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Abstract- Down's syndrome is a very common genetic disorder associated with medical and physical problems such as cardiac disorders, hearing disability, infectious diseases, intellectual disability and developmental delays. Down's syndrome is caused due to non-disjunction of chromosome 21 and translocation of an extra copy of the same chromosome. Oral manifestations include hypodontia, periodontitis, premature exfoliation of teeth, xerostomia, misaligned teeth and decreased vertical occlusal dimension. Due to poor oral hygiene and impaired host defense mechanisms in these patients, the prevalence of periodontal disease is high. This can ultimately lead to tooth loss resulting in edentulism for which prosthetic rehabilitation becomes a necessity. The dental treatment of such patients is challenging and complicated due to the intellectual disability that limits their ability to learn, communicate and adapt to the environment. Behavioural management is sometimes required for Down's syndrome patients. This article discusses a case of Down's syndrome who presented with fully edentulous oral cavity and had psychiatric symptoms. The case was managed with a Dohsa-hou therapeutic approach for prosthetic rehabilitation of the oral cavity.
Keywords-Down's syndrome, complete denture, Dohsa-hou, treatment, behavioural problem
INTRODUCTION
Down's syndrome (DS) is one of the most common congenital disorders.1The incidence of DS has been variously reported as 1 in 800 live births to 1 in 1,100 live births. A recent study puts the incidence at about 1 in 1,000. There is no association between DS and any given culture, ethnic group, socioeconomic status or geographic region.2
Many clinical symptoms of this chromosomal malformation are caused by additional chromosome 21. The appearance of three instead of two chromosomes is referred to as trisomy. Extra chromosome 21 leads to symptoms such as: metabolic disorders, tissue dimorphism, internal organs disorders and characteristic phenotype in physical appearance, muscle hypotony and mental retardation.2The age when children with DS achieve gross motor function is at approximately twice the age of performing motor skills by children typically developed.3 Cognitive development is also delayed among children with DS.4 A slower rate of such areas of development as intelligence, attention, verbal communication, learning, memory and performing motor abilities is observed.
Psychiatric disorders prevalence (e.g., depressive, obsessive-compulsive, and psychotic-like disorders) is 18 to 38% in individuals with Down syndrome.5 Common symptoms in depressive disorder include depressed mood, decreased interest, psychomotor...