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A special needs child requires much from
those around him - patience, attention and
love. Dental health is one more important
need. Often dental care is delayed because
of the pressures of more immediate health
problems.
A healthy mouth is an important part of total
health. It can improve eating, speaking, and
how the child looks and feels about herself.
A diseased mouth can cause the following:
- difficulty in chewing and swallowing
which can take the pleasure out of eating,
and lead to a poor diet
- decayed teeth and swollen, bleeding
gums, which are foul smelling,
unhealthy, and often painful to the child
- poor speech which
can interfere with school work and making friends.
Dental disease is almost 100% preventable.
Preventing dental disease is especially
important for individuals with special needs.
Getting to the dental office can be more
difficult, and restoring the mouth is often
more complicated. Dentures are not always
possible. People with uncontrolled muscle
movements may not be able to learn to keep
a partial or complete denture in place.
Special needs children are at
greater risk for dental disease.
There are a number of reasons why children
with disabilities are more likely to have
dental disease. Some of these are:
- Oral conditions. Some genetic disorders
or very high fevers in young children can cause defects in tooth
enamel that make
decay more likely. Congenitally missing
teeth and teeth that do not align properly
are often seen in children with cleft
palates. Gum problems often occur in
children with Down’s Syndrome.
- Physical limitations. Children who cannot
chew or move their tongues properly
do not benefit from the natural cleaning
action of the tongue, cheek, and lip
muscles. Children with disabilities,
especially those with poor motor
coordination (such as spinal cord injuries,
muscular dystrophy, or cerebral palsy)
may not be able to clean their own teeth or
use the usual brushing and flossing
methods.
- Special diets. Children who have
difficulty chewing and swallowing may
often eat puréed foods, which tend to stick
to their teeth. Frequent eating of sugary
foods or sleeping with a bottle of formula,
milk or juice can increase the chances for
tooth decay. Children who need help
drinking may drink less fluids than other
children, so they do not have enough fluids
in their mouth to help wash away food
particles.
- Medications. Medications using syrup or
sugar to sweeten the taste can cause tooth
decay if they are taken for a long time.
Some anti-seizure medications may cause
bleeding or enlarged gums. Excessive
gum growth can hamper chewing and
speech and lead to gum disease. Sedatives,
barbiturates, antihistamines, and drugs
used for muscle control may reduce saliva
flow. With less saliva, there is less
cleansing action to help protect the teeth against cavities.
Aspirin, taken in large
doses, and dissolved in the mouth before
swallowing, can provide an acidic
environment which can cause tooth decay.
Antibiotics should be prescribed cautiously
because they can stain or discolour newly
erupting teeth.
Diet
Plaque is a layer of sticky, almost invisible
germs that stick to our teeth, gums and
tongue. Plaque causes cavities, gum disease
and bad breath. Plaque uses the sugar from
the foods we eat and drink to make harmful
acids. These acids attack the tooth and cause
cavities.
Sugar is a major cause of tooth decay. The
more often you eat sugar and the longer it
stays in your mouth, the more harm it can
do. To prevent decay:
- avoid sweet snacks, including raisins and
other dried fruits that are sticky and high
in sugar
- avoid serving sugary foods. If you serve
sugary foods, serve them with a meal
when the acid will do less harm
- read food labels. Look for hidden sugars
such as sucrose, dextrose, corn syrup and
honey are all sugars
- offer low sugar substitutes such as
cheese, hard boiled eggs, pizza,
vegetables, and fresh fruits
- offer milk, water or vegetable juices
instead of sweetened carbonated
beverages and fruit drinks.
Fluoride
Fluoride makes the teeth stronger. Fluoride
can be placed on the teeth in a dental office
(liquid or gel), and it can be used at home
(fluoride toothpastes, fluoride mouth rinses
and fluoride drops/tablets). Teeth are protected best when drinking
fluoridated
water daily.
Sealants
Another way to prevent tooth decay is to
have your dentist paint a plastic coating
called a dental sealant on the teeth. Sealants
are placed on the chewing surfaces of the
permanent molar teeth and bicuspids. This
seals the chewing surfaces and protects the
teeth from decay.
The Dental Office
A dental examination is recommended by
age one. Many dentists prefer to work with
the medical team as soon as a special needs
child is born. Although teeth are not present,
this is a good opportunity for the dental staff
to provide preventive instruction to the
caregiver. Regular dental examinations
should continue every year or more often if
recommended by the dentist. The dental
staff will adapt to the special needs child.
For example, the examination area may be
modified to accommodate a wheel chair.
Mouth props to help the child hold his mouth
open and finger guards to protect the dentist
are often used.
Dental care may take place in short time
periods. This helps to keep the child’s
attention and helps her feel less afraid of this
new experience. If a child has trouble
speaking, seeing or hearing, the dental staff
may need to take more time.
Occasionally, it may be necessary to provide
dental treatment under general anesthetic in
a hospital operating room. Dental treatment
done under general anaesthetic has risks. It
should be considered carefully before
proceeding. For more information contact
the
Oral Health Program at
(306) 655-4462
© 2008, Saskatoon Health Region.
(updated February 18, 2009)
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