Dental caries experience in relation to salivary findings and molecular identification of S. mutans and S. sobrinus in subjects with Down syndrome

Parents' oral health promotion efforts for their children with Down syndrome and the children's oral health

AIM

The study evaluated parents' oral health care experiences and practices for their children with Down syndrome and its effect on the child's teeth and gingiva's condition METHOD: 75 parents of children with Down syndrome between 0 and 16 years of age responded to 18-item bilingual questionnaire concerning their child's oral health status RESULT: Most parents rated their child's teeth and gingiva health as good. There is no correlation found between experience score and practice score (r = -0.057), and no correlation between practice score on the child's both teeth (r = -0.001) and gingiva's condition (r = 0.031).

CONCLUSION

The parental oral health care experience and practices for their children with Down syndrome are deemed sufficient. However, a tailor-made comprehensive oral health care for them is very advisable, thus eradicating the barriers and challenges.

The Dental Needs and Treatment of Patients with Down Syndrome

Down syndrome is a common disorder with many oral conditions and systemic manifestations. Dentists need to take a holistic approach including behavioral, oral, and systemic issues. This review of the literature focuses on oral anomalies, systemic interaction, management, and recommendations.

Salivary density of Streptococcus mutans and Streptococcus sobrinus and dental caries in children and adolescents with Down syndrome

Streptococcus mutans and Streptococcus sobrinus are strongly associated with dental caries. However, the relationship between oral streptococci and dental caries in children with Down syndrome is not well characterized.

Five-year longitudinal study of dental caries risk associated with Streptococcus mutans and Streptococcus sobrinus in individuals with intellectual disabilities

Streptococcus mutans (S. mutans) and Streptococcus sobrinus (S. sobrinus) are important etiologic agents in human dental caries. Using quantitative real-time polymerase chain reaction assays for the presence of those strains, we examined 145 outpatients with intellectual disability (ID), calculated the proportion of each of these strains to total bacteria, and compared dental caries incidence over 5 years. Plaque samples were collected from all erupted tooth sites, and dental examinations were performed annually to determine numbers of decayed, missing, and filled teeth (DMFT score; World Health Organization caries diagnostic criteria). Elevated DMFT scores were calculated as ∆DMFT, and sites of newly affected caries (∆SNAC) were identified. Sixty-six patients had both strains. The proportion of S. mutans to total bacteria was moderately correlated with DMFT in year 2, ∆DMFT in years 2 and 5, and ∆SNAC in years 2 and 5 (correlation coefficient = 0.470, P < 0.001), while the proportion of S. sobrinus to total bacteria was moderately correlated with DMFT in years 2 and 5, ∆DMFT in years 1, 2, and 5, and ∆SNAC in years 2 and 5 (correlation coefficient = 0.695, P < 0.001). Individuals with ID who harbored both bacterial strains had a higher risk of dental caries and a significantly higher proportion of S. sobrinus to total bacteria.

Longitudinal study of dental caries incidence associated with Streptococcus mutans and Streptococcus sobrinus in patients with intellectual disabilities

Background

Mutans streptococci (Streptococcus mutans and S. sobrinus) are considered to be major etiologic agents of dental caries. Using a polymerase chain reaction method, we detected those bacteria from 145 outpatients (6–30 years old) with intellectual disabilities (ID) and their presence was compared with the incidence of dental caries.

Methods

Plaque samples were collected from all erupted tooth sites in subjects with a sterile toothbrush. A dental examination was performed to determine the number of decayed and filled teeth (DFT score) in permanent dentition using the WHO caries diagnostic criteria. A Mann–Whitney U-test was employed to compare the caries scores between combinations of the bacteria, and with a Wilcoxon rank test used to compare caries scores between the baseline and after 1 year.

Results

Among all subjects, S. mutans and S. sobrinus were possessed by 78.7 and 83.5 %, respectively, while 13.1 % were positive for S. mutans alone, 17.9 % for S. sobrinus alone, and 65.6 % for both organisms, with 3.4 % were negative for both. The mean DFT score of subjects positive for both S. mutans and S. sobrinus at after 1 year was significantly higher than that of those positive for S. mutans alone (P < 0.01). The increase in caries increment was also significantly greater in subjects with both bacteria detected (P < 0.001).

Conclusion

Our results indicate that patients with ID harboring both S. mutans and S. sobrinus have a significantly higher incidence of dental caries than those with S. mutans alone.

Association between Dental Caries and Down Syndrome: A Systematic Review and Meta-Analysis

Scientific evidence of susceptibility to dental caries in the population with Down Syndrome (DS) is limited and conflicting, making it difficult to establish firm conclusions. The aim of this systematic review and meta-analysis was to obtain scientific evidence of the possible association between dental caries and individuals with DS, compared to individuals without DS (control). An electronic search of five databases was performed, with no language or publication date restrictions. The studies were selected by two independent reviewers (Kappa = 0.83). The systematic review included 13 studies, while eight studies were included in the meta-analysis. The studies are presumably all at risk of bias given their observational character. Two of these evaluated the presence or absence of caries in permanent and deciduous teeth, and six evaluated the mean DMFT index in permanent teeth. Combined odds ratios (OR), standard difference, standard error and a 95% confidence interval (CI) were obtained. The vast majority of the studies found that individuals from control groups had more carious lesions or caries experience than those with DS. The results were statistically significant in seven studies (p<0.05). Meta-analysis of two studies revealed that individuals with DS had a lower dental caries than those in the control group (OR = 0.36; 95% CI = 0.22-0.57). In six studies, individuals with DS had a significantly lower mean DMFT index than individuals from the control group (Sd = -0.18; SE = 0.09; 95% CI = -0.35--0.02). The quality of the studies varied and in general had a high risk of bias. Scientific evidence suggests that individuals with DS have fewer dental caries than individuals without DS.

Comparative study between dental caries prevalence of Down syndrome children and their siblings

The purpose of this epidemiological study was to determine the differences in the prevalence of caries between individuals with Down syndrome (DS) and their siblings. A sibling-matched, population-based and cross-sectional survey was performed. This study involved 138 (62%) children with DS and 86 (38%) siblings, aged 2-26. The children were compared in different subgroups: [2, 6], [6, 12], and [13, 26]. Data was gathered through the use of a complete questionnaire and clinical observation. Data analysis was performed by using SPSS® v.18.0 software with any p value <.05 considered as significant. The DS group presented a significantly higher percentage of children within the caries-free group: 72% versus 46% of the siblings group (p < .001). In the age gap [2, 6[the median value of DMFT was the same in both groups (p = .918). In the age gap [6, 12] the median value of DMFT in the DS group was 0 and in the siblings group was 1 (p = .004). In the age gap [13, 26] the median value of DMFT in the DS group was 0, whereas in the siblings group the median value was 3, which constitutes a significantly high difference (p = .003). The results of this study suggest that Portuguese children with DS have lower caries prevalence than their siblings.