<prompt> A 12 year old female patient complains of multiple missing teeth. The karyogram of the patient is shown below. Intra-oral findings include missing 12, 17, 33 and 43.Open bite, macroglossia and generalised periodontitis is also present. Which of the following is commonly seen in this condition?Mouth breathingPrognathic maxillaMacrodontiaHigh level of caries  <response>: Patient is suffering from Downs syndrome trisomy of chromosome No. 21.Skeletal findings are an underdeveloped mid-face, creating a prognathic occlusal relationship. Oral findings include mouth breathing, open bite, appearance of macroglossia, fissured lips and tongue, angular cheilitis, delayed eruption times, missing and malformed teeth, oligodontia, small roots, microdontia, crowding, and a low level of caries. Children with Down syndrome experience a high incidence of rapid, destructive periodontal disease, which may be related to local factors such as tooth morphology, bruxism, malocclusion, and poor oral hygiene. 