Nita Naomi, - and Tania Saskianti, - and Ardianti Maartrina Dewi, - and Barnabas Bonardo, - and Alit Rahma Estu, - and Brian Maulani, - (2021) Role of Salivary Nitric Oxide on Caries Status of Children with Down Syndrome. Journal of International Dental and Medical Research, 14 (4). ISSN 1309-100X

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Abstract

Down Syndrome (DS) is a genetic congenital disorder caused by additional third chromosome 21 (Trisomy 21). Dental manifestation includes malocclusion, delayed eruption, and open mouth posture. 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 as hematological abnormalities, heart and immune defect also makes dental treatment plan more complex. Research of caries prevalence (as an infectious disease) in DS compared to healthy children have varied result. The purpose of this literature review is to describe the role of salivary Nitric Oxide (NO) and its effect on the caries status of children with Down syndrome (DS). Several studies have linked caries prevalence in DS children with saliva composition. Dental and systemic manifestation of DS cause changes in the oral ecosystem of DS, result in physiological changes in salivary flow rate and composition such as Nitric Oxide (NO). NO can be obtained from breathing, diet, and body metabolism. DS children prefer to consume foods rich in carbohydrates and refuse to consume vegetables and fruit. Since salivary NO can inhibit the growth of cariogenic bacteria such as Streptococcus mutants by forming reactive radical hydroxyl, inhibit respiration and DNA synthesis to damage the bacterial cell, this lack of fiber intake habit causes nutritional deficiencies from which NO obtained and may increase caries risk. This literature review concludes factors influencing the level of salivary Nitric Oxide and their effects on caries status of children with Down syndrome.

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