A Study of Enamel Defects and Dental Caries of Permanent Dentition in School Children with Intellectual Disability.

Justyna Opydo-Szymaczek,Karolina Gerreth,Maria Borysewicz-Lewicka

doi:10.3390/jcm9041031

Justyna Opydo-Szymaczek, Karolina Gerreth + Show 1 more

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https://doi.org/10.3390/jcm9041031

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Abstract

Data concerning the prevalence of developmental enamel defects and their association with dental caries in individuals with intellectual disability are scarce. This paper aims to evaluate the prevalence and distribution of developmental enamel defects and dental caries in the permanent dentition of special-care school children from Poznan (Poland). Out of 1091 students attending all special-care schools in the city, the study covered 268 subjects with intellectual disability (mild, moderate, severe, and profound) with permanent dentition, aged 10–20. One calibrated dentist performed dental examinations. The Statistica Software v10 was used for statistical analysis, assuming the level of statistical significance p ≤ 0.05. Among the subjects of the study, 19.40% presented developmental enamel defects. The number of teeth with changes ranged from 1 to 28, with maxillary incisors most frequently affected. Students without developmental enamel defects had more teeth observed with active caries compared to those with such changes (10.92% vs. 7.82%, p < 0.01). The highest number of students with developmental defects of enamel was observed in the group of individuals with mild intellectual disabilities. The present study revealed that in special-care students from Poznan, enamel defects and dental caries were frequently observed. However, individuals with developmental enamel defects did not show higher dental caries indices.

Highlights

The developing dental enamel is very susceptible to different systemic and local factors, and is unable to regenerate after damage [1,2,3]
Enamel defects associated with various degrees of intellectual disability are typical of several genetically determined diseases, such as velocardiofacial syndrome (22q11.2 deletion syndrome), the Kenny Caffey syndrome, as well as Kohlschütter-Tönz syndrome [8,9]
Already half a century ago, Cohen and Diner noticed that enamel defects occurred with higher frequency in children with IQ deficits compared to neurologically healthy children [10]

Summary

Introduction

The developing dental enamel is very susceptible to different systemic and local factors, and is unable to regenerate after damage [1,2,3]. The lesions may be localized or generalized, qualitative or quantitative, depending on a type of insult and the stage of amelogenesis. Defects with the generalized type of distribution may be caused by genetic disorders or by environmental intoxicants such as fluoride and dioxins as well as systemic disturbances, including perinatal and postnatal problems, malnutrition, infectious diseases, and a range of other medical conditions [1,4,5,6,7]. Several systemic factors that disrupt neurological development may alter amelogenesis [2]. The risk of acquired enamel defects has been discussed in the context of brain development. The ameloblasts might respond to different factors in a similar way, and the exact nature of the insult often remains unknown

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