Dentistry for Patients with Special Needs

The American Association of Pediatric Dentistry defines special health care needs as “any physical, 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. The condition may be developmental or acquired and may cause limitations in performing daily self-maintenance activities or substantial limitations in a major life activity. Health care for individuals with special needs requires specialized knowledge, increased awareness and attention, adaptation, and accommodative measures beyond what are considered routine.”

Dental patients with special needs often have higher rates of poor oral hygiene. As a result, they also have a higher incidence of gum diseases and cavities than people in the general population.

The prevention of oral diseases in children with special needs is based on these main principles:

  • Performance of oral hygiene from the eruption of the first teeth, twice a day. Parents and/or tutors must be capable of routinely performing it.
  • Training of parents, teachers, monitors and other professionals in contact with the child and raising awareness on the impact of sugars on the child's oral health.
  • Reducing cariogenic foods (link nutrition andcaries) as much as possible between meals. We strongly advice not to feed these children refined sugars (e.g. candies, chocolates, ice creams), pastries, sodas or canned juices.
  • Asking the child's pediatrician to prescribe medicines with the lowest content of sugar possible. Also, try to give children their medicine with meals, not in between them.
  • In the case of inhaled corticosteroids (for asthmatic children) we strongly advice to asses the benefits of fluoride mouthwashes after their use.
  • Visit the pediatric dentist during the child's first year of life to perform an oral health risk assessment based on his/her individual risk of caries and periodontal disease.
  • Enroll the child in an early prevention program: frequent visits to the paediatric dentist for risk assessment; fluoride mouthwashes to strengthen the enamel, antibacterial rinses as well as fissure sealant application in dental surfaces susceptible to caries (enamel hypoplasia, deep pits and fissures), etc.
  • Always have the pediatric dentist emergency phone number in case a dental trauma occurs.

Dental Care for Special Child

1.Do special children have special dental needs?
Most do. Some special children are very susceptible to tooth decay, gum disease or oral trauma. Others require medication or diet detrimental to dental health. Still other children have physical difficulty with effective dental habits at home. The good news is, dental disease is preventable. If dental care is started early and followed conscientiously, every child can enjoy a healthy smile.
2.How can I prevent dental problems for my special child?
A first dental visit by the first birthday will start your child on a lifetime of good dental health. The pediatric dentist will take a full medical history, gently examine your child's teeth and gums, then plan preventive care designed for your child's needs.

3.Will preventive dentistry benefit my child?
Yes! Your child will benefit from the preventive approach recommended for all children- effective brushing and flossing, moderate snacking, adequate fluoride. Home care takes just minutes a day and prevents needless dental problems. Regular professional cleanings and fluoride treatments are also very beneficial. Sealants can prevent tooth decay on the chewing surfaces of molars where four out of five cavities occur.

4.Are pediatric dentists prepared to care for special children?
Absolutely. Pediatric dentists have two or more years of advanced training beyond dental school. Their education as specialists focuses on care for children with special needs. In addition, pediatric dental offices are designed to be physically accessible for special patients. Pediatric dentists, because of their expertise, are often the clinicians of choice for the dental care of adults with special needs as well.

5. Will my child need special care during dental treatment?
Some children need more support than a gentle, caring manner to feel comfortable during dental treatment. Restraint or mild sedation may benefit your special child. If a child needs extensive treatment, the pediatric dentist may provide care at a local hospital. Your pediatric dentist has a comprehensive education in behavior management, sedation and anesthesia techniques. He or she will select a technique based on the specific health needs of your child, then discuss the benefits, limits and risks of that technique with you.