People with Down syndrome can have many of the same dental problems as anyone else.

However, some oral health issues are more common and may need extra care and support.

There may also be other health conditions linked to Down’s syndrome that affect the mouth, teeth and gums.

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Common oral health issues in people with Down syndrome

People with Down syndrome may be more likely to have:

• Teeth that come through later than usual.
• Small teeth or missing teeth.
• A tongue that feels large for the size of the mouth.
• Gum disease.
• Tooth decay.
• Tooth grinding.

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Teeth coming through later than usual

In children with Down’s syndrome:

• Baby teeth often appear later than average.
• The first teeth may not come through until 12–14 months, or sometimes later.
• It is common for all 20 baby teeth to appear by 4–5 years of age.
• Adult teeth may also come through later.
• The front adult teeth and first adult molars may not appear until 8–9 years.
• Teeth may come through in a different order.

This is normal and usually does not cause problems, but regular dental checks are important.

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Small or missing teeth

Many people with Down syndrome have:

• Teeth that are smaller than average.
• Some teeth which never develop.
• Shorter tooth roots.

Because the upper jaw is often smaller:

• Teeth may become crowded.
• The bite may not fit together properly.
• Lower teeth may sit in front of the upper teeth.

As children grow older, orthodontic treatment (braces) is often needed to improve tooth position and bite.

Braces can sometimes affect speech, and adjusting to them may take longer for children with Down syndrome.

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Tongue size

Some people with Down syndrome:

• Have a larger tongue.
• Or have a normal-sized tongue in a smaller mouth.

This can make the tongue feel too big and may affect speech or tooth position.

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Tooth grinding

Tooth grinding is more common in people with Down syndrome.

This can lead to:

• Flat or worn teeth.
• Tooth sensitivity.
• Pain over time.

If grinding is noticed, a dentist should assess it.

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Gum disease

People with Down syndrome are at a higher risk of gum disease, even if they do not have much plaque.

This may be linked to differences in how the immune system responds to bacteria.

To help protect the gums:

• Brush teeth last thing at night and at least once more during the day.
• Use a fluoride toothpaste.
• Clean between the teeth once a day using interdental brushes or floss.
• Visit the dentist regularly, as advised.

If gums bleed:

• This means they are inflamed.
• Do not stop brushing.
• More thorough cleaning usually reduces bleeding over time.

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Tooth decay

People with Down syndrome can still get cavities.

To reduce the risk:

• Brush teeth for 2 minutes, last thing at night and once more during the day, with a fluoride toothpaste.
• Clean between the teeth daily.
• Limit sugary foods and drinks.
• Try to keep sugary foods to mealtimes.

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Visiting the dentist

Many people with Down syndrome can be treated in a regular dental practice.

However, some may need extra support.

If a dental visit is difficult:

• The dentist may refer the person to a specialist dental service
• Some hospitals or health centres offer care with sedation and general anaesthesia, if needed.

These services are designed to provide safe, supportive care for people with additional needs.

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Summary

With the right support, people with Down syndrome can have healthy mouths and positive dental experiences.

Regular dental visits, good daily cleaning, and clear communication with the dental team all help protect oral health and wellbeing.

If you have concerns, speak to your dentist – they can help you find the best approach for you.