Feeding and Dental Difficulties
Feeding and Dental Difficulties
From infancy to adulthood, feeding difficulties are very common in individuals with CdLS. Preferably, individuals with CdLS should be fed orally (by mouth). However, feeding difficulties may sometimes result in feeding times becoming unsafe, stressful and taking many hours out of the day. In these circumstances, doctors may temporarily supplement an individual’s feeding with a gastrostomy tube (57). A gastrostomy tube delivers food straight into an individual’s stomach. It is important that dieticians (experts on diet and nutrition) are involved (R12, R13).
Feeding difficulties can be caused by several physical issues such as a cleft palate, micrognathia (undersized jaw) or dental issues (57). Cleft palate is where there is a gap or split in the roof of the mouth. It is present from birth and occurs in 20% of individuals with CdLS. After being diagnosed with CdLS, all individuals should have the roof of their mouth closely examined to assess for cleft palate. If an individual has a cleft palate, they should be referred for specialist assessment (R14).
Dental problems in CdLS may include:
- Delayed secondary tooth eruption
- Small or absent teeth
- Malposition (abnormal positioning of teeth)
- Malocclusion (misalignment between the lower and upper teeth when the jaw closes)
- Overcrowding of teeth
- Tooth decay or cavities
- Periodontal disease (infection affecting the gums of the mouth)
- Bruxism (teeth grinding)
Dental problems may worsen due to poor oral hygiene, especially in individuals with CdLS who have marked intellectual disability. Sometimes, individuals with CdLS may not brush their teeth regularly or thoroughly enough. This may lead to early onset dental decay and periodontal (gum or mouth) disease(59). It is important to ensure regular dental assessment and cleaning to prevent early dental decay. A healthy diet can also help to keep teeth in good condition (61,60 ; R15).
