Oral Health Status Among Iraqi Children with Downs Syndrome

Introduction: Downs syndrome is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. It is usually associated with physical growth delays, mild to moderate intellectual disability, and characteristic facial features.  The average IQ of a young adult with Down syndrome is 50, equivalent to the mental ability of an eight- or nine-year-old child, but this can vary widely. The syndrome can obscure dental treatment for the affected patients; furthermore, children commonly have destructive oral habits. Aim: The aims of this study were to evaluate the Modified Gingival Index (MGI), Plaque Index (PI), salivary pH and buffering capacity of the saliva among children with Down syndrome compared to normal children in AlKut City, Wassit (Iraq) to provide baseline data to enable comparison and future planning of dental services for children with Downs syndrome. Materials and Methods: A total of 50 children diagnosed with Downs syndrome (mean age 9.5 years) were selected from Downs syndrome center AlKut City, Wassit (Iraq). The control group consisted of 50 normal children (mean age 9.7 years), gender matched, selected from Outpatient Dental Clinic, AlKut University College. MGI, PI, salivary pH and salivary buffer capacity test were done for all participants. The buffering capacity of the stimulated saliva was grouped under ‘very low’, low’ and ‘normal’. Pearson’s Chi square and one-way ANOVA were used to find statistical significance if any among the Downs and the normal control group. Results: The results of the study showed that the mean ± standard deviation of MGI, PI and pH of unstimulated resting saliva for Downs group were 1.82 ± 0.65, 1.92 ± 0.35 and 6.8 ±0.5 respectively. Normal control group had values 1.35 ± 0.85,1.44 ± 0.43 and 7 ± 0.4 respectively. A statistically significant difference between both groups for all parameters was found. Salivary buffering capacity was found to be normal for the majority among both groups. However, 60% of children among the Downs group presented with normal buffering capacity of the stimulated saliva as compared to 70% among the normal control group. However, this difference was not statistically significant (p = 0.544). Conclusion: Children with Downs syndrome appear to have higher gingival inflammation, poor oral hygiene and a slightly lower salivary pH as compared to healthy control groups. Special oral health programs regarding treatment and maintenance of good oral health should be taken in consideration for Downs children.