427 - Dental Treatment in Down Syndrome Patients: Prevalence, Barriers, and Interventions

Purpose: Down Syndrome (DS), the most common chromosomal disorder, affects 1/700 infants. With life expectancy averaging 60 years, healthcare professionals must address this growing population’s needs. Common craniofacial features including hypodontia and malocclusions compromise functions like chewing and breathing and predispose individuals to requiring significant dental treatment, including specialty treatment. However, despite the benefits of comprehensive treatment, insufficient understanding of the need and feasibility for specialty treatment lead to inadequate specialty referrals.

Methods: DS patients with orthodontic and prosthodontic referrals at Boston Children's Hospital (BCH) from 2003 to 2023 were reviewed. Patient demographics, histories, and treatment details were analyzed.

Results: The 99 DS patients referred for orthodontic consultation were evenly sex distributed with 43% >10 years at referral. The most common orthodontic issues were crowding (44%), crossbites (25%), and impaction (16%). Thirty-eight % proceeded with and 76% completed treatment. The most frequent reasons for not initiating treatment included loss to follow-up (42%) or inadequate cooperation (21%). The 15 DS patients with prosthodontic referral were mostly female (74%) and >15 years old (47%). Frequent concerns were congenitally missing teeth (73%), peg laterals (13%), and tooth loss (13%). Forty % initiated and completed treatment, including implant-supported prostheses (50%), crowns (17%), dentures (50%), and fixed partial dentures (33%).

Conclusions: Forty % of DS patients with specialty referral proceeded with and completed treatment, indicating the potential for successful dental treatment outcomes. The main barrier to treatment was loss of follow-up rather than inadequate cooperation, suggesting that ongoing support may be key to improving adherence.