Down Syndrome (DS) is a genetic congenital disorder caused by additional third chromosome 21 (Trisomy 21). Dental manifestation includes malocclusion, delayed eruption, and open mouthposture. Combined with muscular hypotony and decrease of visual and audio vestibular capability,these factors make DS children struggle to maintain oral hygiene. Systemic factor such ashematological abnormalities, heart and immune defect also makes dental treatment plan morecomplex. Research of caries prevalence (as an infectious disease) in DS compared to healthychildren have varied result.The purpose of this literature review is to describe the role of salivary Nitric Oxide (NO) and itseffect on the caries status of children with Down syndrome (DS). Several studies have linked cariesprevalence in DS children with saliva composition. Dental and systemic manifestation of DS causechanges in the oral ecosystem of DS, result in physiological changes in salivary flow rate andcomposition such as Nitric Oxide (NO). NO can be obtained from breathing, diet, and bodymetabolism. DS children prefer to consume foods rich in carbohydrates and refuse to consumevegetables and fruit. Since salivary NO can inhibit the growth of cariogenic bacteria such asStreptococcus mutants by forming reactive radical hydroxyl, inhibit respiration and DNA synthesisto damage the bacterial cell, this lack of fiber intake habit causes nutritional deficiencies from whichNO obtained and may increase caries risk.This

Original languageEnglish
Pages (from-to)1611-1616
Number of pages6
JournalJournal of International Dental and Medical Research
Issue number4
Publication statusPublished - 2021


  • Caries
  • Diet
  • Down syndrome
  • Infectious disease
  • Salivary nitric oxide


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