Hand Function and Oral Hygiene Performance among Children with Down Syndrome: A Cross-Sectional Study

Authors

  • Rieza Zulfahmi Taftazani Department of Dental Health, Poltekkes Kemenkes Tasikmalaya, Indonesia
  • Tita Kartika Dewi Department of Dental Therapist, Poltekkes Kemenkes Tasikmalaya, Indonesia
  • Samjaji Department of Dental Therapist, Poltekkes Kemenkes Tasikmalaya, Indonesia

DOI:

https://doi.org/10.51601/ijhp.v6i3.731

Abstract

Background: Children with Down syndrome (DS) may experience limitations in motor function that can affect their ability to perform daily oral hygiene activities. Hand function is an important component of toothbrush manipulation and may influence oral hygiene performance. Purpose: This study aimed to examine the relationship between hand function and oral hygiene performance among children with Down syndrome. Methods: A cross-sectional observational study was conducted among children with DS. Hand function was assessed using hand grip strength measured with an electronic hand dynamometer, while oral hygiene performance was assessed using the Personal Hygiene Performance Modified (PHP-M) index. Participant characteristics included age, sex, functional ability, and tooth alignment. Descriptive statistics and correlation analyses were performed to examine the relationship between hand grip strength and PHP-M scores. Results: Twenty-three children with DS were included in the descriptive analysis, while 15 participants with complete hand grip strength and PHP-M data were included in the correlation analysis. The mean age of participants was 14.17 ± 3.21 years, and the mean PHP-M score was 35.43 ± 11.18. Hand grip strength showed a significant negative correlation with PHP-M scores (Pearson's r = −0.790, p < 0.001). Spearman's correlation analysis also demonstrated a significant negative association (ρ = −0.591, p = 0.020). These findings indicate that greater hand grip strength was associated with lower PHP-M scores, reflecting better oral hygiene performance. Conclusion: Hand function, as assessed by hand grip strength, was significantly associated with oral hygiene performance among children with Down syndrome. The findings suggest that differences in hand function may be relevant to the ability of children with DS to maintain oral hygiene. Assessment of hand function may provide additional information when planning individualized oral hygiene support for children with Down syndrome.

Downloads

Download data is not yet available.

References

[1] M. J. Bull, T. Trotter, S. L. Santoro, C. Christensen, R. W. Grout, and C. on Genetics, “Health supervision for children and adolescents with Down syndrome,” Pediatrics, vol. 149, no. 5, p. e2022057010, 2022.

[2] R. Elrefadi, H. Beaayou, K. Herwis, and A. Musrati, “Oral health status in individuals with Down syndrome,” Libyan J. Med., vol. 17, no. 1, p. 2116794, 2022.

[3] N. Padia, M. Bose, and S. Parab, “Determinants of hand function in children and adolescent with Down syndrome: A scoping review,” J. Hand Ther., vol. 36, no. 3, pp. 622–631, 2023.

[4] M. Contaldo et al., “Oral microbiota features in subjects with Down syndrome and periodontal diseases: A systematic review,” Int. J. Mol. Sci., vol. 22, no. 17, p. 9251, 2021.

[5] A. A. Díaz-Quevedo, H. M. L. Castillo-Quispe, K. J. Atoche-Socola, and L. E. Arriola-Guillén, “Evaluation of the craniofacial and oral characteristics of individuals with Down syndrome: A review of the literature,” J. Stomatol. Oral Maxillofac. Surg., vol. 122, no. 6, pp. 583–587, 2021.

[6] F. A. R. Scalioni, C. F. Carrada, M. C. Tavares, L. G. Abreu, R. A. Ribeiro, and S. M. Paiva, “Oral health characteristics in children and adolescents with Down syndrome,” Spec. Care Dent., vol. 44, no. 2, pp. 542–549, 2024.

[7] V. Vergier, A. M. Collignon, M. Gosset, and A. L. Bonnet, “Periodontal diseases in Down syndrome during childhood: A scoping review,” BMC Oral Health, vol. 25, p. 161, 2025.

[8] J. E. Botero, C. Rodríguez-Medina, S. Amaya-Sanchez, C. L. Salazar, and A. Contreras, “A comprehensive review of the relationship between oral health and Down syndrome,” Curr. Oral Heal. Reports, vol. 11, pp. 15–22, 2024.

[9] P. Schmidt, L. C. Suchy, and A. G. Schulte, “Oral health care of people with Down syndrome in Germany,” Int. J. Environ. Res. Public Health, vol. 19, no. 19, p. 12435, 2022.

[10] R. Z. Taftazani, M. N. Sitaresmi, L. Hanindriyo, and S. Kuswandari, “Optimizing oral hygiene for children and adolescents with Down syndrome: A scoping review,” Can. J. Dent. Hyg., vol. 59, no. 2, pp. 133–142, 2025.

[11] S. M. Kalf-Scholte, C. Valkenburg, F. G. A. van der Weijden, and D. E. Slot, “Powered or manual toothbrushing for people with physical or intellectual disabilities: A systematic review,” Spec. Care Dent., vol. 43, no. 5, pp. 515–529, 2023.

[12] L. Macote-Orosco, A. Martín-Vacas, M. M. Paz-Cortés, M. R. Mourelle Martínez, and M. J. de Nova, “The relationship between manual dexterity and toothbrushing efficiency in preschool children: A crossover study,” Children, vol. 11, no. 12, p. 1498, 2024.

[13] S. Sharma, R. Yeluri, A. A. Jain, and A. K. Munshi, “Effect of toothbrush grip on plaque removal during manual toothbrushing in children,” J. Oral Sci., vol. 54, no. 2, pp. 183–190, 2012.

[14] J. J. Winnier, S. S. Naik, A. Shetty, D. Patil, S. Tandel, and P. Gore, “Impact of manual dexterity on toothbrushing efficacy in typically developing children: A cross-sectional study,” Int. J. Paediatr. Dent., vol. 35, no. 3, pp. 492–499, 2025.

[15] E. Norouzi, M. Soleymani, and R. Abedanzadeh, “Dohsa-hou training improves bimanual coordination among children with Down syndrome,” Int. J. Dev. Disabil., vol. 69, no. 6, pp. 926–935, 2023.

[16] L. I. Stein Duker, M. Martinez, C. J. Lane, J. C. Polido, and S. A. Cermak, “Association between oral care challenges and sensory over-responsivity in children with Down syndrome,” Int. J. Paediatr. Dent., vol. 32, no. 4, pp. 546–557, 2022.

[17] P. A. Priosti, S. M. Blascovi-Assis, R. Cymrot, D. L. Vianna, and F. A. Caromano, “Grip strength and manual dexterity in Down syndrome children,” Fisioter. e Pesqui., vol. 20, no. 3, pp. 278–285, 2013.

[18] L. Droubi et al., “Does customized handle toothbrush influence dental plaque removal in children with Down syndrome? A randomized controlled trial,” Healthcare, vol. 9, no. 9, p. 1130, 2021.

[19] W. N. Wan Roselan, S. N. Bawawi, I. H. Baharuddin, and I. W. Mokhtar, “Parents’ oral health promotion efforts for their children with Down syndrome and the children’s oral health,” Spec. Care Dent., vol. 43, no. 4, pp. 409–415, 2023.

[20] A. H. AlJameel and H. AlKawari, “Oral health-related quality of life (OHRQoL) of children with Down syndrome and their families: A cross-sectional study,” Children, vol. 8, no. 11, p. 954, 2021.

[21] G. R. Otero, B. R. Mundiña, E. García-Mato, I. V Aneiros, L. S. López, and J. R. G. Iglesias, “Development and evaluation of a new website on oral health and Down syndrome,” Spec. Care Dent., vol. 44, no. 5, pp. 1416–1424, 2024.

[22] R. Purnamawati, Z. Shaluhiyah, and A. Suryoputro, “Caretakers’ role in personal hygiene children with Down syndrome,” J. Matern. Child Heal., vol. 8, no. 3, pp. 255–263, 2023.

[23] G. L. R. Melo, R. C. Espírito Santo, V. P. Dubey, and C. Agostinis-Sobrinho, “Handgrip strength measurement protocols in individuals with Down syndrome: A systematic review and meta-regression,” Ann. Med., vol. 57, no. 1, p. 2453077, 2025.

[24] A. G. Podshadley and J. V Haley, “A method for evaluating oral hygiene performance,” Public Health Rep., vol. 83, no. 3, pp. 259–264, 1968.

[25] World Medical Association, “World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects,” JAMA, vol. 310, no. 20, pp. 2191–2194, 2013.

[26] S. Rondón-Avalo, C. Rodríguez-Medina, and J. E. Botero, “Association of Down syndrome with periodontal diseases: Systematic review and meta-analysis,” Spec. Care Dent., vol. 44, no. 2, pp. 360–368, 2024.

Downloads

Published

2026-09-18

How to Cite

Taftazani, R. Z., Dewi, T. K., & Samjaji. (2026). Hand Function and Oral Hygiene Performance among Children with Down Syndrome: A Cross-Sectional Study . International Journal of Health and Pharmaceutical (IJHP), 6(3), 942–952. https://doi.org/10.51601/ijhp.v6i3.731

Issue

Section

Articles