Dental care is important for everybody, but people with Down syndrome can have a number of needs that require special attention.
What is different about the teeth of people with Down syndrome?
The teeth of people with Down syndrome, both baby teeth and permanent teeth, may come in late compared with children who do not have Down syndrome. On average, babies with Down syndrome get their first tooth at 12 to 14 months, but it may be as late as 24 months of age. Babies without Down syndrome usually get their first teeth between 6 and 12 months. It is typical that a child with Down syndrome may not get all 20 baby teeth until he or she is 4 to 5 years old, rather than 2 to 3 years old (which is typical for kids without Down syndrome). The front permanent teeth and permanent 6-year-old molars may not erupt until the child is 8 or 9 years old. It is also common for the teeth of kids with Down syndrome to erupt in a different order than it does in kids without Down syndrome.
Small and Missing Teeth
Frequently, people with Down syndrome have smaller than average teeth, as well as missing teeth. It is also common for the teeth of people with Down syndrome to have roots that are shorter than average.
People with Down syndrome may have large tongues, or they may have an average-size tongue and a small upper jaw that makes their tongue too large for their mouth. It is also common for people with Down syndrome to have grooves and fissures on their tongues.
Problems With Bite
People with Down syndrome may have small teeth, which can cause spacing between the teeth. They also tend to have a small upper jaw. This may cause crowding of the teeth and may result in the permanent teeth being impacted because there is no room in the mouth for them to come in. When the upper jaw is smaller than usual, the top teeth may not go over the bottom teeth the way they are meant to; instead, the bottom teeth may extend farther out than the top teeth. It is also common that the front teeth of people with Down syndrome do not touch in front.
Orthodontics (braces) may be able to improve some of these issues. Orthodontics requires a lot of cooperation and makes the teeth even more difficult to keep clean, so it may not be possible in all people, or it may be a good idea to wait until a child is older and able to tolerate it fairly well. Having orthodontic appliances in the mouth can also pose challenges to speech. Children without Down syndrome typically adapt their speech quickly; however, in a child with Down syndrome, for whom speech may already be an issue, adapting to the appliances can be very difficult. It may therefore be a good idea to delay orthodontic treatment until a child is older and her speech is further along.