Parental Roles in the Oral Health Maintenance of Children with Down Syndrome : A Scoping Review
Keywords:
Parent's role, oral and dental health, Down syndrome, Maintenance of dental healthAbstract
Background : Globally, people with disabilities account for more than 1 billion individuals or 15% of the population. In Indonesia, the 2018 Susenas data reports that 14.2% (30.38 million) of the population lives with disabilities. Children with Down syndrome exhibit distinct orofacial characteristics, including a higher prevalence of periodontal disease, malocclusion, delayed tooth eruption, mouth breathing habits, and congenital dental anomalies such as hypodontia and microdontia. Purpose : This literature review aims to analyze the role of parents in maintaining oral health and supporting oral hygiene practices in children with Down syndrome. Methods : A literature search was conducted using databases (PubMed and Scopus) following PRISMA-ScR guidelines, with inclusion criteria limited to articles published within the last 10 years. Results : The review indicates that children with Down syndrome have a high prevalence of periodontal disease, malocclusion, and poor oral hygiene status (OHI-S), mainly due to functional limitations. Although the DMF-T index tends to be lower compared to other disabilities, oral health problems remain significant. Parents play a crucial role in assisting daily oral hygiene practices, ensuring access to dental care, and supporting preventive behaviors. However, limited parental knowledge and awareness, along with restricted access to dental services, contribute to suboptimal oral health outcomes. Conclusion : Parental involvement is essential in maintaining oral health in children with Down syndrome, particularly in overcoming functional limitations. However, inadequate knowledge and limited access to preventive and promotive oral health services hinder optimal care. Strengthening parental education and improving access to dental health services are necessary to enhance oral health outcomes in this population.Downloads
References
AlJameel, A. B. H., Watt, R. G., Tsakos, G., & Daly, B. (2020). Down syndrome and oral health: mothers’ perception on their children’s oral health and its impact. Journal of Patient-Reported Outcomes, 4(1). https://doi.org/10.1186/s41687-020-00211-y
AlSarheed, M. A. (2015). Comparative study of oral health among trisomy 21 children living in Riyadh, Saudi Arabia: Part 2, gingival condition. Saudi Dental Journal, 27(4), 224–227. https://doi.org/10.1016/j.sdentj.2015.03.004
Az Zahra, A. A., Audrey, N. W., Ichyana, D. S., Saskianti, T., Pradopo, S., Nelwan, S. C., & Masyithah, M. (2021). Effectiveness of the Use of Manual and Electric Toothbrushes and the Effect of Educational Brushing Teeth with Video Animation on OHI-S Children with Down syndrome. Indonesian Journal of Dental Medicine, 4(1), 6. https://doi.org/10.20473/ijdm.v4i1.2021.6-10
Droubi, L., Laflouf, M., Alkurdi, S., Sauro, S., Mancino, D., Haikel, Y., & Kharouf, N. (2021). Does customized handle toothbrush influence dental plaque removal in children with down syndrome? A randomized controlled trial. Healthcare (Switzerland), 9(9). https://doi.org/10.3390/healthcare9091130
Elrefadi, R., Beaayou, H., Herwis, K., & Musrati, A. (2022). Oral health status in individuals with Down syndrome. Libyan Journal of Medicine, 17(1). https://doi.org/10.1080/19932820.2022.2116794
Fageeh, H. N., Mansour, M. A., Fageeh, H. I., Hummadi, A., Khurayzi, T., Marran, K., Alqunfuthi, N., & Patil, S. (2022). Dental Plaque Removal with Two Special Needs Toothbrushes in Patients with Down Syndrome: A Parallel-Group Randomised Clinical Trial of Efficacy. Oral Health & Preventive Dentistry, 20(1), 501–508. https://doi.org/10.3290/j.ohpd.b3630331
Goud, E. V. S. S., Gulati, S., Agrawal, A., Pani, P., Nishant, K., Pattnaik, S. J., & Gupta, S. (2021). Implications of Down ’ s syndrome on oral health status in patients?: A prevalence ? based study. https://doi.org/10.4103/jfmpc.jfmpc
Gupta, N., Bains, R., Gupta, A., Ramchandran, S., & Bains, V. K. (2025). Oral health care in children with Down syndrome: Indian parents’ perceptions on its impact, and challenges faced. Asian Journal of Oral Health and Allied Sciences, 15(5), 5. https://doi.org/10.25259/ajohas_25_2024
Hung, M., Graves, A., Lu, J., Schwartz, C., & Lipsky, M. S. (2025). Navigating Barriers to Dental Care for Patients with Down Syndrome: A Scoping Review of Challenges and Strategies. Children, 12(3), 1–14. https://doi.org/10.3390/children12030330
Pini, D. D. M., & Rigo, L. (2016). Oral health evaluation in special needs individuals. 14(55 54), 501–507. https://doi.org/10.1590/S1679-45082016AO3712
Porovic, S., Zukanovic, A., Juric, H., & Dinarevic, S. M. (2016). ORAL HEALTH OF DOWN SYNDROME CHILDREN IN BOSNIA AND HERZEGOVINA. 28(August), 370–372. https://doi.org/10.5455/msm.2016.28.370-372
Richter, M., Isralowitz, E., Polido, J. C., Cermak, S. A., & Stein Duker, L. I. (2025). Oral Care Experiences of Children with Down Syndrome: Caregiver and Dentist Perspectives. Healthcare (Switzerland), 13(9), 1–17. https://doi.org/10.3390/healthcare13090999
Schnabl, D., Eller, M., Trojer, D., Wiesmueller, V., Schwindling, F. S., & Kapferer-Seebacher, I. (2025). Cleansing efficacy of an auto-cleaning device versus an oscillating- rotating toothbrush in home use. A pilot study in individuals with down syndrome. Clinical Oral Investigations, 29(2), 1–9. https://doi.org/10.1007/s00784-025-06203-w
Silva, A. M., Miranda, L. F. B., Araújo, A. S. M., Prado Júnior, R. R., & Mendes, R. F. (2020). Electric toothbrush for biofilm control in individuals with Down syndrome: A crossover randomized clinical trial. Brazilian Oral Research, 34, 1–11. https://doi.org/10.1590/1807-3107BOR-2020.VOL34.0057
Sosiawan, A., Wahjuningrum, D. A., Setyowati, D., Suhartono, M., Audrey, N. W., Mawantari, T. P., Setiawan, F., & Pawar, A. M. (2022). The relationship between parents’ oral hygiene knowledge and children with Down Syndrome’s oral hygiene via OHI-S. F1000Research, 11, 1–15. https://doi.org/10.12688/f1000research.87848.2
Stein Duker, L. I., Martinez, M., Lane, C. J., Polido, J. C., & Cermak, S. A. (2022). Association between oral care challenges and sensory over-responsivity in children with Down syndrome. International Journal of Paediatric Dentistry, 32(4), 546–557. https://doi.org/10.1111/ipd.12933
Stensson, M., Norderyd, J., Van Riper, M., Marks, L., & Björk, M. (2021). Parents’ perceptions of oral health, general health and dental health care for children with Down syndrome in Sweden. Acta Odontologica Scandinavica, 79(4), 248–255. https://doi.org/10.1080/00016357.2020.1824015
Stensson, M., Norderyd, J., Van Riper, M., Marks, L., & Björk, M. (2022). Dental health care for children with Down syndrome: Parents’ description of their children’s needs in dental health care settings. European Journal of Oral Sciences, 130(3), 1–8. https://doi.org/10.1111/eos.12859
Study, A. C., & Aljameel, A. H. (2021). Oral Health-Related Quality of Life ( OHRQoL ) of Children with Down Syndrome and Their Families?:
Surija, I., Fauziah, E., & Sutadi, H. (2024). Knowledge level of children with Down Syndrome’s parents before and after reading electronic book “Tooth Injuries in Children with Down Syndrome.” Brazilian Dental Science, 27(2). https://doi.org/10.4322/bds.2024.e4040
Willis, J. R., Iraola-guzmán, S., Saus, E., Ksiezopolska, E., Cozzuto, L., & Bejarano, L. A. (2020). Oral microbiome in down syndrome and its implications on oral health. Journal of Oral Microbiology, 00(00). https://doi.org/10.1080/20002297.2020.1865690
Yehia, Z., Silbereisen, A., Koletsi, D., Arabzadehtousi, M., Tsilingaridis, G., & Bostanci, N. (2024). Efficacy of periodontal treatment modalities in Down syndrome patients: a systematic review and meta-analysis. Evidence-Based Dentistry, 25(4), 213–214. https://doi.org/10.1038/s41432-024-01055-x
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