A Case of CHARGE Syndrome With Tooth Eruption Disturbance Caused by Severe Calculus Accumulation.

Abstract

Individuals with disabilities who are unable to maintain oral intake are at high risk of inadequate oral hygiene because of reduced masticatory stimulation and impaired self-cleansing, leading to excessive dental calculus accumulation. However, the effects of this on tooth eruption are poorly understood. Herein, we report the case of an 18-year-old boy with CHARGE syndrome managed with gastrostomy feeding since childhood. Following prolonged inadequate oral care, severe dental calculus accumulated throughout the dentition. Thick calculi encased the mandibular right first and second deciduous molars, physically obstructing eruption of the permanent premolars. Because safe delivery of care could not be ensured under local anesthesia, treatment was performed under general anesthesia. Full-mouth scaling, mobile deciduous tooth extraction, and restorative procedures were performed. No periodontal pockets were observed, and radiographic assessment showed no alveolar bone resorption. After calculus removal, the impacted premolar erupted spontaneously within 2 months and had achieved complete eruption 8 months later. This case demonstrates that severe dental calculus accumulation can cause reversible eruption disturbances in children who do not receive oral intake. Early dental intervention, continuous oral hygiene management, and multidisciplinary care are essential for preventing oral and systemic complications in children with disabilities.