Individuals with Down syndrome have no unique oral health problems; however, there may be some physical and mental challenges that may affect oral and dental care. The National Institute of Dental and Craniofacial Research (NIDCR) stresses that in receiving oral care, the physicians, family, and caregivers should be involved to assemble an accurate medical history.
The NIDCR lists the following health challenges in Down syndrome, and strategies for care.
lNTELLECTUAL DISABILITY. Although the mental capability of people with Down syndrome varies widely, many have mild or moderate intellectual disability that limits their ability to learn, communicate, and adapt to their environment. Language development is often delayed or impaired in people with Down syndrome; they understand more than they can verbalize. Also, ordinary activities of daily living and understanding the behavior of others as well as their own can present challenges.
- Listen actively, since speaking may be difficult for people with Down syndrome. Show your patient whether you understand.
- Talk with the parent or caregiver to determine your patient's intellectual and functional abilities, then explain each procedure at a level the patient can understand. Allow extra time to explain oral health issues or instructions and demonstrate the instruments you will use.
- Use simple, concrete instructions, and repeat them often to compensate for any short-term memory problems.
BEHAVIOR MANAGEMENT is not usually a problem in people with Down syndrome because they tend to be warm and well behaved. Some can be stubborn or uncooperative, but most just need a little extra time and attention to feel comfortable. Gaining the patient's trust is the key to successful treatment.
-Talk to the caregiver or physician about techniques they have found to be effective in managing the patient's behavior. Share your ideas with them, and find out what motivates the patient. It may be that a new toothbrush at the end of each appointment is all it takes to ensure cooperation.
- Schedule patients with Down syndrome early in the day if possible. Early appointments can help ensure that everyone is alert and attentive and that waiting time is reduced.
- Set the stage for a successful visit by involving the entire dental team--from the receptionist's friendly greeting to the caring attitude of the dental assistant in the operatory.
- Provide oral care in an environment with few distractions. Try to reduce unnecessary sights, sounds, or other stimuli that might make it difficult for your patient to cooperate. Many people with Down syndrome, however, enjoy music and may be comforted by hearing it in the dental office during treatment.
- Try to be consistent in all aspects of providing oral health care. Use the same staff, dental operatory, appointment times, and other details to help sustain familiarity. The more consistency you provide for your patients, the more likely that they will be cooperative.
Source: NIDCR.NIH.gov
