Down Syndrome Periodontal Disease — ORE Part 1 MCQ

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ModeratePeriodontologyDown Syndrome Periodontal DiseaseORE Part 1

A child with Down syndrome attends for a routine dental examination. Which oral finding is most characteristically associated with this condition?

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Correct answer: C — Early-onset periodontal inflammation and periodontitis

The best answer is **A**. Down syndrome is strongly associated with periodontal inflammation and periodontitis, including early presentation in children and adolescents. A 2024 systematic review and meta-analysis found a significant association with periodontitis (odds ratio 3.93) and with gingivitis. This periodontal susceptibility is not explained simply by plaque accumulation; older comparative evidence found more gingivitis in children with Down syndrome despite less plaque and calculus. Supernumerary teeth and enamel defects can occur as dental anomalies, but neither is the characteristic association tested here. **Macrodontia** is incorrect because reduced tooth size and hypodontia are more typical dental developmental findings. **Markedly increased caries** is also not the defining oral feature and is less consistently associated than periodontal disease.

Reference: Rondón-Avalo S, Rodríguez-Medina C, Botero JE. Association of Down syndrome with periodontal diseases: Systematic review and meta-analysis. Special Care in Dentistry. 2024. https://pubmed.ncbi.nlm.nih.gov/37341556/