As a dentist, which condition should you be most concerned about when treating a patient with Down syndrome?

When treating a patient with Down syndrome, congenital heart disease (CHD) is a particularly significant concern due to its high prevalence in individuals with this genetic condition. Studies indicate that approximately 40-50% of individuals with Down syndrome are born with some form of heart defect, which can vary in severity and type, including conditions like atrioventricular septal defects and ventricular septal defects.

The presence of CHD can complicate dental treatment in several ways. Patients with severe heart defects may require special consideration regarding the use of anesthetics and sedatives, as well as preventive antibiotics prior to dental procedures to mitigate the risk of infective endocarditis. Furthermore, those with undiagnosed or poorly managed CHD may face emergent situations in the dental setting.

While other health issues like sleep apnea, cleft palate, and hearing impairment are also important to consider in patients with Down syndrome, they do not pose the same level of immediate medical risk during dental procedures as congenital heart disease. Thus, being vigilant about the cardiac health of these patients is essential for safe and effective dental care.