Protruding tongue in individuals with Down Syndrome may be avoidable. Here is a collection of possible causes and solutions:
"Most affected infants have few or no symptoms, because their thyroid hormone level is only slightly low. However, infants with severe hypothyroidism often have a unique appearance, including:
Dull look
Puffy face
Thick tongue that sticks out"
Cause is congenital hypothyroid
Anemia is also a cause, which hypothyroid and anemia play off each other, one making the other worse and makes the other worse with a snowball effect.
Glossitis is often a symptom of other conditions or problems, including:
allergic reaction to toothpaste
mouthwash
breath fresheners
dyes in candy
plastic in dentures or retainers
certain blood pressure medications (ACE inhibitors)
dry mouth
when the glands that produce saliva are destroyed (see: Sjogren syndrome)
infections with bacteria or viruses (including oral herpes simplex)
injury from burns
rough edges of teeth or dental appliances
other trauma
iron deficiency
B vitamins deficiency, such as vitamin B12
skin conditions such as oral lichen planus
erythema multiform
aphthous ulcers
pemphigus vulgaris
syphilis
tobacco
alcohol
hot foods
spices
other irritants
yeast infection in the mouth