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
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. AutismSpeaks.org provides a comprehensive dental guide that covers at-home care to dental
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
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
- Inform the dentist about your special health or financial conditions.
- Ask if the dentist has training and/or experience in treating patients with your
- 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