Preventive Dental Care on Periodontal Health of Down Patients

Objectives: compare the effect of periodic preventive dental care (PPDC) on periodontal health of Down syndrome patients (DS) to mentally challenged non-Down patients (MC) and systemically healthy subjects (SH).

Methods: Fifty-five adult dentulous DS patients (mean age (SD) 36.20 (9.8) yrs), age range (18-62), percent males 52.7%, percent Caucasian 78.2% were recruited from the Georgia Regional Hospital (GRH) health care system in Atlanta, Savannah and Augusta, Georgia. A matched group of MC patients (n = 74) was recruited from the same hospital system. A matched comparison group of SH subjects (n = 88) under care of private dentists was recruited from the general population living in vicinity of the GRH locations used. All DS patients were outpatients residing with their families. All MC patients were inpatients living under care of GRH system. All subjects were nonsmokers. Number of missing teeth was recorded. Periodontal evaluation (including plaque index (PI), gingival index (GI), bleeding-on probing (BOP) and clinical periodontal attachment levels (AL)) was performed at 6 sites per tooth.

Results: Percentage of subjects receiving PPDC once or more per year was DS 97%, MC 100% and SH 93%. Both DS and MC patients showed higher number of missing teeth (p = 0.001), BOP (p = 0.001), GI (p = 0.001), PI (p = 0.001) than SH subjects. DS patients showed higher AL than both MC and SH (p = 0.001). Frequency of preventive visits per year had no effect on any of the periodontal measures in all groups.

Conclusions: Regardless of PPDC, patients with mental retardation (outpatient or institutionalized) have inferior periodontal health than the general population. Despite similar PPDC schedule for all three groups, the DS patients showed greater loss of AL than MC and SH subjects. A conventional PPDC program is insufficient to control periodontitis in DS patients.

NIDCR:DE15012-02