Bruxism, Grinding of the Teeth and Down Syndrome

Down syndrome is a learning disability which results from ‘chromosomal anomaly’ this is an error in cell division that results in the existence of a third copy of chromosome 21 known as trisomy (Down syndrome Ireland, 2013). 47 chromosomes develop rather than the usual 46; the extra gene changes the orderly development of the body and brain causing the physical and learning characteristics that are associated with Down syndrome (Irish Health, 2014). It causes mild to moderate learning difficulties, it is a lifelong condition. Noted by Robert S Ireland in his book Advanced Dental Nursing (2010) Down syndrome occurs in 1 in every 1,100 live births of the population.

Down syndrome Ireland (2013) also explains that Down syndrome is one of the most common known causes of intellectual disability.

Figure 1, Genetic Disorders associated with Down syndrome (Google images 2014)

Physical Features
Down syndrome is characterized by a short stature a ‘flat’ face with epicanthal folds at the inner corners of the eyes and a protruding tongue (Carr et al, 2007)

Table 1: Problems Associated with Down syndrome (Ireland, 2010)
 Learning disability this can result in the ability for a patient to remember their oral hygiene routine resulting in dental problems such as tooth decay
 Increased Prevalence of the virus Hepatitis B
 There is a 3.6% increased risk of coeliac disease which may be related to enamel defects evident in some patients with Down syndrome.
 Alzheimer ‘disease, this can lead back to the ability of the patient to remember oral hygiene practices this disease results in short-term memory.
 Congenital heart defects patients may be need to take antibiotic prophylaxis
 Instability of Cervical Joints , due to this ext...

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Toothbrush adaptations such as the use of angled smaller toothbrushes or a good quality electronic toothbrush when used properly can ensure a good standard of oral health (Hollins, 2009)

Hollins (2009) also explains that there are Several type of flossing equipment available today which allow efficient inter-proximal cleaning these are easier for patients compared to the traditional method of wrapping floss around the fingers.

Bruxism, grinding of the teeth is also associated with Down syndrome if a patient shows signs of this a night guard could be suggested for the patient to use to prevent teeth becoming worn down and exposing dentine.

Alzheimer’s is a common disorder associated with down syndrome as previously mentioned , it is a good idea to write down oral hygiene routine and tips to give to the patient and a copy to carer/guardian