Gingivitis in Children with Down Syndrome: Review of Local and Systemic Factors

Abstract

Background. When compared to healthy children, children with Down Syndrome (DS) have a higher prevalence of gingivitis (46.7%). Individuals with DS have anatomical abnormalities, and mental and orofacial problems. They also have a weakened immune system, resulting in a decrease in the number of T lymphocyte cells, making children with DS more susceptible to infection. This includes an increased prevalence of periodontal diseases, one of which is gingivitis. This systematic review discusses the existing local and systemic factors that may become the etiology of gingivitis in children with DS. Objective. To describe various local and systemic factors as the cause of gingivitis and to find out the main etiological factors of gingivitis in children with DS Methods. We searched PubMed and Google Scholar for Indonesian and English references either in the form of textbook, research results, reviews, and internet articles on the topic. We screened and selected the relevant articles for inclusion into the review. Results. In children with DS, apart from poor oral hygiene, the increasing incidence of gingivitis is caused by changes in other local factors related to systemic factors, such as oral dysfunction, dental and gingival abnormalities, changes in the oral microbial profile, and salivary characteristics. Furthermore, systemic immunodeficiency, changes in inflammatory mediators and proteolytic enzymes, and intellectual subnormality are considered as systemic factors. Conclusion. There is no main etiological factor of gingivitis in children with DS since various local and systemic factors are interrelated with each other causing gingivitis. The severity of gingivitis in children with DS presumably were caused by the systemic factors. Furthermore, good oral hygiene habits and the dentist's intervention in periodontal health can significantly reduce gingivitis in DS patients.