title: Dentofacial and cranial changes in down syndrome.
abstract: OBJECTIVE
  This study aimed to determine the prevalence of certain oral characteristics usually associated with Down syndrome and to determine the oral health status of these patients.
  
  
  METHODS
  The cross-sectional study was conducted among patients attending a special education program at Faculty of Dentistry, Jamia Millia Islamia, Delhi, India. The study design consisted of closed-ended questions on demographic characteristics (age, sex, and education and income of parents), dietary habits, and oral hygiene habits. Clinical examination included assessment of oral hygiene according to Simplified Oral Hygiene Index (OHI-S), dental caries according to decayed, missing, and filled teeth (DMFT) index, periodontal status according to the Community Periodontal Index of Treatment Needs (CPITN), and malocclusion according to Angles classification of malocclusion. Examinations were carried out using a using a CPI probe and a mouth mirror in accordance with World Health Organization criteria and methods. Craniometric measurements, including maximum head length and head breadth were measured for each participant using Martin spreading calipers centered on standard anthropological methods.
  
  
  RESULTS
  The majority of the patients were males (n = 63; 82%) with age ranging from 6-40 years. The Intelligence Quotient (IQ) score of the patients indicated that 31% had moderate mental disability and 52% had mild mental disability. 22% exhibited hearing and speech problems.12% had missing teeth and 15% had retained deciduous teeth in adult population. The overall prevalence of dental caries in the study population was 78%. DMFT, CPITN and OHI scores of the study group were 3.8 ± 2.52, 2.10 ± 1.14 and 1.92 ± 0.63 respectively. The vast majority of patients required treatment (90%), primarily of scaling, root planing, and oral hygiene education. 16% of patients reported CPITN scores of 4 (deep pockets) requiring complex periodontal care. The prevalence of malocclusion was 97% predominantly of Class III malocclusions. Further 14% presented with fractured anterior teeth primarily central incisor. The percentage means of cephalic index was 84.6% in the study population. The brachycephalic and hyperbrachycephalic type of head shape was dominant in the Down syndrome individuals (90%).
  
  
  CONCLUSIONS
  The most common dentofacial anomaly seen in these individuals was fissured tongue followed by macroglossia.
authors.affiliation: Department of Oral Pathology and Microbiology, Faculty of Dentistry, Jamia Millia Islamia University, New Delhi, India.
authors.forename: Deepika
authors.initials: D
authors.lastname: Shukla
authors.affiliation: Department of Oral Pathology and Microbiology, Faculty of Dentistry, Jamia Millia Islamia University, New Delhi, India.
authors.forename: Deepika
authors.initials: D
authors.lastname: Bablani
authors.affiliation: Department of Oral Pathology and Microbiology, Faculty of Dentistry, Jamia Millia Islamia University, New Delhi, India.
authors.forename: Aman
authors.initials: A
authors.lastname: Chowdhry
authors.affiliation: Department of Oral Pathology and Microbiology, Shri Bankey Bihari Dental College, Ghaziabad, India.
authors.forename: Raveena
authors.initials: R
authors.lastname: Thapar
authors.affiliation: Department of Preventive and Community Dentistry, Government College of Dentistry, New Dehli, India.
authors.forename: Puneet
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shashwat
authors.initials: S
authors.lastname: Mishra
keywords: dentofacial anomaly; down syndrome; macroglossia; oral Hygiene Index