Dental health: why it needs different follow-up

Quick answer. Teeth in children with Down syndrome tend to come in later and in different shapes, and gum disease risk is higher even with minimal plaque buildup — that’s why the first dental visit should happen before age one, not once a visible problem shows up.

Why it matters. This isn’t just cosmetic: teeth that erupt late, crowded, or with shorter roots affect chewing and, sometimes, speech. And since baseline gum inflammation risk is already higher, waiting for something to “look wrong” means starting too late.

What the source says. According to NDSS (National Down Syndrome Society), babies with Down syndrome typically get their first tooth between 12 and 14 months (sometimes as late as 24 months), compared to the usual 6-12 months. All baby teeth usually finish coming in between ages 4 and 5 (versus the typical 2-3 years), and permanent front teeth and 6-year molars may not erupt until age 8-9. Teeth are commonly smaller, with shorter roots, missing teeth are frequent, and spacing, crowding, or bite problems are common. On gum disease, NDSS is clear: people with Down syndrome have a different immune system and lack some of the natural protections against periodontal disease, so the risk is higher even with minimal plaque buildup.

What can you do now? Schedule the first dental visit within 6 months of the first tooth erupting, or by age one — whichever comes first. Brush twice daily with fluoride toothpaste and soft bristles, and floss between any teeth that touch. If your child has or had a congenital heart defect, ask their cardiologist whether antibiotics are needed before dental appointments, and always tell the dentist about any health condition.

To go deeper. NDSS — Dentistry & Down Syndrome: more detail on dental care and finding a dentist experienced with Down syndrome.

⚠️ This isn't medical advice. It describes what the cited sources say — always check with your child's pediatrician or specialist before making health decisions.