Down Syndrome
Our experience with down
syndrome patient us taught us that early to severe periodontal
disease is often seen with onset in the mid to late teen years. Some
studies report an incidence of periodontal disease to be between 90
and 96% of adults with Down syndrome. This is related to a
compromised immune system in Down syndrome. The teeth most affected
are the mandibular incisors and maxillary molars. Good oral hygiene
and semi-annual cleaning appointments may not be enough to prevent
the progression of periodontal disease in these patients. More
frequent cleaning is needed and as well as early, aggressive
treatment. These patients may need to be seen as often as every
three months for deep cleaning and may also benefit from the use of
chlorhexedine mouth rinse and possibly systemic antibiotic therapy.
Parents and care giving need to realize the importance of proper
daily home care because the child with Down syndrome may be
resistant to tooth brushing. Our approach to Down Syndrome patients
is first to carefully gaining their trust. We will assure them that
they will not be hurt, restrained or harmed in any way. In most
cases, I.V. sedation is required for patient with Down Syndrome for
the comprehensive treatment because gagging reflex due to their
often enlarged tongue and it is hard for them to sit in the dental
chair for long duration. We will take great care of them during
their comprehensive dental treatment. For the most part of the
treatment, they will be a sleep and will remember very little of the
treatment. We will be vigilant of factoring their compromised immune
system and they are prone to periodontal disease into our treatment.
We will treat that aggressively and get them to a dental healthy
state. At the end, we will show them and the parent the proper
brushing technique and ways to getting them brushing daily because
we stress home prevention is the most important part of dentistry.
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