When a child is born with Down's syndrome, they will have a diverse range of physical disabilities, cognitive impairments, developmental delays, and physiological differences. The presence of an extra chromosome, Chromosome 21, is responsible for these congenital malformations and intellectual disabilities. Soft tissue and dental anomalies are just one of many areas that may be malformed in a Down's syndrome child. These issues will require special attention as the child grows. Here is a look at some of the common differences that can affect their teeth.
Teething Occurs Later
A normal child will usually get their first tooth around 4-6 months of age. Typically, they will first get their front teeth, followed by the incisors on either side, followed by the canine teeth, and then lastly the first and second molars. A child will normally have all 20 teeth by the time they are about 30 months. A child with Down's syndrome may not get his first tooth until around his first birthday. It is not uncommon to reach the age of 4 or even 5 before all 20 teeth have erupted. They may also not come in in the usual order. Some may not come in at all, and the teeth tend to be smaller than usual. This can cause delay the introduction to solid food as well as contribute to speech delays. Teeth May Be Impacted
The jaw in the Down's child is commonly smaller than usual, particularly the upper jaw. Even though the baby teeth may be smaller, overcrowding can still occur. A tooth may grow in sideways as well. This can cause issues when it is time for the permanent teeth to come in.
They may also have an underbite, which can become more pronounced with age. This can be problematic with their bite. A child may have to have one or more baby teeth pulled if the permanent teeth are being prevented from erupting.
Additionally, while a misaligned bite may cause issues with eating, orthodontic care should generally be delayed until the child is in late childhood or adolescence. This is because speech may be affected in a younger child as well as the teeth are harder to care for. In some cases, the decision is made not to provide orthodontic care at all.
Periodontal Disease Because of the inherent weak immune system with Down's children, they are more apt to get gum disease. Many children with Down's syndrome are also born with congenital heart disease. As there is a clear link between heart health and oral health, it is imperative the child's teeth are properly cared for at home They should also see the hygienist and dentist more often. While antibiotics are not usually given preemptively, they are recommended in these patients before any procedures are done to prevent the risk of endocarditis, an infection of the inner heart lining.
Since these children will typically have more dental issues, need to be seen more often by a professional like Rupp and Grabowski Family Dentistry, and the extra risk to their heart, it's important to find a dentist who is experienced in caring for Down's children. Your child may also require sedation dentistry for many procedures, possibly even routine checkups and hygienist appointments.