Dental anomalies and dental age in children with down syndrome: a comparative retrospective study with healthy controls

BACKGROUND: Children with Down syndrome (DS) are known to present various dental anomalies; however, evaluating anomaly types together with dental age remains limited, in Turkish pediatric populations. The aim of this study was to investigate differences in dental anomaly prevalence and dental age between children with DS and healthy controls. METHODS: This retrospective study was conducted at a university dental clinic using panoramic radiographs obtained between 2009 and 2024. A total of 61 children with DS and 61 age and sex-matched healthy controls (5-14 years) were included. Dental anomalies were categorized as size, shape, number and structure on radiographic evaluation. Dental age was estimated using the Nolla method by assessing six mandibular teeth. Statistical analyses were performed using chi-square, Fisher's exact, Mann-Whitney U tests and p-value < 0.05 was considered statistically significant. RESULTS: Dental anomalies were more prevalent in the DS group. Taurodontism was significantly more common in children with DS (36.1%, 95% CI: 24.2-48.0) compared to controls (19.7%, 95% CI: 9.7-29.7; p = 0.043). Hyperdontia (14.8% vs. 1.6%, p = 0.008), hypodontia (42.6% vs. 4.9%, p < 0.001), and combined hyperdontia and hypodontia (p < 0.001) were also significantly higher in the DS group. Structural anomalies (8.2% vs. 0%, p = 0.022), microdontia (59.0% vs. 11.5%, p < 0.001), and macrodontia (54.1% vs. 6.6%, p < 0.001) were observed more frequently in children with DS. Mean dental age was lower in the DS group (8.3±1.4 vs. 8.5±1.2; 95% CI: 7.95-8.65 vs. 8.20-8.80), although the difference was not statistically significant (p=0.605). Age-group analysis showed a significant difference only at 8 years of age (p=0.019). CONCLUSIONS: Children with DS demonstrated a higher occurrence of dental anomalies than healthy peers. Although dental maturation appeared to be delayed in the DS group, the difference was not significant. These findings highlight the importance of individualized radiographic assessment in children with DS and may support more precise timing of preventive and interceptive dental interventions.