1. Oral Health in Prader-Willi Syndrome
Andrei Barasch, DMD, MDSc
Chair, Dept. of Dental Medicine
Winthrop University Hospital

2. 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

3. 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

4. Other reported oral findings
Mucosa: trauma due to picking; candidiasis
Dentition: hypodontia; enamel defects; rampant caries
Gums: periodontal disease

6. Candidiasis

7. Gingivitis

8. 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

9. The future
We need more study to better define problems and possible solutions
Potential identification of the genetic mechanism
Potential targeted therapy