Downs Syndrome-Associated Periodontitis
The article I chose to summarize is a critical review of Periodontitis in patients with Downs Syndrome which is also called Trismony 21 (T21). T21 occurs during spermogenisis or oogenisis and results when a single chromosome has three copies. This condition occurs in one in every 800-1,000 live births and has immunologic and physiologic differences that contribute to these patients having poor periodontal conditions. Some of the oral differences include macrogossia, high arched palates, prognathism, and fissured tongues. There are many altered differences in the dentition that happen during formation such as shovel shaped incisors, missing or reduced marginal ridges, nipple appearance of canine tips, wrinkled occlusal of molars. Even though there are many abnormalities within the teeth it is believed that the main concern for periodontitis is associated with the altered physiology, this includes the diminished chemotaxis of neutrophils, decreased phagocytic ability and suspected shortened half life of the neutrophils. Our neutrophils are our body’s first line of defense in fighting infection and their absence sets the stage for disease, where we then get tissue destruction.
In conclusion, advanced tissue destruction seen in the T21 patients show an increase in collagen degration by gingival fibroblasts coinciding with increased activation of neutrophils and lowered tissue inhibitor of metalloproteinase levels when exposed to prophyromonas gingivalis made them more susceptible to periodontitis and juvenile periodontitis.
How this will help me with DH care and personal reflection
I think as a dental hygienist I will definitely have to provide care to a patient with Downs Syndrome. I think it will be very beneficial to know the problems associated with this condition so I can better educate the care giver as to what they can do at home along with the etiology factors so they are aware that allot of the oral conditions we can run into is not necessarily something that can be prevented, but managed. Poor oral hygiene is directly related to the degree of mental disability. Limited access to care and manual dexterity are all factors of increased risk of gingivitis and periodontitis. Knowing how to teach the caregiver how to manage the plaque control is going to benefit the patient drastically.
Additional Information
Down Syndrome occurs when there are three chromosomes 21's resulting in 47 total chromosomes instead of the normal 46. It’s an error in cell division at fertilization when the sperm and ovum are joined. There are three types of Downs Syndrome
1) Masacism: Results in an error in one of the first cell division shortly
after conception.
2) Translocation: Hereditary and occurs when a piece of chromosome in pair 21
breaks off and
attaches to another chromosome, usually chromosome 14, 21, or 22.
3) Trisomy 21: Failure of a pair of number 21 chromosomes to segregate during
formation of either
an egg or sperm before conception, it is not inherited, and has no known cause.
APA
References
Frydman, A., & Nowzari, H. (2012). Down
Syndrome-Associated Periodontitis: A Critical Review of the Literature.
Compendium Of Continuing Education In Dentistry (15488578), 33(5),
356-361.
Michele , D. , & Walsh, M. (2010). Dental Hygiene Theory and
Practice. (3rd ed.). canada: Linda Duncan