Sigal M J, Levine N
Department of Pediatric Dentistry, Faculty of Dentistry, University of Toronto, Ont.
J Can Dent Assoc. 1993 Oct;59(10):823-5, 829.
Individuals with Down's syndrome (DS) who live to be 40 years of age will demonstrate neuropathological changes that are consistent with Alzheimer's disease (AD). Due to modern medical intervention, we are now observing an aging DS population. Middle-aged Down's syndrome adults are actually considered to be "very old," and it is not uncommon to observe a progressive loss of cognitive function and a decline in the ability to perform daily tasks consistent with that seen in Alzheimer's disease. At this stage, the DS individual will not be able to perform daily preventive dental care and may be unable to cooperate for professional dental care. Clinicians who care for DS adults must be aware of this problem when preparing their dental treatment plans, which must emphasize preventive care prior to the onset of dementia and the maintenance of that program during their patients' cognitive decline. In the latter stages of AD, it may be necessary to extract all the remaining teeth due to the inability of the individual or care giver to provide adequate oral hygiene to prevent dental caries or periodontal disease.
活到40岁的唐氏综合征（DS）患者会出现与阿尔茨海默病（AD）一致的神经病理学变化。由于现代医学干预，我们现在观察到唐氏综合征患者群体正在老龄化。中年唐氏综合征成年人实际上被认为“非常年老”，认知功能逐渐丧失以及日常任务执行能力下降的情况并不罕见，这与阿尔茨海默病患者的情况一致。在这个阶段，唐氏综合征患者将无法进行日常预防性口腔护理，可能也无法配合专业口腔护理。照顾唐氏综合征成年患者的临床医生在制定牙科治疗计划时必须意识到这个问题，治疗计划必须强调在痴呆症发作前进行预防性护理，并在患者认知能力下降期间维持该计划。在阿尔茨海默病的后期，由于患者或护理人员无法提供足够的口腔卫生护理以预防龋齿或牙周疾病，可能有必要拔除所有剩余牙齿。
