathic mandible (bone forming the upper jaw)


2. Periodontal Disease

Periodontal (gum) disease is common among DS individuals. Presumably, it affects over 90% of Down syndrome patients under 30. This inflammation and infection of the tissues holding teeth in place often starts early in life and progresses with age, leading to tooth loss.

Research suggests that etiologic factors, including a weak immune system, delicate gums, lack of proper oral care, early aging (senescence), reduced saliva production, and chewing difficulty (mastication), may contribute to gum disease prevalence among DS patients.


3. Microdontia

Between 35% to 55% of those with Down syndrome have microdontia, a dental disorder wherein the teeth are smaller than usual. Microdontia often equates to small and conical roots, which can lead to gum disease and premature tooth loss.


Barriers Between Oral Health and Down Syndrome Patients

The following may prevent an individual with Down syndrome from 


1. Sensory and Motor Issues

Approximately 49% of people with Down syndrome experience sensory processing challenges. Sensitivities during brushing and flossing can make dental care routines uncomfortable or even unbearable, leading to poor oral health.

Moreover, fine motor skills are necessary for proper tooth brushing and flossing. Down syndrome children with low muscle tone or hypermobility in their hands, wrists, or elbows may struggle to brush and floss without assistance.


2. Communication Troubles

Kids with Down syndrome may have a hard time conveying dental discomfort or toothaches due to communication challenges associated with the condition. Their ability to articulate or explain how they feel may have limitations, making it difficult to catch problems early. Regular visits to a family dentist in Chandler, Arizona, can help detect and address oral health concerns as soon as possible, promoting better oral health and quality of life for those with DS.


Oral Care Tips for Children with Down Syndrome

Here are oral care tips for maintaining healthy teeth and gums in children with DS.


1. Early and Consistent Dental Care

If you are a parent or guardian of a child with Down syndrome, start dental visits early to introduce them to the environment, build familiarity, and create a positive and non-threatening dental experience. Scheduling dental check-ups every six months helps monitor their oral health, identify issues, and provide preventive care. Bring them in for an appointment within six months of the first tooth emerging.

Also read: All About Baby Teeth: 10 Common Problems to Watch Out For


2. Demonstrate Proper Brushing and Flossing Techniques

Use a visual and hands-on approach to demonstrate proper brushing and flossing techniques to someone with Down syndrome, especially children. Begin by showing them a step-by-step visual guide with simple, clear images. Provide a soft-bristle toothbrush and demonstrate how to hold it, applying gentle pressure. Use their hand to guide brushing, focusing on all tooth surfaces.

Similarly, show how to use floss threaders or interdental brushes to clean between teeth. Make the process interactive, ensuring they participate actively. Offer positive reinforcement and praise for their efforts. Frequent, supervised practice sessions will help them become more independent in maintaining good oral hygiene.

Also read: Five Tips for Promoting Oral Health for Children at Home


Role of Caregivers and Dentists

Providing effective oral care for individuals with Down syndrome requires a collaborative effort between caregivers, dental professionals, and the patients themselves.

  • Oral care guidance from caregivers: Caregivers must have the knowledge, skills, and patience to encourage kids with Down syndrome to maintain proper oral hygiene. Aside from our tips above, Family Caregivers Online has an amazing guide.
  • Dentist’s role in accommodating patients: A family dentist must be understanding and considerate, making all necessary adaptations to provide a positive dental experience. If you need a dentist experienced in working with children who have unique needs and different abilities to cooperate, choose Kyrene Family Dentistry in Phoenix, AZ. Complete this form to schedule an appointment.

Being aware of the common teeth and gum problems and following these dental care tips allows children with Down syndrome to enjoy better oral health and a higher quality of life. The key is for families, caregivers, and dental professionals to work together to provide proper care, support, and guidance.