Salivary pH and oral status in children with Down syndrome

Objectives: To examine the relationships between salivary pH and oral and dental status in children with Down syndrome (DS) compared to healthy individuals. Methods: 94 children and adolescents were examined. The study group comprised 68 children with DS, while 26 healthy children served as control. Plaque and gingival indices (PI and GI) as well as caries status (number of carious or restored teeth observed clinically) were recorded. Salivary pH was measured in the palate, the left and right mucosa and the tongue. Results: Scores of pH in all sites were significantly lower in the DS group while caries status scores were significantly higher in this group. 38 DS and 6 healthy children were caries-free. GI was significantly higher in the DS group while no difference was found in PI. Among the DS children, pH scores were significantly higher in the caries-free children compared to the caries-children in all the locations except the hard palate. In the control group, no significant difference in pH between the caries and caries-free children was found. The total pH and the pH in the palate were significantly higher in the caries-free- healthy children (6.8±0.25, and 7.38±0.53 respectively) compared to the caries-free-DS children (6.43±0.32 and 6.58±0.34 respectively). However, pH scores were significantly higher in the caries-control group compared to caries-DS group. In the DS group a significant correlation between pH and caries status was found in all pH sites except the hard palate, however no such correlation was found in the controls. Conclusions: Children with DS have higher pH in the oral cavity than normal children, but they demonstrate fewer carious lesions. pH differences were more prominent in the caries-groups than in caries-free groups of both DS and normal children. pH measurements can assist in predicting vulnerability to caries among children with DS.