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Oral Health in Prader-Willi Syndrome. Andrei Barasch, DMD, MDSc Chair, Dept. of Dental Medicine Winthrop University Hospital. Oral Changes in PWS. PWS is a multi-systemic genetic disorder (chromosome 15) Oral physiology and pathology not adequately studied

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oral health in prader willi syndrome

Oral Health in Prader-Willi Syndrome

Andrei Barasch, DMD, MDSc

Chair, Dept. of Dental Medicine

Winthrop University Hospital

oral changes in pws
Oral Changes in PWS
  • PWS is a multi-systemic genetic disorder (chromosome 15)
  • Oral physiology and pathology not adequately studied
  • The largest study included only 50 subjects aged 5 to 40 years (Saeves et al, Int J Ped Dent 2012)
  • Majority of publications are case reports
salivary abnormalities in pws
Salivary Abnormalities in PWS
  • Decreased salivary flow has been the only consistently documented oral finding
  • Thick, sticky or frothy saliva is common
  • Amount produced equivalent to about 1/3 to 1/5 normal
  • Results in decreased cleansing, taste perception, remineralization, immune function
other reported oral findings
Other reported oral findings
  • Mucosa: trauma due to picking; candidiasis
  • Dentition: hypodontia; enamel defects; rampant caries
  • Gums: periodontal disease
potential solutions
Potential Solutions
  • Impeccable hygiene from the very start
  • Frequent dental appointments
  • Application of preventive measures (e.g. sealants, floride)
  • Avoid refined carbohydrates
  • Avoid lemon drops, even if sugarless
  • Avoid acidic foods and drinks
  • Rx: sialogogues and antimicrobial rinses
the future
The future
  • We need more study to better define problems and possible solutions
  • Potential identification of the genetic mechanism
  • Potential targeted therapy
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