Turner syndrome

Overview

Board takeaway: Review aortic disease, blood pressure, and renal function before complex care; plan orthodontics from root morphology and individual growth.

Growth and dental development need assessment alongside cardiovascular and endocrine care.

How does Turner syndrome affect dental management?

• Cardiology review: bicuspid valve, coarctation repair and aortic size; prophylaxis only for qualifying indications
• Blood pressure and kidneys: Check blood pressure; review renal function
• Growth and treatment: Plan orthodontics around the individual growth pattern and endocrine treatment.
• Root assessment: Assess root length and morphology before treatment and monitor according to orthodontic risk; the syndrome alone does not establish a standard force or imaging interval.
• Associated disease: Screen for celiac-related enamel defects and hypothyroidism

Exam pearl

What is Turner syndrome?

A chromosome condition in females involving loss of all or part of one X chromosome, with variable short stature, ovarian insufficiency, and cardiac or renal abnormalities.

What are the main systemic features of Turner syndrome?

• Chromosomes: 45,X (about half) or mosaicism or structural X abnormalities; ~1 in 2,500 live female births
• Growth and body features: Short stature, webbed neck, low posterior hairline, broad chest, lymphedema of hands and feet at birth
• Ovaries: Primary ovarian insufficiency
• Heart and aorta: Bicuspid aortic valve and coarctation of the aorta; aortic dilation and dissection risk
• Other systems: Horseshoe kidney; hypothyroidism, celiac disease, hearing loss; usually typical intelligence
• Treatment: Growth hormone and estrogen replacement

What oral findings occur in Turner syndrome?

• Occlusion: High-arched, narrow palate; micrognathia with Class II and lateral crossbite
• Eruption: Early eruption of permanent teeth
• Tooth structure: Smaller crowns, short roots (external root resorption risk with orthodontics), thinner enamel

For Turner syndrome, how do short roots affect orthodontics?

• Risk: limited root length reduces the support available if further resorption occurs; document baseline morphology and previous resorption.
• Technique: use light forces and radiographic monitoring.
• Timing: coordinate with growth hormone therapy.

For Turner syndrome, does a bicuspid aortic valve need endocarditis prophylaxis?

No, unless there is a prosthetic valve, prior endocarditis or another qualifying condition.

Sources

• AAPD dental guidance: AAPD: Antibiotic prophylaxis (2026 revision)
• Supplemental systemic features: MedlinePlus Genetics: turner syndrome
• Supplemental study guide: Pediatric Dental Study Guide: Turner Syndrome
• Management of Dental Patients with Special Health Care Needs
• Management of the Developing Dentition and Occlusion in Pediatric Dentistry
• Cardiology Consultation for Pediatric Dental Patients