Special Needs Dental Care

Disabling conditions can make it difficult to accomplish basic dental care needs.

Everyone deserves a healthy smile. However, dental care is one of the most seriously neglected issues for children and adults with physical, medical and mental disabilities. Disabling conditions can make it difficult to accomplish even the most basic dental needs ― brushing, flossing, regular dental checkups and getting a balanced diet needed for healthy teeth.

Some medical or oral conditions may require more specialized care, but most people with disabilities can be successfully treated in a general dental practice. Regular checkups and some tips for good dental hygiene can help prevent toothaches and other dental problems.

Tips for Caregivers Who Help with Oral Hygiene

• Before beginning an oral hygiene task, explain what you are about to do. "I am going to brush your teeth now." Or "I am going to help floss your teeth now.".
• Work in a slow, calm manner to avoid startling the person.
• Support the person's head. Take care to prevent choking or gagging when the head is tilted back.

If the person is unable or unwilling to keep his or her mouth open, consult your dentist for possible solutions.

Tips for Holding On To Your Toothbrush or Dental Floss

When it is difficult to hold on to dental hygiene devices, the dentist can make suggestions for changes that can be made at home.

• Use a wide elastic band to attach the brush to the hand.
• Enlarge the brush handle with a sponge or rubber ball. Or widen the handle by wrapping it with an elastic bandage or adhesive tape.
• Lengthen the handle with a piece of wood or plastic by taping on a ruler, wood stick or tongue depressor.
• Tie floss into a loop for easier handling.
• Use an electric toothbrush or commercial floss holder.

Children with Special Needs

Children with special needs often have unique challenges that make dental visits and good oral health habits extremely difficult. For example, many children with autism have sensory challenges that make touch, smell, sound, and light uncomfortable or even intolerable. Children with autism also have difficulties with new experiences and unfamiliar people.

• Plan a pre-appointment visit to the dental office to familiarize the child with the setting. Ask your dentist for tips that can help your child feel comfortable.
• Schedule appointments during less busy times; avoid the after-school rush.

Dental Care Tips for Children with Special Needs

Home care takes just a few minutes and helps prevent dental problems. Effective brushing, flossing and moderate snacking are important for teeth throughout one's lifetime. Here are a few tips:

• Start regular dental visits by the child's first birthday ― or earlier if you think there might be a dental problem.
• Set up regular professional cleanings and fluoride treatments.
• Ask your dentist about sealants. Sealants can prevent tooth decay on the chewing surfaces of molars where most cavities occur.
• Pediatric dentists have additional training beyond dental school and may be a good choice for ongoing care of your special needs child.

Visual Communication Tools for Special Needs Children

Empower children by providing alternative ways of communicating.

• Use a card with a visual symbol to express when it is time to take a break (for example, a stop light with green, yellow and red options).
• Another example is a pain rating scale to communicate discomfort. The scale typically has a range of 1 to 5, or 1 to 10. The child points to the number that corresponds with his/her discomfort level, with lower numbers representing less stress. A similar idea would be to create a scale using a series of faces that are sad, scared or happy ― to help the child communicate emotions.

See your dentist for additional ideas. It is important for the child to understand how to use any visual supports or communication tools prior to visiting the dentist. Before visiting the dentist, practice at home.

Preparing Children for the Trip to the Dentist

A trip to the dentist can be a scary or intimidating experience for a child. Many children feel anxiety during dental visits when new or uncomfortable procedures are performed. Noises, such as the sound of a drill, can be scary. Not being able to speak (because dental tools are in the mouth) can cause additional stress.

• Some dental offices provide audio or video equipment upon request or allow families to bring items with them.
• Use earplugs to muffle the noises that cause stress.
• Have the child bring along a favorite toy to help ease anxieties.

Note: Before packing any of these items, parents should contact the dental office to be sure the items will be allowed in the exam area.

A child's first successful dental visit can provide the foundation for a lifetime of good oral health. It is important for parents and children to feel comfortable with dental professionals. If your child does well with a certain hygienist or dentist, ask to see the same person next time. This provides consistency as the professional becomes familiar with your child's needs.

Care Beyond the Routine

With the demands of a disease, disabling condition or simply difficulty in getting around, the oral health of special care individuals is too often neglected.

When special care is needed, ask questions:

• Does the dentist have experience in treating patients with disabilities?
• Is the dental office accessible?