How Down Syndrome Affects Bite, Teeth, and Palate
Mouth and Palate Size
The oral cavity, and more specifically the mid-face region, is smaller in size in a child with Down syndrome compared to their typical counterpart. This causes the upper jaw to be small in size and the roof of the mouth (palate) to become narrow. This results in a reduction of the overall amount of space needed to accommodate all teeth. This lack of adequate space also affects the amount of available space for the tongue.
Tongue and Airways
As a consequence, the tongue “appears” to be larger than normal size and may develop deep creases on the top and side surfaces. Pay particular attention to these areas, as they can be hard to clean. Food can also accumulate, resulting in foul smelling breath. The smaller dimensions of the mid-face region also contribute to smaller airways. This, accompanied with a large tongue compared to the mouth, can cause mouth breathing, snoring, and sleep apnea. These can result in problems in how your child’s upper and lower teeth relate to each other.
Every child wants a beautiful smile, and every child deserves a properly functioning bite.
The most common issue is “open bite” where their front top teeth do not touch/overlap bottom teeth. An open bite can also be caused by or exaggerated by sucking on a pacifier or sucking on his/her thumb. This should be discouraged and remedied as soon as possible. It will only worsen the problems associated with an open bite. Braces may or may not be appropriate for your child. A pediatric or general dentist can guide you through that decision; however, do not let the fact that your child has Down syndrome discourage you from pursuing braces. Every child wants a beautiful smile, and every child deserves a properly functioning bite.
Delayed Tooth Eruption Sequence
Eruption of both primary and permanent teeth vary greatly from one individual to another. We see this variability in children with Down syndrome to a greater extent. The eruption of the first tooth is sometimes delayed in a child with Down syndrome and can be as late as 24 months. The uniqueness of children with Down syndrome does not stop there. It is not uncommon for children to have congenitally missing teeth (oliogodontia) or have teeth that are smaller in size (microdontia). This is not necessarily a bad thing. This prevents over-crowding in the relatively small size of the oral cavity.