Dental caries and associated factors in twins with Down syndrome: a case report

: Down syndrome (DS) is the most common genetic disorder in humans, but its incidence in monozygotic twins is extremely rare. The aim of this study was to determine the factors associated with dental caries in a pair of monozygotic twin girls with DS, where one had caries experience and the other did not. Clinical examination, salivary Streptococcus mutans (S. mutans) levels and their genotypic diversity, the biochemical composition of the dental biofilm, the frequency of sucrose consumption, and toothbrushing habits were assessed from the twin girls. Twin with caries experience showed higher levels of S. mutans in the saliva and lower concentrations of calcium, phosphate, and fluoride and higher concentrations of extracellular polysaccharides in the biofilm compared to her sister. Genotypic diversity of S. mutans was also higher in the twin with caries experience. Dental biofilm composition showed different patterns of cariogenicity between the two sisters, which may also by itself explain the difference in the dental caries between them.