Oral health problems and quality of life
Sue Buckley and Ben Sacks
There is a higher incidence of oral health problems among individuals with Down syndrome, particulary after 10 years of age, indicating a need for better teaching of teeth brushing and more regular visits to the dentist. Do these oral health problems affect their quality of life?
Buckley SJ, Sacks B. Oral health problems and quality of life. Down Syndrome Research and Practice. 2007;12(1);17-17.
doi:10.3104/updates.2049
This is the question addressed by Loureiro and her colleagues in Brazil[1].
A number of studies have indicated that children and adults with Down syndrome may experience
higher rates of gum disease and its consequences than typically developing individuals. In this
study of 93 children and young people (6 to 20 year olds), the researchers investigated their
oral health by individual clinical examinations and also interviewed their mothers about the
impact of oral health issues in their daily lives.
The clinical examinations included investigating the health of gums, and the state of the bones
to which teeth are joined. Gum disease (gingivitis) can lead to sore gums, to the shrinking of
gums away from the teeth and to loss of bone supporting teeth (periodontitis). All these
indicators were measured and the degree of bone loss was rated as slight/moderate or severe
defined by measurement of bone loss. Disease is caused by the build up of plaque and the amount
of plaque present was also measured with a standard measure. The results of this part of the
study showed that the incidence of plaque was high and that the oral hygiene of 68% of the
individuals could be classified as bad or extremely bad. Bleeding on brushing or probing is an
indication of gum disease and bleeding was reported for 91% of the individuals with Down
syndrome. Some 30% of the group showed evidence of bone loss affecting the attachment of teeth
to the bone.
Glossary
Dental plaque is a film of mainly bacteria that builds up
on teeth and is not easy to remove completely by tooth brushing. It can form
a hard deposit between teeth and gums. The bacteria in plaque can, over
time, lead to gingivitis and periodontal disease, damaging both teeth and
gums.
Gingivitis (inflammation of the gums around the teeth) is a
general term for diseases affecting the gingiva (gums). The symptoms of
gingivitis include:
- swollen gums
- gums that bleed easily
- receding gum line
Periodontitis in the mouth refers to progressive loss of
bone around the teeth which may lead to loosening and eventual loss of teeth
if untreated.
Individuals who have symptoms of gingivitis will benefit from having teeth
and gums cleaned professionally every 3-4 months to prevent long term damage
to them.
The researchers then investigated the effects of the degree of oral health problems on various
quality of life indicators including parents' perceptions of effects on speech, bad breath
(halitosis), taste and discomfort when eating, and general daily life. From the quality of life
questionnaire, they computed an impact score and report a significant correlation between the
severity of gum and periodontal disease and quality of life.
In another recent study, Folakemi Oredugba[2] reports the findings of a study of the oral health and dental
needs of individuals with Down syndrome from preschool to adult years in Nigeria. They compare
their oral health with that of an age-matched comparison group of typically developing
individuals. As a group, the individuals with Down syndrome have a higher level of oral health
problems, but this only applies to those over 10 years of age, suggesting that while parents and
carers are helping to clean teeth, oral hygiene may be satisfactory. Overall, more individuals
with Down syndrome were in need of dental treatment.
These data clearly raise issues about the dental health care needs of individuals with Down
syndrome as these figures are higher than would be expected in the general population.
Interestingly, a recent study from Japan[3] reports on the positive effects of dental visits and cleaning
at 3-4 month intervals for a group of young adults with Down syndrome. They compared those who
received this regular care with those who had not been seen for any dental or oral hygiene care
for more than a year. The progress of periodontal disease was significantly less in the group
with regular care.
Sue Buckley
and Ben Sacks are at Down Syndrome Education International,
Portsmouth, Hampshire, UK.
e-mail: sue.buckley@downsed.org
doi:10.3104/updates.2049
References
- Loureiro ACA, Costa FO, da Costa JE. The impact of periodontal disease on the quality of
life of individuals with Down syndrome. Down
Syndrome Research and Practice.
2007;12(1):50-54. [Open
Access Full Text
]
- Oredugba F. Oral health condition and treatment needs of a group of Nigerian individuals
with Down syndrome. Down Syndrome Research and
Practice. 2007;12(1):72-76. [Open
Access Full Text
]
- Yoshihara T, Morinushi T, Kinjyo S, Yamasaki Y. Effect of periodic preventative care on the
progression of periodontal disease in young adults with Down's syndrome. Journal of Clinical Periodontology, 2005;32:556-560.
Our information and advice services build on 30 years of research examining all
aspects cognitive development, speech, language, reading, maths and social development
for people with Down syndrome.
This research is delivering life-changing results today for children with Down syndrome
in homes and classrooms around the world.
Over 70% of this work is funded by voluntary donations.
Your support is essential.
Please help us to improve life for people
with Down syndrome today