When Dr. Paddy was earning his degree to become a pediatric dentist, he also underwent advanced training to learn the ins and outs of dentistry for special needs patients. The additional education is necessary because there are challenges and considerations for children with certain developmental, emotional, physical, cognitive or medical conditions. While the truth is, all kids are unique, which is why we offer personalized care that takes into account their personalities and preferences, some young patients have dental anxiety, sensory likes and dislikes, medical issues and other factors that make visiting the dentist and even brushing and flossing difficult. We know that every case is different, however, based on our experience at Kids Mile High Pediatric Dentistry, there are some steps parents can take to help boost the dental health of kids with special needs.
Why Kids With Special Health Care Needs May be at Risk for Oral Disease
The American Academy of Pediatric Dentistry defines special health care needs as “developmental, mental, sensory, behavioral, cognitive, or emotional impairment or limiting condition that requires medical management, health care intervention, and/or use of specialized services or programs.” When kiddos have special health care needs, they have a higher risk of developing oral diseases ranging from gum disease to cavities. Since children’s dental health is so closely tied to their overall health, preventing and promptly treating any issues are extremely important. So, why the increased risk of dental problems?
- Some medications, especially when taken on a daily basis for a chronic condition, can cause dry mouth or the overgrowth of gum tissue, both of which are no good for oral health. Additionally, flavored medications often contain sugar.
- Muscle issues, problems with fine motor skills and other physical limitations can make brushing, flossing and sitting in a dentist’s chair for an exam challenging.
- For patients on special diets that are high in carbohydrates, the starches can sit on the teeth for too long causing tooth decay as the acid-producing bacteria in the mouth love to chow down on carbohydrates.
- Parents may be overwhelmed with other doctors’ appointments and the cost of care, so dental health takes a back seat.
- Sensory or oral defensiveness means that for some special needs kids brushing teeth is unpleasant.
- Genetic disorders, such as Down syndrome, can cause the teeth to erupt later than usual or lead to extra, missing or misaligned teeth, eventually resulting in gum disease, uneven wear and tooth decay.
- Children with an impaired immune system are more susceptible to oral disease.
- Some conditions make children prone to grinding their teeth, which wears down the enamel.
- Sensory seeking kids or those with attention difficulties who crave constant movement, may find brushing their teeth and flossing incredibly boring and hard to commit to.
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Tips to Improve the Dental Health of Kids with Special Health Care Needs
Now that we’ve addressed why children with special health care needs are at a higher risk for gum disease, tooth decay and other dental health issues, you’re probably wondering what to do about it. Here are some suggestions for promoting oral health:
Regular Dental Visits
- Find a pediatric dentist you trust with experience in treating children with special health care needs (we’re partial to Dr. Paddy, of course!). A fun, welcoming, accessible office is always a plus. A specialist in pediatric dentistry will have training in different behavioral techniques (tell-show-do, distraction, positive reinforcement, etc.) as well as in other options that can make treatment more comfortable and safer, such as protective stabilization and sedation.
- Having a dental “home” is important. Your provider will learn about your child’s health and dental history and their preferences and needs so visits will be a breeze and an appropriate homecare routine can be developed. It allows your little one to get comfortable with the office, the staff, the doctor and exams. Since pediatric dentists are used to a wide range of reactions from their patients, don’t stress yourself unnecessarily worrying if your child will scream, squirm or act out in some way because we’ve seen it all and we know how to handle the situation with compassion and composure.
- Check out our post on helping kids overcome a fear of the dentist. The suggestions, which run the gamut from playing pretend to reading books about dental visits, are effective for a lot of children regardless of their health care needs.
- Bring your child’s favorite toy or object with you to their dental appointments to help ease anxiety.
- Visit the dentist a few times before actually scheduling any procedures so it becomes a familiar environment. You might even want to take your child with you to your own dental appointments.
- Focus on prevention. Be sure to ask your dentist about the steps you can take to ward off tooth decay and gum disease, particularly if your child takes medication with oral side effects, follows a special diet or has habits like teeth grinding. Sealants can be a great option for reducing the risk of cavities. Topical fluoride treatments or mouth rinses might also be beneficial. In some cases, more frequent trips to the dentist will be necessary.
Homecare
- Brushing twice a day and flossing once daily are the best ways to keep your child’s mouth healthy. Yet, we know for children with special needs, this is easier said than done. Keep trying different tactics until you find the one that’s most successful for your child. Be sure to supervise the process and step in when you have to so their pearly whites remain cavity-free.
- Adopt some of the techniques your pediatric dentist uses including tell-show-do where you tell your child what you’re going to do and why and then show them how it will be done (you can illustrate on yourself or a stuffed animal) before getting down to business. After a few appointments, you should be able to get a good idea of what works and what doesn’t and incorporate what’s effective into your homecare regimen.
- Make it a family affair by brushing together. Let them watch you brush and floss your teeth and model the proper technique. If they’re okay with a toothbrush, you can even have them chew on their own toothbrush while you get your mouth sparkling clean.
- Establish a routine. Brush and floss in the same place, at the same time, every single day. Familiarity is comforting and it will eventually become a habit.
- Don’t underestimate the power of music. Put your child’s favorite song on or sing songs while brushing and flossing. It can be a great distraction if they have an aversion to the feel of the toothpaste or toothbrush and it will keep them from getting bored.
- Fraser, a special needs organization, has a great method to try if your child has sensory defensiveness or oral sensitivity. You begin by applying pressure to the back of their head before moving on to other parts of their face and working your way up to their lips over a period of days, weeks or even months. When they’re comfortable with that, repeat the process with a wet wash cloth. Eventually, encourage them to chew on the wash cloth. Once you’ve successfully been able to touch their teeth with it, switch to a finger toothbrush or regular toothbrush (without toothpaste) and again go through all of the steps. Get them involved in the experience and stick with it until they can tolerate the toothbrush. The final step will be adding toothpaste to the mix. You can experiment with different toothbrushes and toothpastes. There are also specialty toothbrushes created specifically for people with sensory integration issues that might be helpful. Consider the addition of a weighted blanket or noise-canceling headphones to reduce other sensory stimuli.
- If the taste or feel of toothpaste is unbearable, your child has trouble spitting or they have a severe gag reflex, you can try using just a dab of fluoridated toothpaste or chat with your dentist dentist about a fluoride rinse. Instead of swishing, a mouthwash can often be diluted and applied with a toothbrush. You can minimize a gag reflex by having them hold their chin in a neutral or downward position and brushing before they eat or drink in the morning.
- If your child moves around a lot, constantly puts things in their mouth (sensory seeking) or has a condition that makes sitting still difficult like ADHD, going with a vibrating toothbrush, either rotary or sonic electric, fun toothpaste flavors and kid-friendly floss can work wonders. Put on a timer to ensure they’re brushing for the recommended time and try out different methods such as brushing while moving around or making a game out of it.
- Sometimes limited coordination and motor skills make holding a regular toothbrush impossible. There are a bunch of DIY toothbrush modifications that could solve the problem, such as building up the handle with tape, using a Velcro® strap to attach the toothbrush to your child’s hand, which also happens to work for utensils too, cutting a small slit into a tennis ball and slipping the toothbrush handle into it or sliding the handle into foam tubing.
- If your child is unable to floss or brush themselves, The National Institute of Dental and Craniofacial Research has a guide on how to floss for them as well as how to position your body to ensure brushing and flossing are comfortable and safe. A Waterpik is another solution when flossing is difficult. There are also video tutorials that walk you through techniques.
- If necessary, enlist an adult to help. One person holds, comforts and distracts your child while the other does the brushing and flossing.
- Watch your child’s sugar and starch intake. If they need to eat a carbohydrate-rich or soft foods diet, have them brush after meals or at least rinse with water.
- Consult with your dentist about the oral side effects of your child’s medications. If there are no alternatives and it can lead to dental problems, try to balance it out. Things like dry mouth can often be counteracted by drinking lots of water or chewing sugar-free gum.
If these general pointers aren’t effective, ask your dentist to help you develop a plan that’s customized to your situation. On the lookout for a Denver pediatric dentist experienced in treating kids with special needs? Schedule a visit at Kids Mile High in Englewood, CO. Dr. Paddy and his team have the training, tools and sparkling personalities to ensure a stress-free, positive experience. We get to know each and every patient, really listen and then tailor our approach. Dr. Paddy is well versed in working with children with special health care needs and their families to give them the care they deserve and put them on the path to a lifetime of stellar oral health.
