# Associations between enamel defects and caries in patients with Down syndrome compared with normotypic patients

## TL;DR

Children with Down syndrome have more enamel defects but fewer cavities compared to children without Down syndrome.

## Contribution

This study identifies a significant association between Down syndrome and enamel defects, along with reduced caries prevalence.

## Key findings

- Children with Down syndrome had a significantly higher prevalence of developmental enamel defects.
- Children with Down syndrome had a significantly lower prevalence of dental caries.
- Children without Down syndrome were more likely to have caries when enamel defects were present.

## Abstract

This study aimed to explore the prevalence of developmental defects of enamel (DDE) and dental caries in children with and without Down syndrome (DS) and evaluate potential associations between these conditions. This was a cross-sectional, exploratory, census-based study with children of both sexes aged 6 to 11 years. The sample consisted of 10 children diagnosed with DS and 61 without DS. Standardized forms and records of dmft/DMFT and modified developmental defects of enamel (mDDE) were used. Inter- and intraexaminer agreement was assessed, with an intraclass correlation coefficient (ICC) of 0.93 for DDE and 0.81 for caries. The data were tabulated using SPSS 20.0. Categorical variables were subjected to Pearson’s chi-square test to identify significant associations (p = 0.05). The Kolmogorov–Smirnov test revealed a nonnormal distribution pattern of the data (p <0.001). Therefore, numerical variables were subjected to the Mann–Whitney test to verify statistically significant differences (p = 0.05). Among the 71 study participants, 43 (60.6%) were male, and 28 (39.4%) were female. Among them, 10 (14.1%) had DS, 42 (59.2%) had caries, and 19 (26.8%) had DDE, with demarcated opacity as the most common type of DDE. A significant association was identified between having DS and not having dental caries (p = 0.007) and between having DS and having DDE (p <0.001). Individuals with DS were found to have 9.8 times greater odds of having DDE (p = 0.018). Compared with normotypic children, children with DS had a greater prevalence of DDE and a lower prevalence of dental caries. Additionally, children without DS were more likely to have caries in the presence of DDE.