Children with special needs include those with intellectual, emotional or physical disabilities, as well as those with chronic and complex medical problems. Meeting the oral health care requirements for these children can be a difficult task – not only for them but for their caregivers and dentists as well.
There are many serious oral health issues that are linked directly to certain medical conditions that affect children with disabilities.
The following oral conditions can occur in children with special needs:
- Teeth grinding (bruxism) affects children with cerebral palsy and other severe or profound levels of intellectual disability. Severe tooth wear from grinding can result in teeth being worn flat or tooth abrasion – which can lead to tooth loss.
- Dental trauma (injury) is most common in children who experience seizures, uncontrolled protective reflexes or poor muscle coordination.
- Dental/oral anomalies are abnormal variations in the development of teeth that are linked to inherited defects or spontaneous genetic mutations. Tooth anomalies include malformed, missing or extra teeth. They can affect children with ectodermal dysplasia (a genetic disorder that affects teeth, hair, nails and sweat glands), Down syndrome or cleft lip and/or palate.
- Early onset periodontal disease may be experienced by children with immune response and connective tissue disorders.
- Early, late, stagnant or erratic tooth eruption may happen to children with growth disturbances in their tooth formation and development.
- Malocclusion (misalignment of upper teeth with lower teeth) and teeth crowding create problems for oral health care because affected teeth and their interdental spaces are harder to clean. Children with developmental disorders, craniofacial anomalies, muscular dystrophy and intellectual disabilities may be affected.
In addition to the oral health conditions associated with a specific health disorder or disability, children with special needs may require assistance when going to see a dentist for their oral health care.
Children who experience physical disabilities may need help with physically accessing the dental environment, such as the dental chair. If that child experiences involuntary movements or reflexes, then safety measures need to be taken to ensure that they can receive dental treatment safely – especially when a dentist is using potentially harmful dental tools on a patient who cannot sit still.
For children with intellectual or behavioural problems (e.g. autism spectrum disorders), even the thought of visiting a dentist and entering a dental treatment room may cause them anxiety and distress.
If a child has a serious medical condition, such as HIV/AIDS or cancer, safety and preventative measures need to be in place before or during dental treatment.
It is vitally important to take into consideration all the needs of a child with a disability when planning, adapting and providing their oral health care. And don’t forget your family dentist who can support and guide you all the way.