Etiological considerations for the heightened incidence and intensity of periodontal disease in Down syndrome: a narrative review

Cross-sectional and longitudinal studies have consistently reported a heightened prevalence and severity of periodontitis in individuals with Down Syndrome (DS), a phenomenon not solely attributable to poor oral hygiene. Much focus has been placed on the altered immune response and we revisiting immune system abnormalities from an immune cell perspective. Notably, recent studies have investigated the involvement of multiple metabolic pathways in the pathogenesis of DS periodontitis, including phosphoinositide 3-kinase-Akt (PI3K-Akt) signaling pathway, which regulates cell proliferation and inflammatory responses, and we have synthesized these for the first time. Both local and systemic factors predispose patients with DS. This article summarizes the latest contemporary knowledge on periodontal disease in individuals with Down syndrome, which can be used to monitor the oral health status of children with Down syndrome for early intervention.