Oral Health for Children with Disabilities and Special Needs

Children with disabilities and special needs are at greater risk for health problems, require extra help and rely on others to achieve and maintain good health. Oral health is no exception. A clean mouth is one of their most important health needs for life and will be infl uenced by your ability to provide necessary support.

Who are children with special needs?

Children with special needs are those who have or are at increased risk for a chronic physical, developmental, behavioral or emotional condition and who also require health and related services of a type or amount beyond that required by children generally.

Why are they at higher risk?

Common oral problems, such as tooth decay or gum disease, affect all children. But children with disabilities and other special needs have more oral health problems than the general population. For example, children with disabilities may have impaired cognitive abilities, behavioral problems, impaired mobility, neuromuscular problems (drooling, gagging and swallowing problems), uncontrolled body movements, gastroesophageal refl ux, or seizures. These complications can be barriers to adequate oral care and put them at higher risk for developing oral health problems.

What causes oral health problems in children with disabilities?

Some contributing factors to poor oral health in children with disabilities and other special needs are:

• Oral Conditions. Some genetic disorders in young children can cause defects in tooth enamel, missing teeth and teeth that do not align properly. Children with Down’s syndrome often suffer from gum disease.
• Physical limitations. Children who cannot chew or move their tongues properly do not benefi t from the natural cleaning action of the tongue, cheek, and lip muscles.
• Difficulty brushing and flossing. Children 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.
• Reduced saliva flow. Children who need help drinking may drink less fl uid than other children, and may not have enough saliva in their mouth to help wash away food particles.
• Medications. Children using sweetened medications for a long time can get tooth decay. Some anti-seizure medications may cause swelling or bleeding in the gums.
• Restricted diets. Children who have diffi culty chewing and swallowing may often eat puréed food which may stick to their teeth.

Which children may require special oral health care?

Children may need special oral health care if they have any of the following conditions: Down’s syndrome, epileptic or seizure disorders, cleft lip or cleft palate, other structural anomalies of the head, face, and/or mouth, cerebral palsy, learning or developmental disabilities, vision or hearing impairments, or HIV infection.