Children from various backgrounds often share a common aversion to dental care, making it challenging for parents to get their children to brush their teeth before bed. This task becomes even more demanding for parents of children with special needs.

Children with special needs face distinct challenges when it comes to oral health. These challenges may arise from oral sensitivity, the necessity of taking sugar-containing medications, symptoms of their condition, difficulties with eating, or dietary restrictions.

Several developmental issues can make everyday dental care for children problematic

• Autism
• Depression
• Down syndrome
• Muscular dystrophy
• Cerebral palsy
• Seizures
• Spinal cord injury
• Visual and hearing impairments

Their condition can have an impact on:

• The development of teeth and oral structures.
• How enamel forms and where calcium is deposited.
• The quantity of saliva in your child's mouth, which is crucial for protecting teeth and removing food particles.
• The variety and frequency of foods your child consumes. A diet consisting mainly of soft foods and liquids may not provide the necessary stimulation for gums, teeth, and oral muscles. Children with G-tubes may be more prone to tartar buildup and cavities, emphasizing the importance of thorough oral hygiene.

What are the Common Dental Concerns for Children with Special Needs?

• Tooth Eruption Irregularities: Children usually begin teething around 6-12 months, with the full set of teeth typically appearing by age 3. This process depends on factors like jaw development and genetics. Growth disturbances can accelerate, delay, or cause inconsistent tooth growth. For example, Down syndrome may delay tooth eruption by up to two years.
• Gastroesophageal Reflux Disease (GERD): GERD causes a high level of acidity in the mouth, which can lead to tooth erosion. Dentists can prescribe pastes to help manage this condition. Additionally, antacids may be recommended if other physical symptoms are present.
• Grinding (Bruxism): Bruxism, or the grinding and gnashing of teeth, can occur during the day or while sleeping, potentially damaging teeth. This is common in children with severe intellectual disabilities or those with cerebral palsy.
• Teeth Anomalies: Conditions such as Down syndrome can cause irregularities in tooth development, manifesting as unusual shapes, sizes, or numbers of teeth.
• Malocclusion: Children with developmental disabilities often experience malocclusion, where the upper and lower teeth don't align properly. Muscle dysfunction in
• Medication Issues: Managing special needs often involves taking frequent medications, some of which contain sugar and may lead to dry mouth, tooth decay, and gum overgrowth.
• Cavities and Gum Disease: Conditions associated with special needs can weaken the immune system. Combined with connective tissue disorders, this can lead to tooth decay and gum infections.

Dental Care Tips Children With Special Needs

Even though your child may resist and may not enjoy it, it's crucial to introduce them to the concept of oral hygiene as early as possible. Starting early will help them adopt and incorporate it into their daily routine.

Begin dental hygiene practices before the first tooth appears. Use a damp gauze pad to wipe your child’s gums. Once teeth start to emerge, consult your pediatrician about the appropriate amount of fluoride toothpaste to use. Utilize a soft toothbrush and brush your child’s teeth twice daily, and make sure to floss every day.

Patience is key when laying the foundation for proper oral care. Your child may have sensory challenges, especially if they have autism. Focus on making them comfortable with the process rather than solely on brushing their teeth. Although it can seem difficult, it is often more stressful for them. Break the process down into smaller steps to make it easier for both of you.

Instead of immediately putting the toothbrush in their mouth, start by gently rubbing it against their cheek. Gradually move towards their mouth, and begin brushing only when they appear comfortable.

Try these tips to make the process smoother:

• Apply a very thin layer of toothpaste.
• Rinse your child’s mouth with water after meals, snacks, or medication, especially when you’re out of the house.
• Brush in areas of the house where your child feels comfortable, such as their bedroom.
• Use distractions to divert their attention from their teeth. For example, give them something to hold or ask them to brush your teeth while you brush theirs.
• Have your child lie down on a bed, sofa, or your lap while you brush their teeth. This helps them stay still and keep their mouth open.
• If your child is sensitive to toothpaste, dip the toothbrush in a fluoride mouth rinse instead.
• Seek professional assistance to help reduce sensitivity.
• Use a cloth to wipe your child’s mouth if they cannot spit.