Special Needs Dentistry
According to a 2010 report by the US Census Bureau, 56.7 million or one-in-five Americans had some kind of disability. As per the Americans with Disabilities Act (ADA), a person with a disability is someone who is physically or mentally impaired.
Good dental care is crucial for the general well-being of special needs patients. A preventive and therapeutic dental program for special needs patients is the priority.
Our article walks you through special needs dentistry for adults and children, dental hygiene tips for parents and caregivers, and much more.
Who Are Dental Patients with Special Needs?
Special needs patients are those who have medical, developmental, physical, and cognitive conditions that limit one or more life activities and make dentistry more challenging. They do not accept any change in their everyday routines and require special considerations when receiving dental treatment.
Dental patients with special needs include:
- Patients with mobility issues
- Mentally-challenged patients
- Patients with mental illness
- Patients with complex medical issues
- Children with emotional or behavioral conditions such as Autism and ADHD
- Children with chromosomal abnormalities and anomalies such as down syndrome, cerebral palsy, etc.
People with special needs often have poor oral hygiene resulting in more cavities and gum diseases than the general patient population. Hence it becomes crucial to keep them under observation.
Special Needs Dentistry
Special Needs Dentistry is a branch of oral care that treats special needs patients.
A dental professional is someone who is trained in preventive, diagnostic, and treatment services. They can treat various medical conditions that require more than just routine oral care and tailor it to every person’s needs.
As such, it becomes essential that you find someone who is dedicated to promoting oral health care for special needs patients. You can find this information at Special Care Dentistry Association (SCDA).
Special Needs Dentistry for Patients with Special Health Care Needs
Dental care to patients with special needs cannot be the same as that of the general population. It needs to be modified according to physical limitations, mental impairments, developmental problems, and medical complications.
- Patients with mobility issues will need help getting in and out of the dental chair. They may require modified equipment if they cannot get out of their wheelchair for some reason.
- Mentally challenged patients with intellectual disabilities may not comprehend the oral care instructions given by the dentist.
- Patients with mental illness need shorter appointments scheduled, especially when they are in a balanced state.
- For patients with complex medical issues like cardiovascular or diabetes, the dentist may consult with their physician before issuing medications.
- The elderly may need frequent dental visits to control the pain, observe tooth wear and treat accordingly.
- Children with emotional or behavioral conditions such as Autism and ADHD cannot handle changes and prefer seeing the same dental team every visit.
- Children with chromosomal abnormalities would have difficulties communicating depending on their severity. As such, the dentist should be able to communicate with them using pictures if they are non-verbal.
What Do Dental Patients with Special Needs Require?
Since the treatment needs of a special needs patient are different from that of the general populace, you require experienced health care professionals. The dental treatment planning and the requirements will be different for each individual.
Dental patients with special health care needs will need the following accommodations:
- Appointments need to be short and to the point; To achieve this, there should be a thoughtful and well-organized approach to examining and dental treatment.
- The dentist should be knowledgeable about the medical, physical, or mental condition of the patient. This helps him/her better manage the patient’s oral health needs.
- Make the patient’s comfort the priority and sedate in the case of longer appointments.
- Flexible appointments and scheduling.
- More assistants and technicians in the dental team during the appointment to better monitor and control the patient if needed.
- Involve the case manager or the caregiver when you are formulating a treatment plan. Ensure they are present during the dental procedures.
- Dentists should also provide the caregivers with home care instructions.
Oral Health Care for Children with Special Needs
As with adults, children with special needs also have unique issues related to oral care. The reason being their developmental delays, oral sensitivity, trouble with eating, etc. The typical medical conditions requiring special needs dental care include:
- Cleft lip or palate
- Cerebral Palsy
- Down Syndrome
- Vision and/or Hearing Impairment
- Neurological Disorders
In the face of the multitude of medical, developmental, and behavioral issues the children face, dental care may take a backseat. But the risk is greater with special needs children, and they require extensive dental care.
It is crucial that the parents encourage good oral health care.
Common dental problems faced by children with special needs:
- GERD or gastroesophageal reflux disease causes your child’s mouth to be acidic, which wears down the enamel.
- Children may sometimes hold food in their mouth for a long time leading to bacterial growth, causing cavities in the long run.
- Diabetes, chronic sinusitis, and digestive problems can cause bad breath.
- Children with Down syndrome may have a delay in cutting their first teeth.
- Some children may grind their teeth which can cause damage in the long run.
- The ongoing medications can cause dry mouth, which leads to gum disease, tooth decay, and infections sooner rather than later.
- Apart from dry mouth, medications like anti-GERD medicine, antihistamines, antidepressants, sedatives, and barbiturates cause cavities due to the sugar content present. Seizure medicines, on the other hand, cause enlarged gums or bleeding gums.
Special Needs Dentistry for Cerebral Palsy
Cerebral palsy is a collection of motor abnormalities and functional impairments. It is also associated with health challenges such as developmental disabilities, uncontrolled body movements, improper muscle coordination, seizures, sensory issues, intellectual disability, and more.
Cerebral palsy in itself doesn’t cause any oral deformities, but many of its associated symptoms can cause problems.
- Misalignment of upper and lower teeth
- Lack of muscle control when brushing
- Issues with chewing and swallowing
- Excessive gagging
- Lip, tongue, and cheek biting
Health professionals working with children with special needs can help make the appointment go smoothly without any issues. Since they are specially trained, they can accommodate the children better with a calm environment.
Dentists working with special needs children require safety training, including CPR, clearing breathing passages, supporting them through involuntary tremors, etc. Moreover, they must know how to monitor breathing since the kids cannot express pain or discomfort.
Special Needs Dentistry for Down Syndrome
Down syndrome is a genetic disorder associated with health conditions such as hypotonia, hearing loss, infectious disease, and cardiac disorders. They also face developmental delays with speech and language, while a small percentage have a severe intellectual disability.
Though children with down syndrome do not have any unique dental problems, whatever they have tends to be severe and frequent.
- Periodontal Disease
- Underdevelopment of the maxilla
- Delayed eruption of permanent teeth
- Congenitally missing teeth
- Malformed teeth
Most children with down syndrome are well behaved, but it is still important that the dentist develops a level of communication with them with the caregiver’s help. It may be beneficial to have a parent or caregiver in the room.
While most patients with special needs can handle the dental treatment without any issues, few others may need more time and attention during the appointment and/or sedation.
Preparing Children with Special Needs for the Dentist
The American Board of Pediatric Dentistry recommends that the first visit to a dentist should be by the child’s birthday. With special needs children, it is even more so important. But many parents are not so keen on it since the children exhibit intolerance.
Here’s how you prepare them for a dental visit.
- Find a pediatric dentist who specializes in special needs children. The Special Care Dentistry Association should be able to guide you.
- Prior to the first visit, talk with the dentist about the health care needs of children. Talk to them about your concerns, ask questions and make sure that you both are on the same page.
- Read through the pamphlet and get your child ready for the appointment.
- Ensure that oral care is a priority. Drinking enough water and regular cleaning goes a long way in dental care. Proper nutrition and limiting sugary foods also promote oral health care.
- Share a fun song or story about the dentist’s visit to make the child comfortable.
- Talk to them about the dentist and what happens during the visit.
Problems Associated with Access to Health Care Services for Special Needs Patients
Individuals with disabilities have significant health problems due to a lack of oral health care. They face untold issues when they try to access health care services. From lack of accessible equipment to lack of proper access, there are quite a few problems that prevent the patients from getting adequate health care.
- Most people with special needs rely on government programs for their medical expenditure. But, not all health care providers accept programs such as Medicaid.
- Limited transportation
- Not all dental offices are not wheelchair accessible.
ADA CERP is a service of the American Dental Association that helps individuals with special needs to find appropriate health care providers.
Oral Health Care for Patients with Special Needs
It is not easy caring for people with special needs. But with proper planning, time, and patience, you can maintain proper oral hygiene.
- Brush twice every day. If the patient cannot brush for himself, the caregiver can brush their teeth for them. Ensure that you support the head and take care that the patient doesn’t gag or aspirate.
- Instead of a regular toothbrush, you can use an electric or battery-operated toothbrush. Attach the brush to your hand
- If the patient cannot hold the mouth open, use a rolled-up washcloth to prop the mouth open.
- Floss your teeth once a day, even for patients with special needs. Check out for floss holders, and floss picks to make their lives easier.
- Maintain a healthy diet rich in vitamins and minerals.
- Limit your sugar intake; Avoid sugary drinks, fruit juice, and sports drinks.
- Use fluoride toothpaste, especially for individuals with special needs.
Tips to Help a Special Needs Patient with Dental Care
Behavioral and intellectual disabilities make oral care difficult for the caregivers. Here are a few tips for caregivers and parents to make the activity an enjoyable one:
- Hang fun pictures and play music to keep the environment a pleasant one and not about cleaning.
- Keep a toothbrush and paste ready. Use verbal and non0verbal communicating to convey what you are about to do every step of the way.
- Give the patient something like a toy or a cushion to distract them while cleaning the teeth.
- Place your hand over them and guide them in the process of cleaning. This way, they hold some level of independence rather than when you clean their teeth.
Dental Tips for Parents of Special Needs Children
More than 2.8 American children have a physical, sensory, or intellectual disability. Children with special needs require special dental care, which is sometimes quite difficult in the run of things.
Here are a few tips to help practice dental care.
Practice proper dental care at home every day. Consistency, stability, and adaptation is the key to make this time a pleasurable one.
Establish a proper schedule and routine. Stick to the routine so that your child comes to recognize it rather than it being an unpleasant surprise.
Find the right toothbrush. Children with sensory issues come to hate the toothbrush and the cleaning routine.
Caring for a patient with special needs requires a special person who is patient, compassionate, and understanding. All dentists can meet the needs of the person, but only a few can work within the limitations set by their disability.
A special needs dentist will put the patient at ease and use gentle and safe treatment with a focus on preventive care. It is up to the dentist to educate his/her team members about special needs so that their visit is a more pleasurable one.
Preventive dentistry is crucial when it comes to special needs children. So, your dentist may focus on that at a very young age.
A visit to the dentist should not be a dreaded one. The right dentist can work magic with special needs patients or children. Ensure that you make the right choice when it comes to dentists.
One of the best dentists in the Tucson area is Dr. Dalesandro, who has the experience you want to help you with your dental problems; call today for your next appointment.