Question 1

When should I register my child with the dentist?

Accepted Answer

Caregivers should register and scheduled their child’s first appointment as soon as the first tooth has erupted.  This first dentist experience should be focused on creating a positive experience.

Question 2

When should I start brushing my child's teeth?

Accepted Answer

Before the first tooth eruption, individual’s mouths should be cleaned daily with soft gauze or cloth. As soon as his first tooth appeared, his mom transitioned to brushing twice a day with a smear size of toothpaste.

Question 3

What age should I increase brushing to twice a day?

Accepted Answer

At age 3, brushing should be increased to twice a day, using a pea-sized amount of toothpaste, and should be supervised by a caregiver.

Question 4

How can I maintain good oral health through my child's adulthood?

Accepted Answer

By maintaining twice a day brushing, once a day fluoride mouth rinsing and semi-annual check-ups with your dentist throughout adulthood.

Question 5

Should I introduce fluoride mouth rinsing? If so when?

Accepted Answer

By age 7, the child should be introduced to mouth rinsing with fluoride if tolerable by the child.  It is important that the child is able to spit and not swallow the solution.  Because the severity of physical and intellectual delays vary within individuals with Down syndrome, it is best decided by a caregiver and or a dentist.

Question 6

When will I expect my child's first tooth?

Accepted Answer

Those with Down syndrome will not see their 1st tooth until 12-14 months but maybe as late as 2 years old.

Question 7

Why do my child's teeth seem small and spaced out?

Accepted Answer

The size and overall stature of teeth of a person with Down syndrome, is smaller and shorter than average.  The roots are seen to have a condensed cone-like shape as well.  In addition, it is not uncommon to have missing teeth, particularly the third molars and lateral incisors.  Large gaps between teeth, are also quite common and most seen between the central two incisors.

Question 8

I have heard my child is less prone to cavities?  Is this true?

Accepted Answer

Those with Down syndrome are seen to be less susceptible to cavities than the average person, but still have a chance of getting them.  This phenomenon has not yet fully been explained.  One theory suggests it is a genetic characteristic, and individuals possess a more protective saliva with a higher flow around the teeth.  Other possibilities, include the factor of having a highly supervised diet.  Lastly, it is believed to be due to the spacing between smaller-sized teeth, making it much easier to clean.  Nonetheless, universal susceptibility to cavities depends on environmental factors.

Question 9

Why should I be concerned about gum disease?

Accepted Answer

Because the immune systems of a person with Down syndrome are more impaired than the average person’s, people with Down syndrome do not have the same level of protection against the disease, leaving them more susceptible.  This disease begins as frequent bleeding of the gums, moving to gingivitis, and progresses to periodontal disease.    Gum disease can be prevented by regular brushing, focusing on the gums.  It is also crucial to regularly attend your dentist for monitoring and assessment.  If they can identify problems early, they are often easier to treat.

Question 10

Why does my child frequently have dry and cracked lips?

Accepted Answer

Relaxed and low muscle tone often leaves the mouth open leading to dry mouth generating chapped lips.

Question 11

Why does my child's jaw often pop or cause pain?

Accepted Answer

Due to a misaligned bite, low muscle tone around the joint, small oral cavity, and large tongue, the jaw joint of an individual with Down syndrome can be sensitive and unstable causing susceptibility to additional disorders.  These dysfunctions can restrict the range of motion and make chewing and moving the mandible more uncomfortable and even painful. Individuals are prone to developing TMD which includes symptoms of clicking, popping, locking of the jaw, jaw soreness, headaches, pain in eyes and ears, tooth sensitivity, and grinding. Talk to your dentist for further advice if you think your child may have TMD.

Question 12

Are cracks in the tongue normal?

Accepted Answer

The tongue frquently displays large grooves and ridges, giving it it’s name “fissured tongue”and is a common trait with individuals with Down syndrome.

Question 13

My child frequently has bad breath.  What causes this?

Accepted Answer

The fissures or cracks in the tongue often attract and collect debris and bacteria, causing bad breath.  Mouth breathing, dry mouth and possible acid reflux also contribute.