SIGN IN YOUR ACCOUNT TO HAVE ACCESS TO DIFFERENT FEATURES

FORGOT YOUR PASSWORD?

FORGOT YOUR DETAILS?

AAH, WAIT, I REMEMBER NOW!
CALL US: 954 461 1114
  • LOGIN

Orofacial Myology

  • No products in cart.
  • HOME
  • Myo Training
  • Myo Products
  • Qualification (QOM)
  • Myo Resources
    • Q&A
    • Orofacial Myology News
    • The Orofacial Myology Conundrum Podcast
    • Myo Articles & Papers
    • Myo Videos
    • Professional Information
  • Myo Therapists
  • About Us
    • Sandra R. Holtzman
    • Becky Ellsworth
    • Karen Wuertz
    • Zohara Nguyen
    • Carma Stump
    • Greta Vigil
  • Myo Grads

Down syndrome teeth eruption

Monday, 06 August 2012 / Published in Dental Hygienist, Parents, Therapists

Down syndrome teeth eruption

See below in Blue for Dr. Mason’s comments. Dr Mason, My 8 year old patient with Downs Syndrome exhibits an anterior, interdental resting tongue posture. We’ve been working on lip competence for lip seal at rest  and tongue tip elevation  for quite some time. S. exhibits mature upper cuspids , but mixed dentition on lower teeth, with mature cuspids erupting and baby teeth still in place. 

By “mature” cuspids, I am assuming that you are referring to adult (permanent) canines. If so, this is very precocious for an 8 year old. At age 8, the adult upper and lower incisors should have erupted, and as well, the adult first molars. I doubt very much that this child’s upper arch contains all adult teeth, as you seem to be reporting. I would expect that the primary molars are still there, so this child is in mixed dentition in both arches. Also, you report that the lower permanent canines are erupting while the primary canines are still there. This would mean that the adult teeth are either lingual or facial to the primary canines, and if so, the primary canines will not be expected to spontaneously loosen. A dentist may have to extract the primary canines at some point. 

Additionally, she presents with a slight class III malocclusion, although her mother reported that her jaws are properly aligned this is probably not correct, as a Class III relationship is almost universal with Down syndrome due to the small maxilla. and it is only her teeth that appear in a class III underbite. It sounds like the mother has not received appropriate information about the charactertistics of Down syndrome.  (FWIW She also exhibits enlarged tonsils and adenoids–there is always a risk of anesthesia associated with surgery for Down syndrome and other syndromes, so I understand the mom’s fear of seeing a surgeon about the tonsils and adenoids; however, large tonsils also compete with the space of the posterior tongue and encourage the tongue to rest and move forward. With this finding, I am wondering why you are even working with this 8 year old, since the airway needs would not seem compatible with any attempts to retroposition the tongue? As well, maintaining a clear airway, as explained in the attachment, is another challenge that is not compatible with trying to impose a nasal pattern of breathing on such patients by doing lip exercises, which require a patent nasal airway. mom rejected my rec to see an ENT and said her pediatrician ensured that S. indeed has enough airspace to breath orally) Sadly, pediatricians occasionally say things like this wihout sufficient documentation. I’m guessing that a lateral ceph has not been taken, which would show the relationship of tonsils and adenoids (especially the adenoids) to the airway and the patient’s ability to achieve and maintain a nasal pattern of breathing. I am wondering again what diagnostic criteria you used to approve this child’s candidacy for your therapy? My question: Her dentist reportedly told her mother that these lower front baby teeth haven’t fallen out yet because her tongue is too weak to push against them. If so, this is news to me. This is wrong, with no evidence to support such a view. The primary teeth will not spontaneously loosen if there are no adult teeth underneath the primary teeth, as in this situation that you report.

I was taken aback by such reasoning. IS this true? No, and I wish dentists would not say silly things like this. Is that why lower teeth fall out? And, if the mature teeth are there, waiting behind her baby teeth, how could her tongue even reach them to loosen them? the tongue losening teeth is not how teeth become loose – it is, rather, by resorption of roots of the primary teeth as the adult teeth, underneath them, mature and grow their roots. She is able to eat, drink and swallow with ease, albeit with an anterior thrusting  swallow pattern.  If so, why are you even doing therapy, except for the cosmetic component, and if this is the reason, you should first establish that the child’s airway is sufficient to permit lip closure and nasal breathing. A simple test is to have the child hold his/her lips together for a minute or more to see whether nasal breathing is pissible,. With any 8 year old with poor nasal hygiene, I doubt that this is possible, and for this patient, I suspect that any gains you make are only temporary. Please advise. I respect your expert opinion.It would help you to find a cooperative orthodontist who could take a lateral ceph and then evaluate it with you with regard to the airway. Even though there is not a one-to-one relationship between the size of the adenoids and ability to breathe nasally, a lateral ceph would provide some basic morphological information about the size and shape of the jaws and whether this is truly a dental malocclusion or, more likely, a skeletal Class III malocclusion. I also think that you need to revisit why you are working with this child and what diagnostic information led you to the conclusion that your work would help. Having said that, however, is the fear that if you don’t try, you cannot find out whether your help could be successful, and the attachment also discusses this.  Hopefully, the information provided here and in the attachment will help you to evaluate where you are and where you are going with this child. Thanks for asking. Dr. M  

Tagged under: anterior, anterior thrusting swallow pattern, Downs Syndrome, enlarged tonsils and adenoids, interdental resting tongue posture, lip seal at rest, slight class III malocclusion

What you can read next

orofacial-myology-allergies-nares
Compromised Nares
No facial movement bilaterally post CVA
Two year old mouth open retrognathic mandible

Search

Archives

  • May 2025
  • April 2025
  • March 2025
  • February 2025
  • May 2024
  • April 2024
  • March 2024
  • February 2024
  • January 2024
  • December 2023
  • November 2023
  • October 2023
  • September 2023
  • August 2023
  • April 2023
  • January 2023
  • December 2022
  • November 2022
  • August 2022
  • July 2022
  • June 2022
  • May 2022
  • April 2022
  • March 2022
  • February 2022
  • January 2022
  • November 2021
  • October 2021
  • September 2021
  • August 2021
  • May 2021
  • September 2020
  • August 2020
  • July 2020
  • June 2020
  • May 2020
  • March 2020
  • February 2020
  • January 2020
  • December 2019
  • November 2019
  • October 2019
  • September 2019
  • August 2019
  • July 2019
  • June 2019
  • May 2019
  • April 2019
  • March 2019
  • December 2018
  • November 2018
  • October 2018
  • September 2018
  • August 2018
  • July 2018
  • June 2018
  • May 2018
  • April 2018
  • March 2018
  • February 2018
  • January 2018
  • December 2017
  • November 2017
  • October 2017
  • September 2017
  • August 2017
  • July 2017
  • June 2017
  • May 2017
  • March 2017
  • February 2017
  • December 2016
  • November 2016
  • October 2016
  • September 2016
  • May 2016
  • April 2016
  • March 2016
  • February 2016
  • December 2015
  • November 2015
  • October 2015
  • September 2015
  • August 2015
  • July 2015
  • June 2015
  • May 2015
  • April 2015
  • March 2015
  • February 2015
  • January 2015
  • December 2014
  • November 2014
  • October 2014
  • September 2014
  • August 2014
  • July 2014
  • June 2014
  • May 2014
  • April 2014
  • March 2014
  • February 2014
  • January 2014
  • December 2013
  • November 2013
  • October 2013
  • September 2013
  • May 2013
  • March 2013
  • February 2013
  • January 2013
  • December 2012
  • November 2012
  • October 2012
  • September 2012
  • August 2012
  • July 2012
  • June 2012
  • May 2012
  • April 2012
  • March 2012
  • February 2012
  • January 2012
  • December 2011
  • November 2011
  • October 2011
  • September 2011
  • August 2011
  • July 2011
  • June 2011
  • May 2011
  • April 2011
  • March 2011
  • February 2011
  • January 2011
  • December 2010
  • November 2010
  • October 2010
  • September 2010
  • August 2010
  • July 2010
  • June 2010
  • May 2010
  • April 2010
  • March 2010
  • February 2010
  • January 2010
TOP