Letters to the Editor

Emphasizing Oral Health Care in Children with Down Syndrome

 

Am Fam Physician. 2015 Jul 1;92(1):8.

Original Article: Role of the Family Physician in the Care of Children with Down Syndrome

Issue Date: December 15, 2014

Available at: http://www.aafp.org/afp/2014/1215/p851.html

to the editor: I appreciated the comprehensive article on caring for children with Down syndrome and the inclusion of hypodontia and delayed dental eruption in Table 4. Dental care is the leading unmet health care need among children with Down syndrome.1 Rapid destructive periodontal disease, leading to the loss of permanent anterior teeth in the early teens, is the most significant oral health problem in this population.2 Contributing factors include poor oral hygiene, malocclusion, bruxism, conical-shaped tooth roots, and abnormal host response because of a compromised immune system. Because of the difficulty distinguishing missing teeth from delayed eruption (as late as 24 months), as well as an increased incidence of malformed teeth, it is imperative that children with Down syndrome be referred to a dentist within six months of the eruption of the first tooth or by one year of age.3

Preventive advice for parents should include twice-daily supervised brushing and flossing, low-cariogenic snacks, and regular systemic and topical fluoride. The dentist may advise chlorhexidine rinses for better periodontal health. Because there is more malocclusion and crowding, orthodontics may be more common as well.

Resources for family physicians include the American Academy of Pediatric Dentistry to help find dentists who are comfortable treating children with special needs (http://www.mychildrensteeth.org/) and the National Institute of Dental and Craniofacial Research for practical information for health professionals and parents (http://www.nidcr.nih.gov/OralHealth/OralHealthInformation/SpecialNeeds/). Family physicians can also access free online training covering general pediatric oral health issues on the Smiles for Life website (http://www.smilesforlifeoralhealth.org).

Author disclosure: No relevant financial affiliations.

REFERENCES

1. Newacheck PW, McManus M, Fox HB, Yung YY, Halfon N. Access to health care for children with special health care needs. Pediatrics. 2000;105(4 pt 1):760–766.

2. National Institute of Dental and Craniofacial Research. Practical oral care for people with developmental disabilities. NIH publication no. 09–5193. July 2009. http://www.nidcr.nih.gov/oralhealth/Topics/Developmental-Disabilities/Documents/DownSyndrome.pdf. Accessed January 2, 2015.

3. Debord J. Dental issues and Down syndrome. National Down Syndrome Society. http://www.ndss.org/Resources/Health-Care/Associated-Conditions/Dental-Issues-Down-Syndrome/. Accessed January 2, 2015.

in reply: We appreciate Dr. Silk's letter highlighting several key factors about oral health care in children with Down syndrome. Dental care should never be overlooked, and we agree that early referral to an oral health professional is essential.

Dr. Silk's letter also addresses the importance of dialogue between clinicians, parents, and other health professionals. Parents should be empowered to ask questions and seek necessary referrals. The resources provided by Dr. Silk can help facilitate access to appropriate care.

Author disclosure: No relevant financial affiliations.

The views expressed herein are those of the authors, and do not necessarily reflect those of the Air Force Medical Service or the Department of Defense.

Send letters to afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680. Include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the AAFP permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.

This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.


 

Copyright © 2015 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


MOST RECENT ISSUE


Dec 1, 2016

Access the latest issue of American Family Physician

Read the Issue


Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article