The common dentofacial manifestations are tooth structure anomalies, hypodontia, malocclusion, tooth wear due to bruxism, decreased occlusal vertical dimension (OVD), periodontal disease, hypotonic oro-facial musculature, reduced salivary flow, as well as a high incidence of dental caries. In addition, underdeveloped maxillary arch and mandibular prognathism are common skeletal defects in patients with DS.3-7 All the previously mentioned manifestations can result in masticatory dysfunction in patients with DS.8, 9
The intellectual disability of people with DS varies widely, with mild to moderate intellectual disability, which may have an effect on their overall behavior during any dental procedures. The dental management of patients with DS mostly depends on the level of this disability. In addition to the oral manifestations, the their cooperation may add a complexity to the treatment. Thus, the trust relationship between the patient with DS and the dentist is very important for the treatment outcome.4,