Dental care for Special needs children

Children with special needs can have unique issues when it comes to caring for the health of their teeth, gums, and mouth. This may be due to the symptoms of their health condition, need for medications that contain sugar, diet, trouble with eating, or oral sensitivity. Dental care may take a back seat to other burning medical issues. Yet, because of the greater risk for children with special needs, it is vital to practice good oral health care

Common Dental Concerns

Your child may have dental problems as a result of their health condition or from treatments, therapies or medicine that they take.  Talk with your child’s dentist and paediatrician about any questions or issues that you have.  Ask how medicine, treatment, or diet may affect your child’s oral health.

Your child’s condition may affect:

• How their teeth and oral structures will grow.
• How the calcium is laid down in the tooth’s enamel (the tooth’s top layer) as the teeth grow
• How much spit (saliva) your child makes in their mouth: saliva helps clear food and protects teeth.
• How often and what your child is able to eat: soft foods and liquids do not give the teeth, gums, and muscles of the mouth the stimulation they need.  Children who use Gastric tubes are still at risk for cavities and may be more likely to build up tartar on their teeth, making it important to keep their teeth and gums cleaned and cared for.

Common dental concerns in children with special needs:

• GERD (gastro-oesophageal reflux disease):  GERD can cause your child’s mouth to be acidic which can wear down the teeth. Your dentist may prescribe pastes to help prevent teeth damage from the acid.
• Holding food in the mouth:  some children will hold food in their mouth or cheeks much longer than usual (this is called food pouching). This creates a good place for bacteria that cause cavities to grow.
• Grinding (bruxism):  your child may grind or gnash their teeth while sleeping or during the day. Over time, grinding can damage teeth. This is common and most children outgrow the habit.  Treatments are available if it becomes a problem.
• Bad breath:  some digestive problems, chronic sinusitis, diabetes, and certain medications may cause bad breath.
• Dry mouth:  may be a result of your child’s condition or from medication. This can affect nutrition and can lead to tooth decay, gum disease, and mouth infections. Check with your dentist and your child’s doctor for treatment ideas.
• Delay in first teeth coming in:  This is common in children with Down syndrome.
• Medicine can affect teeth and gums: liquid syrups and medicines with sugar can cause cavities. Other medicines can cause dry mouth and reduce how much saliva (spit) your child makes.  These may include: antihistamines, antidepressants, anti-GERD medicine, sedatives, and barbiturates.  Some seizure medicines may cause enlarged gums, causing them to bleed.  Help reduce the impact of medicine by rinsing or spraying your child’s mouth with water after each dose.

Tips for a Healthy Mouth

Daily tooth and mouth care

• Start cleaning your infant’s gums with a soft baby toothbrush or cloth and water.
• Begin brushing twice daily with fluoride toothpaste when your child’s teeth begin to come in.
• Use a very thin smear of toothpaste on the toothbrush.
• When you are away from home, rinse your child’s mouth with water after meals, snacks, and giving medicine.
• If your child wants to brush, make sure you do a thorough cleaning at the end of the day. After your child brushes, you “check” with the toothbrush and finish with a thorough cleaning.

Q: Do special children have special dental needs?

Most do. Some special children are very susceptible to tooth decay, gum disease or oral trauma. Others require medication or diet detrimental to dental health. Still other children have physical difficulty with effective dental habits at home. Dental disease is preventable. If dental care is started early and followed conscientiously, every child can enjoy a healthy smile.

Q: How can I prevent dental problems for my special child?

A first dental visit by the first birthday will start your child on a lifetime of good dental health. The paediatric dentist will take a full medical history, gently examine your child’s teeth and gums, and then plan preventive care designed for your child’s needs.

Q: Will preventive dentistry benefit my child?

Yes! Your child will benefit from the preventive approach recommended for all children- effective brushing and flossing, moderate snacking, adequate fluoride. Home care takes just minutes a day and prevents needless dental problems. Regular professional cleanings and fluoride treatments are also very beneficial. Sealants can prevent tooth decay on the chewing surfaces of molars where four out of five cavities occur.

Q: Are paediatric dentists prepared to care for special children?

Paediatric dentists have two or more years of advanced training beyond dental school. Their education as specialists focuses on care for children with special needs. In addition, paediatric dental offices are designed to be physically accessible for special patients. Paediatric dentists, because of their expertise, are often the clinicians of choice for the dental care of adults with special needs as well.

Q: Will my child need special care during dental treatment?

Some children need more support than a gentle, caring manner to feel comfortable during dental treatment. Restraint or mild sedation may benefit your special child. If a child needs extensive treatment, the paediatric dentist may provide care at a local hospital. Your paediatric dentist has a comprehensive education in behaviour management, sedation and anaesthesia techniques. He or she will select a technique based on the specific health needs of your child, and then discuss the benefits, limits and risks of that technique with you.