Managing the dental care of children with special needs
Managing the dental care of a child with special needs requires careful consideration.
A child with special needs may have mobility issues, (for example, as seen in children with cerebral palsy), have a behavioural condition, such as autism spectrum or Attention Deficient Hyperactivity Disorder (ADHD), or have another physical or intellectual disability.
Children with special needs can have unique issues when it comes to caring for the health of their teeth and gums. This may be due to symptoms of their medical condition, which can affect how their teeth and mouth grow, how calcium is laid down in the tooth’s top layer (enamel) and how much saliva is made.
Children with special needs may have oral sensitivity, making it difficult for them or for a parent/carer to assist with brushing at home. Some medicines can also affect teeth and gums. Medicines that cause the side effect of reducing the amount of saliva and those that contain sugar increase the risk of developing decay.
Children with special needs may require a specific diet. For example, diabetic children need to have juice or sweets at regular intervals which poses a risk to the health of the teeth. Some children have trouble with eating and swallowing food. Holding food in the mouth (this is called food pouching) can increase the risk of decay and bad breath, as bacteria will grow in these areas.
Gastro-oesophageal reflux (GERD) is another concern in children with special needs. GERD can cause the mouth to become acidic so teeth are worn down. Tooth grinding (bruxism) is another common concern in these children. When a child grinds or gnashes their teeth throughout the day or while sleeping, damage to the teeth can occur. Children with special needs may take longer to have new teeth come through the gums. This is a common issue for children with Down syndrome.
For these reasons, it is essential that children with special needs be able to access a specialist paediatric dentist to be examined early, so families can learn how to prevent dental infection in their child and practise good oral health care. Unfortunately, dental care may take a back seat to burning medical issues, resulting in these children having a greater risk of dental and gum problems.
In the context of dentistry and oral health, a child with special needs requires a change in regular approaches to dental care in order to receive treatment.
It can take more visits than usual to get the treatment finished. It is imperative to be patient and to slowly prepare the child for each step we take. A team of passionate people who have energy a good sense of humour is important to meet the needs of these children.