Down syndrome is a learning disorder that results from a “chromosomal abnormality”. This is an error in cell division that results in the existence of a third copy of chromosome 21 known as trisomy (Down Syndrome Ireland, 2013). 47 chromosomes develop instead of the usual 46; the extra gene alters the orderly development of the body and brain, causing the physical and learning characteristics associated with Down syndrome (Irish Health, 2014). It causes mild to moderate learning difficulties and is a lifelong illness. Noted by Robert S Ireland in his book Advanced Dental Nursing (2010), Down syndrome occurs in 1 in 1,100 live births in the population. Down Syndrome Ireland (2013) also explains that Down syndrome is one of the most common known causes of intellectual disability. .Figure 1, Genetic disorders associated with Down syndrome (Google images 2014) Physical characteristics Down syndrome is characterized by short stature, a “flat” face with epicanthal folds at the inner corners of the eyes, and a protruding tongue (Carr et al, 2007) Table 1: Problems associated with Down syndrome (Ireland, 2010) Learning disabilities that can result in a patient's ability to remember their oral hygiene routine, leading to dental problems such as tooth decay. Increased prevalence of hepatitis B virus There is a 3.6% increased risk of celiac disease which may be linked to enamel defects evident in some patients with Down syndrome . Alzheimer's disease, this can lead to the patient's ability to remember oral hygiene practices as this disease causes short-term memory. Patients with congenital heart defects may need to take prophylaxis antibiotic. Instability of the cervical joints, due to this extension...... middle of paper ...... health problems. Toothbrush adaptations such as using angled teeth, smaller toothbrushes or a good quality electronic toothbrush, when used correctly, can ensure a good level of oral health (Hollins, 2009). Hollins (2009) also explains that there are several types of flossing equipment available today that provide effective interproximal cleaning and are easier to use. for patients compared to the traditional method of wrapping dental floss around the fingers. Bruxism, teeth grinding, is also associated with Down syndrome. If a patient shows signs of this, night protection could be suggested to the patient to prevent wear of the teeth. and expose the dentin. Alzheimer's disease is a common disorder associated with Down syndrome, as mentioned earlier it is a good idea to write down the oral hygiene routine and advice to give to the patient and a copy to the caregiver/guardian.