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Promoting oral care in special needs children

Children with special needs—behavioral issues, developmental disorders, cognitive disorders, and systemic diseases—face an increased risk for developing oral disease, according to the American Academy of General Dentistry.

This population includes approximately 17 percent of US children. The AGD cites special diets, frequent use of medication and lack of proper oral hygiene as reasons maintaining good oral health presents a challenge. Practicing vigilance when it comes to oral health is especially important to these children.

For instance, special diets can cause concern when high-carbohydrate drinks that demineralize teeth are consumed in high quantities; medications may be made of sugary syrups, which results in sugars pooling around teeth and gums and promoting tooth decay.

Proper hygiene can be impacted a number of ways. Children with special needs may have dexterity issues that make brushing their own teeth difficult. They may also have sensory issues that make teeth brushing and flossing physically unpleasant.

Among its “Dental Health Care Tips for Children with Special Needs,” the Kern County Children’s Dental Health Network lists the following ways parents and caregivers can ease the stress of brushing and flossing for special needs children:

  • Try the tell-show-do approach. Tell your child/patient what you are going to do before you do it. Show how you are going to do each step before you do it. Do the steps in the same way that you have explained them.
  • Help your child/patient care for their own teeth. If it is helpful, assist them in using a modified toothbrush (you can put the toothbrush handle in a tennis ball or bicycle handle for easier grip, or use tape or velcro to help them hold it—or an electric toothbrush may be advisable). There are also modified flossers.
  • Choose the same time, position (sitting or standing), and place (room) every day for oral care procedures. Soft light and relaxing music may help.
  • Allow the child/patient to have a comfort toy such as a stuffed animal or blanket may be helpful.

Blogs such as The Autism Angle offer practical suggestions for oral hygiene in autistic children. provides a comprehensive dental guide that covers at-home care to dental office visits.

Finding a dentist

At home care is important, and regular checkups are equally so. In addition to an increased risk for oral disease, children with special needs often have disturbances in oral development. Those who experience seizures or intellectual disability may have increased risk for oral trauma or teeth grinding. The National Institute for Craniofacial Research further outlines potential problems in its “Oral Conditions in Children with Special Needs: A Guide for Health Care Providers.

Feeling comfortable that your dentist can meet your child’s needs and make his or her office visit as pleasant as possible is important. You may want to ask other parents or your child’s other health care providers for recommendations. If you already have a dentist, contact his or her office to discuss your concerns and see if he or she can accommodate your child’s needs.

For anyone with special needs looking for dental care, the ADA Council on Access, Prevention and Interprofessional Relations also suggests the following tips, as listed on WebMD:

  • Inform the dentist about your special health or financial conditions.
  • Ask if the dentist has training and/or experience in treating patients with your specific condition.
  • Ask if the dentist has an interest in treating patients with your specific condition.
  • Find out if the dentist participates in your dental insurance program.
  • Ask if the dental facility is accessible to the disabled.

In addition, the Council suggests that patients with special needs:

  • Contact the dental director at your state department of public health. The ADA's web site provides information on locating this person.
  • Contact the nearest dental school clinic or hospital dental department, especially if it is affiliated with a major university.
  • Contact the Special Care Dentistry Association at 312-527-6764.

Depending on your child’s individual needs, you may or may not wish to seek out a dentist who specializes in special care. As defined by the Special Care Dentistry Association, special care is a branch of dentistry that provides oral care services for people with physical, medical, developmental, or cognitive conditions that limit their ability to receive routine dental care.

Many dental organizations and advocacy groups for special needs populations are working to educate dentists in treating such children. The American Academy of Pediatric Dentistry published and continues to update a “ Guideline on Management of Dental Patients with Special Health Care Needs,” to better inform health care providers, parents, and ancillary organizations.

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