Periodontal disease in adolescent Down’ syndrome patients. Clinical case presentation

Down’s syndrome or trisomy 21 is man’s most frequent genetic disorder. It affects one out of 600-700 live births. It is characterized by the presence of an additional chromosome at the 21 pair which elicits generalized decrease of growth as well as intellectual disability. In scientifi c literature there are many reports of cranio-facial and oral manifestations of this disorder. Chief oral condition reported in this group of patients is periodontal disease. Objective: Establishment of preventive oral care for the development of periodontal disease in adolescent patients afflicted with Down’s syndrome. Case presentation: 15 year old Mexican-Indian male patient with trisomy 21. The patient was bilingual, affl icted with congenital heart disease, pulmonary hypertension and nephrotic syndrome. The patient equally presented ectopic dental eruption as well as congenital dental absences, Angle’s class III occlusion, anterior and posterior unilateral crossbite, oral respiration, labial eversion, fi ssured tongue and lips, clinodactyly and localized gingivitis. Behavior management was achieved with the «show-tell-do» technique alongside with voice control. Initial treatment consisted on sweeping brushing technique with parental assistance, use of dental fl oss (Dento Bacterial Plaque Control [DBPC]) (100%) as well as topical application of fl uoride varnish. It was recommended to the parents they should use home applications of bioadhesive gel (Perioxidin®). After these measures, oral rehabilitation was undertaken. Conclusions: The most relevant aspect of the treatment was the decrease (40%) in bacterial plaque reported in later control visits.