Oral and General Health in Down Syndrome: A Sibling Study

Objectives: To assess the relationship between oral health and general health in people with Down syndrome (DS) and their non-DS siblings. Methods: A validated, 20-item, proxy questionnaire designed to describe the oral health (OH) of people with DS, aged 4 years and older, was distributed to 2327 members of the Canadian Down Syndrome Society. Parents were asked to complete the questionnaire twice: first regarding their offspring with DS and second for the sibling closest in age without DS. The questionnaire comprises four domains (communication, parafunction, eating and oral symptoms). Questions on frequency of visits to medical specialists were added. Logistic regression models evaluating the association between two or more visits to a specialist per year and OH domain scores were performed on 1572 subjects, controlling for age and sibling pair. Age-adjusted ANCOVA was used to analyze the association between OH domain scores and number of visits to a medical specialist for those with DS only (n=994). Results: DS subjects saw a specialist for heart, immunological, ear nose and throat (ENT), speech and visual problems more frequently than their non-DS siblings (Wilcoxon signed rank test, p<0.001). Seeing a specialist two or more times per year was significantly associated with increases in domain scores for OH. In subjects with DS, a dose-response relationship was noted between the number of visits to a specialist and the OH scores for most domains, the exception being between oral symptoms and visits to a heart, ENT or speech specialist. Conclusion: This cross-sectional study indicates a positive association between oral health problems and likelihood to consult a medical specialist in people with DS, when age and familial factors are controlled for. This study was supported by the Toronto Hospital for Sick Children Foundation (Grant XG 01-038) and the Canadian Institutes of Health Research (Grant MOP-43897).