Bruxism in Children and Adolescents with Down Syndrome: A Comprehensive Review

Prevalence of Malocclusions in Down Syndrome Population: A Cross-Sectional Study

Background and Objectives: A higher prevalence of dental malocclusion has been suggested among individuals with Down Syndrome (DS) compared to controls, although no studies to date have investigated such a difference according to age group. Therefore, the aim of this study was to compare the prevalence of dental malocclusion and other orthodontic measures between DS and non-syndromic (non-DS) individuals across three age groups of children, adolescents, and adults. Materials and Methods: This cross-sectional study was conducted on a total of 147 patients. Of those, 72 were diagnosed with DS and were divided into N = 15 children (<10 years), N = 23 adolescents (10-18 years) and N = 34 adults (>18 years). The remaining 75 patients were sex- and age-matched controls. The two groups were compared according to age group in terms of the prevalence of dental malocclusion, measures of sagittal, vertical, and transverse discrepancy, facial profile, and probable sleep bruxism with chi-square tests for proportion. Results: The DS patients consistently exhibited a higher prevalence of Class 3 malocclusion, concave profile and anterior crossbite compared to the non-DS patients, regardless of age group. The non-DS adolescents presented with a significantly higher prevalence of convex profile than the DS adolescents. The adolescent and adult DS patients most commonly presented with a maxillary transverse discrepancy and posterior crossbite compared to the non-DS controls. The DS adults had a higher prevalence of probable sleep bruxism. Conclusions: Patients with DS showed a higher prevalence of Class 3 malocclusion, concave profile and anterior crossbite compared to non-DS controls, regardless of age group. Other orthodontic measures showed a fluctuation according to the age group considered.

Obstructive Sleep Apnoea in Children with Down Syndrome: A Multidisciplinary Approach

A comprehensive evaluation of obstructive sleep apnoea (OSA) may allow for the development of more efficient management of Down syndrome (DS). We aimed to evaluate the effect of a multidisciplinary approach to DS with OSA. A total of 48 DS children aged 4−12 years were prospectively investigated with nasal endoscopy, orthodontic examination, and overnight polygraphy (PG); the Italian Child Sleep Habits Questionnaire (CSHQ-IT) was filled out by the mothers. The total CSHQ-IT score was 63 (96% of children reporting sleep problems). The major ear, nose, and throat characteristics were enlarged palatine tonsils (62%), adenoid tonsils (85%), and chronic rhinosinusitis (85%). DS children showed orthognathic profile in 68% of cases, class I relationship in 63%, and cross-bite in 51%. PG revealed OSA in 67% of cases (37% mild, 63% moderate−severe). The oxygen desaturation index (ODI) was higher in the group with OSA (5.2) than with non-OSA (1.3; p < 0.001). The ODI was higher (p = 0.001) and SpO2 lower (p = 0.03) in children with moderate−severe OSA than with mild OSA. The apnoea−hypopnea index (AHI) and percentage time with SpO2 < 90% were higher in DS children with grade III than with grade I or II adenoids (5 vs. 1, p = 0.04, and 1.2 vs. 0.1, p = 0.01, respectively). No significant correlations were found between PG and the total CSHQ-IT score or orthodontic data. However, children showing associated cross-bite, grade III adenoids and size 3 or 4 palatine tonsils showed higher AHI and ODI than those without (p = 0.01 and p = 0.04, respectively). A coordinated multidisciplinary approach with overnight PG is a valuable tool when developing diagnostic protocols for OSA in DS.

Down Syndrome Children, Malocclusion Characteristics and the Need for Orthodontic Treatment Needs (IOTN): A Cross-Sectional Study

The purpose of the present study was to assess the characteristics of malocclusion and determine the orthodontic treatment needs of a group of children with Down syndrome. The study group comprised 23 children aged 10–14 years with Down syndrome who were attending special schools. A clinical examination was performed to measure several parameters that assessed malocclusion as well as classifications based on the Index of Orthodontic Treatment Need (IOTN-DC). When the dental health component (DHC) of the IOTN-DC was considered, results showed that a high percentage of children involved in the current study needed orthodontic treatment (81.9%). Moreover, 59.1% showed Angle’s class-III malocclusion compared to 36.4% who showed class I. However, the differences between the IOTN-DC values for the boys and girls were not statistically significant (p > 0.05). The present study has concluded that a higher percentage of children, suffering from Down syndrome, had very severe malocclusion; therefore, treatment can be considered mandatory. Similarly, more than three-fourths of the children with Down syndrome had visited a dental clinic at least once during their life. However, 30.4% of the children’s mothers have mentioned that they had not visited any orthodontic clinic. Therefore, there is a need to develop awareness and knowledge among the parents of children suffering from Down syndrome.