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Safe and Effective Dental Care for Patients With Fragile X Syndrome

Oral health professionals may likely treat patients with FXS, as it is the most common form of inherited intellectual disability. Not only are its symptoms similar to autism, those with FXS are also far more likely to have autism. The periodontium may suffer in patients with FXS. Poor oral hygiene, periodontitis, and caries are common. Fluoride varnish, prescription fluoride toothpaste, and SDF should be considered. Specialized and dynamic oral hygiene instruction should be suggested depending on what the patient is able to tolerate and what the caregiver is able to perform.

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Linked to the X chromosome, fragile X syndrome (FXS) is inherited by males who carry the premutation allele.

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FXS occurs most commonly in females.

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Symptoms of FXS are similar to autism spectrum disorder: hyperactivity, developmental delays, difficulty communicating, unique physical behaviors (eg, hand flapping), behavioral problems, and hypersensitivity to sensory input.

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Although treatment planning for all patients should consider individual needs, additional measures are necessary when treating those with FXS.

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The common oral findings in patients with FXS show large variability, but include a narrow palate and long face, macroglossia, microdontia, supernumerary teeth, and abnormal occlusion (eg, open or cross-bite).

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In what percentage of individuals with FXS are behavioral problems—such as anxiety, depression, aggression, and attention deficit hyperactivity disorder—evident?

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Medications used to treat FXS often cause xerostomia, which can lead to further problems in the oral cavity.

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Prior to visiting the dental office, patients with FXS may benefit from advance preparation from their caregivers.

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Poor oral hygiene in individuals with FXS is common, so a dynamic and tailored oral hygiene regimen is recommended depending on the touch aversion of the patient and skill of the caregiver.

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Safe and Effective Dental Care for Patients With Fragile X Syndrome
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This information is from the article “Understanding Fragile X Syndrome” by Amy DeStaffany, RDH, BS. To read the article, click here.

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