Correlation between dental maturation and chronological age in patients with cerebral palsy, mental retardation, and Down syndrome.
Expect girls with cerebral palsy or Down syndrome to have younger-looking teeth than their birth age, so plan dental care using developmental age, not the calendar.
01Research in Context
What this study did
Spanish dentists looked at teeth from kids with cerebral palsy, Down syndrome, or other intellectual disabilities.
They compared each child's dental age to their calendar age to see if teeth grew slower than normal.
The team used standard X-ray charts to score how mature the teeth were.
What they found
Boys with any disability showed no tooth delay; their dental age matched their real age.
Girls with cerebral palsy or Down syndrome had clearly delayed dental age.
For these girls, teeth looked younger than the birthday cake said.
How this fits with other research
Tsao et al. (2017) saw the same delay pattern in handwriting: kids with Down syndrome write like younger typical kids, not in a weird way.
Tudella et al. (2011) also found motor milestones running late in babies with Down syndrome, so the delay theme repeats across body systems.
Costa et al. (2017) and Klein et al. (2024) flip the picture to adulthood: older age brings weaker bones and more fractures in Down syndrome, hinting that early delay may turn into faster ageing later.
Together the papers trace a line—slow start in childhood, then quicker wear-down after 50—so age markers shift depending on life stage.
Why it matters
When you treat girls with CP or Down syndrome, remember that their body clocks tick slower than the calendar.
Use developmental age, not birthday age, to judge when permanent teeth might erupt or when to refer for orthodontic care.
The same rule helps set realistic goals for motor, dental, and daily living skills across the board.
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02At a glance
03Original abstract
Determining a child's chronological age and stage of maturation is particularly important in fields such as paediatrics, orthopaedics, and orthodontics, as well as in forensic and anthropological studies. Some systemic conditions can cause abnormal physiological maturation, and skeletal maturation is usually more delayed than dental maturation. The aim of this study was to determine dental age in a group of patients with the most prevalent congenital or perinatally occurring physical and mental disabilities. The study group comprised 155 white Spanish children aged 3-17 years (35 with cerebral palsy, 83 with mental retardation and no associated syndromes or systemic conditions, and 37 with Down syndrome). The dental maturation indices described by Nolla and Demirjian were used to generate regression lines for the dental age of individuals in a control group (688 white Spanish children aged 3-17 years) and the formulae were then used to determine the dental age of patients in the study group. No significant differences were found between dental and chronological age in boys with cerebral palsy, mental retardation, or Down syndrome. In contrast, dental age (calculated from the linear regression model that included values for the Demirjian index) was significantly delayed compared with chronological age in girls with cerebral palsy or Down syndrome.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2010.10.019