A high number of individuals with cognitive disabilities and physical limitations have a difficult time maintaining a healthy dental hygiene routine. The level of help that an individual needs is based upon the type of disability they have and where they happen to land on that particular spectrum. Children with Down’s Syndrome are unique, and our approach to their dental issues should be the same.
Implications of Down’s Syndrome on Oral Health Status in Patients: A Prevalence-Based Study is an attempt by researchers to study how, generally, the children in question take care of their teeth so that we, the dental professionals, know what to expect and how to approach them for care. What instruction do they need, and how do we give it to them?
The Test Subjects
One hundred children with Down’s Syndrome, between the ages of 5 and 16 years old, were studied for a single year. In order to be a part of the study, each participant must:
- Have an official diagnosis of Down’s Syndrome from a licensed doctor.
- They must understand how to behave in the dental chair and be comfortable with the process.
- Written and informed consent from guardians.
Children with Down’s are usually very gentle, but many have feelings of anxiety when they don’t understand what is going on. There is a possibility that their fear and anxiety can lead to uncooperative behavior and permanent fear of the dentist. So the researchers decided that this study was not the time to approach that particular problem. This means that the test subjects chosen were either naturally amiable or have experience already in the chair, so they are unafraid.
Each individual was chosen from a special school that teaches them how to be independent and make smart decisions. The children went through an initial examination for gingivitis, calculus, and plaque levels that gave them a baseline evaluation. Researchers also asked questions related to their guardians’ ability to help them, their diet, and their socioeconomic status.
The children’s I.Q. levels were also recorded, and the subjects were placed into groups based upon their I.Q. number:
- Mild: 50-70
- Moderate: 35-50
- Severe: under 35
The study brought out several important statistics.
The Study and Related Statistics
When it came to this particular study, researchers discovered that 47% of the subjects brushed their teeth routinely once a day, with 53% reporting that they brushed their teeth twice. While 65% of them used a toothbrush, 14% used their fingers, and 21% used neem sticks, which are widely available in this area of India.
Children aged 12-16 had a dramatic increase in the Calculus Index, Gingival Index, and Plaque Index compared to the younger children’s rates. Children with severe Down’s suffered significantly further gingival and plaque issues, but there was no difference in the Calculus Index.
The study also concluded that a person’s Calculus Index is based on the child’s age and their mother’s level of education. Their Plaque Index was related to the subjects I.Q. level, their age, and their father’s educational journey. A child’s Gingival Index stems from their mother’s level of education, their age, and their I.Q.
The natural balance of intraoral microflora in those with Down’s Syndrome is significantly different from the mouths of people without the syndrome; children with Down’s have a lower salivary pH and a limited microbiome.
Final Thoughts
The results suggest that older children with Down’s Syndrome need more guidance and support to maintain their dental health than when they were younger, and they go through a significant change.
The researchers suggest that the schools and guardians that care for these children purposefully add dental hygiene to their ‘curriculum.’ A multidisciplinary approach and open communication between medical and dental caregivers is ideal for these children. Their quality of life depends on it.
