Do Down's Syndrome patients in Scotland have access to appropriate treatment and support for aggressive periodontal disease?

Abstract

My aim is to discuss whether patients in Scotland receive appropriate treatment and support for aggressive periodontal disease. My literature review will consist of three parts. The first part will look at the relationship between Down's Syndrome (DS) and aggressive periodontitis. The second part will identify treatments relevant to this particular group of patients, and discuss the effectiveness of such treatments. Finally, I will investigate how readily available treatment is in Scotland, and whether service provision is adequate, or insufficient.

This paper will review the current literature in order to answer the question stated above.

Periodontal disease is one of the two most common dental diseases affecting a significant percentage of the population. DS patients are more susceptible to periodontal disease and require ongoing dental care, either to prevent onset of the disease, or to halt its progression.

People are living longer as health, hygiene, and nutrition are improving. During the twentieth century, life expectancy rose from 50 to over 70 years. This increase has a knock-on effect on health care professionals as social and medical care becomes more heavily relied on. Patients are keeping their teeth for longer, requiring more complex and demanding treatments. This literature review will investigate whether patients with both DS and aggressive periodontitis have access to and are receiving the appropriate dental care.

Periodontitis is a chronic inflammatory disease affecting the teeth and their surrounding structures. Various periodontal diseases have been classified by Armitage 1999. Aggressive periodontitis is a more severe form usually occurring in younger, otherwise healthy patients. It is quickly progressing with loss of attachment and rapid bone destruction. DS is a genetic disorder in which the person has an extra copy of chromosome 21 giving them 47 chromosomes in total, one more than normal. Around 9.2 people in every 10,000 are affected.

There is no difference in prevalence across racial groups. Characteristics include congenital heart defects, and an impaired immune system.