Macroglossia, also called enlarged tongue or giant tongue, is an oral health condition characterized by the presence of an oversized tongue. In some cases, macroglossia is an isolated finding in otherwise healthy children, but more often, it's a symptom of an underlying health condition, like Down syndrome. Here are four things parents need to know about Down syndrome and macroglossia.
What are the signs of macroglossia?
If your child has macroglossia, you'll notice that their tongue looks too large for their mouth. Their tongue may even stick out of their mouth. They may also experience related symptoms like trouble speaking or eating. Their oversized tongue may interfere with their breathing, resulting in stridor. Stridor is a medical term that describes abnormal, high-pitched breathing. This high-pitched sound is a sign that the airway is being narrowed or obstructed. This may also result in snoring.
How does Down syndrome cause macroglossia?
Macroglossia is one of the characteristic facial features of Down syndrome and has been well documented. To understand how macroglossia occurs, you need to understand a bit more about Down syndrome and genetics.
Chromosome 21 is the smallest chromosome in humans; it only makes up 1.5% to 2% of the total DNA. While chromosome 21 is small, it's very important. This gene contains as many as 300 genes that tell the body how to make various proteins. These proteins are found throughout the body and have numerous roles, including telling the tongue how to develop.
Children with Down syndrome receive an additional copy of Chromosome 21. Normally, children should receive one copy from each of their parents, but children with Down syndrome have three copies of the chromosome. These extra copies interfere with the affected genes' ability to tell the body how to develop, resulting in developmental abnormalities like macroglossia.
Why is macroglossia an oral health concern?
Macroglossia can cause a number of overall health problems for affected children, including difficulty eating, speaking and breathing, but it can also cause a number of dental problems.
When the tongue is oversized, it interferes with oral hygiene activities like toothbrushing and flossing. If your child isn't able to brush and floss effectively, they'll be at risk of cavities and gum disease. Since severe gum disease is a significant health risk for children with Down syndrome, it's very important that they're able to clean their teeth effectively to ward off this condition. Severe gum disease can lead to further oral health problems like the loss of permanent teeth.
How do dentists treat macroglossia?
Not all children with Down syndrome require treatment for macroglossia. If your child's condition is mild and not causing too much interference in their daily activities or health, your dentist may decide that invasive treatment isn't worth the risk. On the other hand, if their tongue is very oversized and is putting their health in danger, surgical treatment will be required. Your dentist will be able to tell you if your child needs treatment after examining their tongue and can refer your child to the necessary oral surgeons and doctors.
Surgical treatment involves reducing both the height and width of the tongue. Tissue can be removed either from the tip of the tongue or from the midsection of the tongue, depending on the oral surgeon's strategy. Once the excess tissue has been removed, the tongue will be stitched back together from the inside out.
Since this procedure can cause a lot of swelling and obstruct the airway, the surgeon may perform a tracheostomy to ensure that your child can breathe safely during their recovery period. Expect for them to remain in the hospital for several days after the procedure, and once they're sent home, they'll need regular followups with your dentist.
If you think your child has macroglossia, take them to a dentist to determine if surgical treatment is necessary to protect their oral health, or visit websites like http://www.nwidentist.com/ for more general information.