Teeth-whitening is Not Just for Women

Down Syndrome and Acute Necrotizing Gingivitis: 4 Things Parents Need to Know

by Dianne Rodriquez

Down syndrome is a chromosomal disorder that occurs when a child inherits an extra copy of chromosome 21. This extra copy leads to both intellectual and physical disabilities, as well as related health problems like gingivitis. Gingivitis, also called gum disease, is a serious problem for people with Down syndrome, and severe gum disease tends to develop early for those with this condition. A particularly serious type of gum disease that affects Down syndrome children is acute necrotizing gingivitis. Here are four things parents need to know about Down syndrome and acute necrotizing gingvitis.

1. What are the signs of acute necrotizing gingivitis?

Milder forms of gum disease cause gum bleeding after brushing or flossing, but acute necrotizing gingivitis causes spontaneous bleeding. This means that your child's gums may start bleeding without any apparent inciting trauma. It's also possible for very minor trauma, like taking a bite of a sandwich, to lead to bleeding. Ulcers may also develop on the gum tissue.

Your child may tell you that their gums hurt or that their food tastes strange. People with acute necrotizing gingivitis tend to have a metallic taste inside their mouths. Your child may also seem more tired than normal, and their breath may smell very bad.

2. How can Down syndrome lead to acute necrotizing gingivitis?

Poor oral hygiene is a major factor in the development of this infection. Plaque—a sticky biofilm—builds up on your child's teeth, and if they don't remove it quickly, it will harden and turn into tartar. Tartar, also called calculus, is much harder to remove than plaque is and typically needs to be removed by a dentist.

Tartar is full of bacteria, and if it's allowed to remain in your child's mouth, the bacteria will irritate their gums. This makes the gums swollen, sore, and, ultimately, infected. Over time, this infection can spread from the gums to the deeper tissues beneath the teeth, resulting in severe gum disease.

Anyone can develop severe gum disease, but since most people with Down syndrome have a compromised immune system, they have a greater chance of developing the condition. Your child's immune system is less able to fight off the bacteria contained within the tartar, which allows the infection to develop and spread.

3. What are the complications of acute necrotizing gingivitis?

Like other serious types of gum disease, acute necrotizing gingivitis can lead to tooth loss. This can occur if the infection damages the tissues that hold your child's teeth in place, such as their gums or alveolar bone. In some cases, the gums can be completely destroyed.

It's also possible for this type of gum disease to lead to systemic health problems. For example, the infected tissues may die and lead to gangrene. This dead tissue will need to be cut away. Fortunately, this is a rare complication and is associated with untreated acute necrotizing gingivitis. As long as your child's gum disease is treated promptly, they should be fine.

4. How is acute necrotizing gingivitis treated?

If your child has acute necrotizing gingivitis, their dentist may prescribe antibiotics. Antibiotics are not a cure on their own, but they can make up part of the treatment for the infection. Your child may also be prescribed painkillers to help them manage the pain of their ulcerated gums.

To cure the infection, the tartar will need to be removed from your child's teeth. The dentist will use a scaler to scrape all of the tartar off. The dentist may also need to scrape beneath the gums to remove plaque that has gathered on the roots of the teeth; this procedure is known as root planing. If this treatment is not sufficient, the affected gum tissue may need to be surgically removed.

If your child has Down syndrome and you're worried that they have acute necrotizing gingivitis, take them to a dentist right away. Look for dental services by Bloor Smile Dental or another establishment in your area. 

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