RESUMEN
Objective@#To describe various local and systemic factors as the cause of gingivitis and to find out the main etiological factors of gingivitis in children with DS.@*Methods@#We searched PubMed and Google Scholar for Indonesian and English references either in the form of textbook, research results, reviews, and internet articles on the topic. We screened and selected the relevant articles for inclusion into the review. @*Results@#In children with DS, apart from poor oral hygiene, the increasing incidence of gingivitis is caused by changes in other local factors related to systemic factors, such as oral dysfunction, dental and gingival abnormalities, changes in the oral microbial profile, and salivary characteristics. Furthermore, systemic immunodeficiency, changes in inflammatory mediators and proteolytic enzymes, and intellectual subnormality are considered as systemic factors.@*Conclusion@#There is no main etiological factor of gingivitis in children with DS since various local and systemic factors are interrelated with each other causing gingivitis. The severity of gingivitis in children with DS presumably were caused by the systemic factors. Furthermore, good oral hygiene habits and the dentist's intervention in periodontal health can significantly reduce gingivitis in DS patients.