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
• 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
• 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
• Mucosa: trauma due to picking; candidiasis
• Dentition: hypodontia; enamel defects;
rampant caries
• Gums: periodontal disease
Candidiasis
Gingivitis
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
• We need more study to better define
problems and possible solutions
• Potential identification of the genetic
mechanism
• Potential targeted therapy