Oral soft tissue conditions in Down syndrome patients
Abstract
Introduction: Down syndrome is an abnormality caused by an extra chromosome 21. Oral soft tissue conditions are one of the most frequently reported clinical features in Down syndrome because their prevalence is relatively high. The purpose of this study was to determine the various oral soft tissue conditions in children with Down syndrome from various literatures. Methods and Material: The literature review was conducted using the Scoping Review method following the frameworks published by Arksey and O'Malley (2005) and developed by Levac, et al. (2010) and Peters, et al. (2015). Screening and selection of studies was carried out using PRISMA-ScR. Articles were searched using keywords, boolean operators, limit functions, and inclusion criteria on the Pubmed, EBSCOHost, ScienceDirect, and Google Scholar search engines. Results: There were 12 articles that met the criteria and were analyzed. The most commonly reported oral soft tissue conditions in Down syndrome are fissured tongue, macroglossia, and cheilitis. Fissured tongue varies from 28% - 78%, macroglossia varies from 36.8% - 94%, total & angular cheilitis varies from 6.3% - 51%. Incompetent lip, geographic tongue, everted lower lip, chapped lower lip, protruded tongue, gingivitis, and several other soft tissue conditions have also been reported in only a few articles. Conclusion: The most common frequently oral soft tissue conditions reported in the Down syndrome population are fissured tongue varies from 28% - 78%, macroglossia varies from 36.8% - 94%, and total & angular cheilitis varies from 6.3% - 51%.
Keywords: Cheilitis, Down syndrome, Fissured tongue, Macroglossia, Oral soft tissue conditions
Keywords:
Cheilitis, Down syndrome, Fissured tongue, Macroglossia, Oral soft tissue conditionsDOI
https://doi.org/10.22270/jddt.v16i1.7530References
1. Al-Maweri SA, Tarakji B, Al-Sufyani GA, Al-Shamiri HM, Gazal G. Lip and oral lesions in children with Down syndrome: A controlled study. J Clin Exp Dent. 2015;7(2):e284-8. https://doi.org/10.4317/jced.52283 PMid:26155347 PMCid:PMC4483338
2. Sandeepa NC, Al Hagbani S, Alhammad F, Al Shahrani A, Al Asmari S. Oral health status of Down's Syndrome patients in Aseer, Saudi Arabia. J Pharm Bioallied Sci. 2021;13(5):S656-9. https://doi.org/10.4103/jpbs.JPBS_593_20 PMid:34447174 PMCid:PMC8375836
3. Ashwinirani S, Suragimath G. Oral and perioral manifestations in Down's syndrome patients. BLDE Univ J Heal Sci. 2020;5:77-82. https://doi.org/10.4103/bjhs.bjhs_73_19
4. Macho V, Coelho A, Areias CM, Macedo AP, D A. Craniofacial features and specific oral characteristics of Down syndrome children. Oral Health Dent Manag. 2014;13(2):408-11.
5. Contaldo M, Santoro R, Romano A, Loffredo F, Stasio D Di, Della Vella F, et al. Oral manifestations in children and young adults with Down syndrome: a systematic review of the literature. MDPI Journals. 2021;11(12):1-15. https://doi.org/10.3390/app11125408
6. Kusuma H, Saptarini R, Sasmita I, S W, Hidajat Effendi S. Correlation between flow rate, viscosity, buffering capacity, pH and carries in full and mozaic Down syndrome children: a study in trisomy and mozaic type Down syndrome. J Int Dent Med Res. 2017;10(2):343-9.
7. Utami RD, Purnami N, Kalanjati VP. Characteristics of Down syndrome children with delayed speech and hearing loss in audiology clinic, dr. soetomo Surabaya hospital. Indian J Public Heal Res Dev. 2020;11(05):758-62.
8. Soewondo W. Pendidikan kesehatan gigi untuk penyandang sindrom Down. J Pengabdi Kpd Masy. 2019;4(3):55-8.
9. Arumugam A, Raja K, Venugopalan M, Chandrasekaran B, Kovanur Sampath K, Muthusamy H, et al. Down syndrome-A narrative review with a focus on anatomical features. Clin Anat. 2016;29(5):568-77. https://doi.org/10.1002/ca.22672 PMid:26599319
10. Chadi MJ, Saint Georges G, Albert F, Mainville G, Nguyen JM, Kauzman A. Major salivary gland aplasia and hypoplasia in Down syndrome: review of the literature and report of a case. Clin Case Reports. 2017;5(6):939-44. https://doi.org/10.1002/ccr3.975 PMid:28588844 PMCid:PMC5457992
11. Hayuningrum CF. Respon imun pada kasus sindrom Down: kajian terhadap risiko infeksi saluran pernapasan. Hermina Heal Sci J. 2021;1(2):49-54.
12. Ram G, Chinen J. Infections and immunodeficiency in Down syndrome. Clin Exp Immunol. 2011;164(1):9-16. https://doi.org/10.1111/j.1365-2249.2011.04335.x PMid:21352207 PMCid:PMC3074212
13. Rahul VK, Mathew C, Jose S, Thomas G, Noushad MC, Feroz TPM. Oral manifestation in mentally challenged children. J Int oral Heal. 2015;7(2):37-41.
14. Wahyuni IS, Putri FM, Fatriadi F, Hidayat W, Nur'aeny N. The most common and predicted diagnosis or conditions of oral mucosal lesions among elementary school children. Padjajaran J Dent. 2021;33(2):94-101.
15. Werdiningsih CR, Hartanti. Status kesehatan gingiva pada penderita sindrom Down di balai besar rehabilitasi sosial bina grahita (BBRSBG) Temanggung. Insisiva Dent J Maj Kedokt Gigi Insisiva. 2013;2(1):68-72.
16. Irwanto, Wicaksono H, Ariefa A, Samosir SM. A-Z Sindrom Down. 1st ed. Surabaya: Airlangga University Press; 2019.
17. Asokan S, Muthu M, Sivakumar N. Oral findings of Down syndrome children in Chennai city, India. Indian J Dent Res. 2008;19(3):230-5. https://doi.org/10.4103/0970-9290.42956 PMid:18797100
18. Norwood KW, Slayton RL. Oral health care for children with developmental disabilities. Pediatrics. 2013;131(3):614-9. https://doi.org/10.1542/peds.2012-3650 PMid:23439896
19. Rodiawati R, Nurnaningsih H. Gambaran status kebersihan gigi dan mulut pada anak berkebutuhan khusus (sindrom Down) di sekolah luar biasa di Bandung. Bandung: Politeknik Kesehatan Kemenkes Bandung Jurusan Keperawatan Gigi; 2016.
20. Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020;18(10):2119-26. https://doi.org/10.11124/JBIES-20-00167 PMid:33038124
21. Pham MT, Rajić A, Greig JD, Sargeant JM, Papadopoulos A, Mcewen SA. A scoping review of scoping reviews: Advancing the approach and enhancing the consistency. Res Synth Methods. 2014;5(4):371-85. https://doi.org/10.1002/jrsm.1123 PMid:26052958 PMCid:PMC4491356
22. Peters MDJ, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015;13(3):141-6. https://doi.org/10.1097/XEB.0000000000000050 PMid:26134548
23. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018;169(7):467-73. https://doi.org/10.7326/M18-0850 PMid:30178033
24. Cruzes DS, Dyba T. Recommended steps for thematic synthesis in software engineering. Int Symp Empir Softw Eng Meas. 2011;(7491):275-84. https://doi.org/10.1109/ESEM.2011.36
25. Daneshpazhooh M, Nazemi TMJ, Bigdeloo L, Yoosefi M. Mucocutaneous findings in 100 children with Down syndrome. Pediatr Dermatol. 2007;24(3):317-20. https://doi.org/10.1111/j.1525-1470.2007.00412.x PMid:17542890
26. Al-Shawaf R, Al-Faleh W. Craniofacial characteristics in Saudi Down's syndrome. King Saud Univ J Dent Sci. 2011;2(1-2):17-22. https://doi.org/10.1016/j.ksujds.2010.12.001
27. Sureshbabu R, Kumari R, Ranugha S, Sathyamoorthy R, Udayashankar C, Oudeacoumar P. Phenotypic and dermatological manifestations in Down syndrome. Dermatol Online J. 2011;17(2):3. https://doi.org/10.5070/D38JX5F2V2 PMid:21382286
28. Shukla D, Bablani D, Chowdhry A, Thapar R, Gupta P, Mishra S. Dentofacial and cranial changes in Down syndrome. Osong Public Heal Res Perspect. 2014;5(6):339-44. https://doi.org/10.1016/j.phrp.2014.09.004 PMid:25562042 PMCid:PMC4281609
29. Camacho FM, Mazuecos J, Ferrándiz L, Cantalejo C, Cabello Á. Phenotypical and dermatological findings of down syndrome in Southern Spain. Eur J Pediatr Dermatology. 2014;24(1):7-12.
30. Ghaith B, Al Halabi M, Khamis AH, Kowash M. Oral health status among children with Down syndrome in Dubai, United Arab Emirates. J Int Soc Prev Community Dent. 2019;9(3):232-9. https://doi.org/10.4103/jispcd.JISPCD_396_18 PMid:31198694 PMCid:PMC6559046
31. Fansa H, Salama RI, Filfilan S. The prevalence of oral and dental anomalies in Down syndrome children in western region, Saudi Arabia. Int J Heal Sci Res. 2019;9(9):309.
32. Tipe C, Tapia PR, Balbin GS, Robles A, Gamboa E, Tovalino FM. Oral epidemiological profile and risk factors in adolescents with different degrees of Down syndrome in a vulnerable Peruvian rural population. J Contemp Dent Pract. 2019;20(6):670-4. https://doi.org/10.5005/jp-journals-10024-2577 PMid:31358707
33. Al-Sufyani GA, Al-Maweri SA, Al-Ghashm AA, Al-Soneidar WA. Oral hygiene and gingival health status of children with Down syndrome in Yemen: A cross-sectional study. J Int Soc Prev Community Dent. 2014;4(2):82-6. https://doi.org/10.4103/2231-0762.139429 PMid:25254190 PMCid:PMC4170549
34. Hakim LN. Urgensi revisi undang-undang tentang kesejahteraan lanjut usia. Aspir J Masal Sos. 2020;11(1):43-55. https://doi.org/10.46807/aspirasi.v11i1.1589
35. Soewondo W. Sindrom Down ditinjau dari kedokteran gigi anak. 1st ed. Bandung: DreXa; 2018.
36. Hennequin M, Allison PJ, Veyrune JL. Prevalence of oral health problems in a group of individuals with Down syndrome in France. Dev Med Child Neurol. 2000;42(10):691-8. https://doi.org/10.1111/j.1469-8749.2000.tb00681.x PMid:11085298
37. Scully C, Van Bruggen W, Diz Dios P, Casal B, Porter S, Davison MF. Down syndrome: Lip lesions (angular stomatitis and fissures) and Candida albicans. Br J Dermatol. 2002;147(1):37-40. https://doi.org/10.1046/j.1365-2133.2002.04741.x PMid:12100182
38. Alkahtani F. Down syndrome and its oral effects in saudi arabian region: A review of literature. J Datta Meghe Inst Med Sci Univ. 2022;17(4):1013-8. https://doi.org/10.4103/jdmimsu.jdmimsu_433_22
39. Shore S, Lightfoot T, Ansell P. Oral disease in children with Down syndrome: causes and prevention. Community Pract. 2010;83(2):18-22.
40. Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology. 4th ed. Missouri: Elsevier; 2016.
41. Sridharan GK, Rokkam VR. Macroglossia. StatPearls. StatPearls Publishing; 2022.
42. Ibrahim AF, Salem EE, Gomaa NE, Abdelazeim FH. The effect of incentive spirometer training on oromotor and pulmonary functions in children with Down's syndrome. J Taibah Univ Med Sci. 2019;14(5):405-11. https://doi.org/10.1016/j.jtumed.2019.09.004 PMid:31728137 PMCid:PMC6838806
43. Desai SS, NY F. Down syndrome: A review of the literature. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 1997;84(3):279-85. https://doi.org/10.1016/S1079-2104(97)90343-7 PMid:9377191
44. Casamassimo PS, Fields HW, McTigue DJ, Nowak AJ. Pediatric dentistry: infancy trough adolenscence. 5th ed. Missouri: Elsevier Saunders; 2013
Published
Abstract Display: 23
PDF Downloads: 15
PDF Downloads: 3 How to Cite
Issue
Section
Copyright (c) 2026 Evelyn Priscilia Surjadi , Willyanti Soewondo , Nanan Nur’aeny

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).

.