When it comes to oral health care special needs children, usually tend to get overlooked for various causes. Children in general need to be soothed before going to the dentist but if a child has some special needs s/he may need additional time and support. As many children find it difficult to undergo surgeries or even sitting on the dentist’s chair for that matter, both primary as well as comprehensive therapeutic oral care needs to be provided to kids with special needs.
Children with special needs like Down syndrome, cerebral palsy or mild anxiety disorders need special attention. Tooth eruption in case of children with growth disturbances for instance may be hindered, fast-tracked or erratic. Gums may even become sore before the teeth erupt in the mouth. It depends on hereditary traits, jawline development, muscular action and other factors. Children with Trisomy 21 tend to show postponements in teething up to the period of 2 years.
Tailored dental care needs to be provided to children who require consideration beyond routine approaches as they present a varied array of disorders and impairment stages.
Usually there is a hindrance in maintaining oral hygiene in case of poor motor coordination as it constrains the natural sanitizing ability of the lips, tongue and cheeks. Furthermore habits like keeping food in the mouth for a long time or breathing through the mouth also interfere with self-sanitizing abilities.
More often than not medications tend to be sweetened with syrup or sugar. Even special diets of pureed foods are susceptible to sticking to the teeth – which further contributes to the decaying of teeth. Sometimes several problems are caused by drugs used to treat disability. Anti-seizure drugs may trigger gingival overgrowth which tends to hinder speech and chewing. It also causes gingival bleeding and periodontal diseases.
Certain sedative drugs adopted for muscle control may also reduce the generation of saliva that protects the teeth. As children with mental disability are unable to express themselves it is fundamental for caregivers to be alert about their oral hygiene.
The mobility of hands can be a problem for certain children hence making the process of cleansing the mouth all the more tedious. Usually, dentists suggest toothbrushes with small to medium heads with bristles that are soft to medium. Moreover, you can also avail special handgrips and other adaptations that can be attached to manual toothbrushes. Electric or power toothbrushes are also recommended in certain cases. People with learning difficulties can also find these helpful as they will be a novelty and encourage them to brush their teeth.
Caregivers must adopt methods that help in desensitizing their charges to dental treatment. They should acquaint the children with a daily tooth brushing routine and about proper oral care at home in comfortable surroundings. Dental team members must instruct them about proper techniques to avoid injury.
Caregivers should also familiarize children to the environment of the dental clinic. Having the child drop by the office and bond with the staff, will help them relax during treatment.
Protective Body Stabilization Disabled patients frequently have problem with support, balance and even aggressive behavior. Sudden movements can endanger the child as well as the dental team. Hence severe cases require hospitalization, sedation or general anaesthesia.
However a complete consultation can be given only after getting a holistic view of the child’s oral health. The family, caregiver, physician, social services and the dental team altogether make the health care team and communication between them is a mandate.