Ears, Nose, Throat & Teeth

Information about hearing and dental care along with useful resources and links.

Hearing

Hearing loss will affect many people who have Down’s syndrome at some point in their lives. This may be mild temporary hearing loss or a longer-term difficulty with hearing. Here are some of the reasons that may cause higher levels of hearing loss in people who have Down’s syndrome:

Increased incidence of chronic ear diseases
Differences in the structure of the ear
Weaker immune systems.

Types Of Hearing Loss

Conductive hearing loss

This is a hearing difficulty because sounds cannot pass freely into the inner ear. Conductive losses are usually temporary. A small number are permanent.

The most common type of conductive hearing loss in children is glue ear (sometimes called Otitis Media with Effusion OME) although adults can also experience this. In children, this often happens because they have a build-up of fluid in the space behind the eardrum. Conductive hearing loss can also be caused by a build-up of earwax or an ear infection. Ear wax that blocks the ear is very common in people who have Down’s syndrome.

Sensorineural hearing loss

This is a permanent hearing difficulty that happens in the inner ear (cochlea or hearing nerve). Some children who have Down’s syndrome will be born with this type of hearing loss and for some it may develop as they get older. Sensorineural hearing loss is the most usual type of hearing loss that occurs when we get older and hearing loss with old age frequently occurs earlier in people who have Down’s syndrome.

It is possible to have both conductive and sensorineural hearing loss.

An audiologist at your local audiology service will carry out hearing tests. You can ask a paediatrician, GP or health visitor to make a referral to the audiology service. Audiology services can provide information about what they offer and what a hearing assessment will involve. Ideally, an audiologist with experience in supporting people with a learning disability should do the assessment. Audiology services can also provide reasonable adjustments to facilitate appointments.

Routine hearing tests should be offered at the following times:

All babies under 3 months of age should be offered universal newborn hearing screening
Between the age of 8 months and 1 year of age all children who have Down’s syndrome should be offered a hearing assessment
A child should be offered a hearing assessment once or twice a year until the age of 6.
A hearing assessment should be included in the school entry health check.
A hearing assessment should be offered every 2 years from the age of 6, or more frequently if required.
From the age of 35 an annual hearing assessment should be offered.

Questions about hearing are also included at the Annual Health Check.

Hearing plays an important part in children’s development and learning, especially speech and language and social skills. It is vital all children who have Down’s syndrome have their hearing tested regularly. Research highlights the need for audiology and speech and language therapy services to work together as soon as a child is diagnosed with severe, ongoing hearing difficulties.

If someone you support develops sudden unexplained hearing loss, get a referral to the audiology service for an assessment. If a person is displaying signs of confusion or changes in behaviour, it is always a good idea to check for an underlying medical cause such as a loss of hearing.

Dental

People who have Down’s syndrome do not have any unique oral health conditions but there are some conditions which are more common. In children who have Down’s syndrome, the eruption of teeth may be delayed, and they will not necessarily appear in the same sequence as other children.

There is further information in our resource about oral health care for children (see link at the bottom of the page). Children and adults who have Down’s syndrome appear to be more susceptible to gum disease (periodontal disease). This may be because of impaired immunity. Good oral hygiene and regular check-ups with a dentist will help to reduce the chance of developing gum disease.

Dental Care

There is a link to information about eligibility for free dental care and general health benefits at the end of this page. Any general dental practitioner should be able to take care of the dental needs of children, young people and adults who have Down’s syndrome. However, for children it is a good idea to find a paediatric dentist who will have much more experience of treating children in general. They should also have more experience of providing dental care to children who have additional needs.

Community Dental Services provide services for people who are not able to attend their local dentist for whatever reason (including children and adults who have learning disabilities).

You should be able to find your local service via your NHS Trust website. You may need to be referred to community dental services by your regular dentist or doctor. The Oral Health Foundation provide advice about dental care for people who have additional needs. You can contact them via their Dental Helpline on Tel: 01788 539780. There is a link to their website at the bottom of this page.

Dental issues should be covered in an Annual Health Check. This does not replace the need for regular check-ups with a dentist

Further Info & Advice

If you have any questions about health issues, you can call DSA’s Helpline (Tel: 0333 1212 300) or email using info@downs-syndrome.org.uk. If an information officer is unable to answer your question, they can make a referral to the medical adviser at the UK & Ireland Down Syndrome Medical Interest Group (DSMIG).

Please note DSMIG can provide general advice about health issues but they are not able to comment on individual test results. DSMIG are happy to take enquiries from health professionals but they will not take direct from enquiries from families or supporters.