Dental Health Tips - Oswal Dental Clinic

Special needs children can have unique issues when it comes to caring of their teeth, mouth and gums. Children with special needs require special care when planning their dental treatment. They face a greater risk as far as the dental problems are concerned. It is very important to practice good oral health care as far as special needs children are concerned.

Oswal Dental & Oral Surgery Clinic has a team of dedicated pediatric dentists in Pune who have been effectively treating special needs children. They are of the opinion that children with special needs require special considerations when their dental treatment is planned. The basic skills required by a dentist to treat special needs children should include the following:
1. A complete knowledge of the medical conditions of the child which will enable them to apply the proper treatment option.
2. Knowledge of the implications of the oral health like gingival hyperplasia in patients with seizure disorder or periodontal disease in children with Down syndrome.
3. Awareness of the cultural, social and therapeutic surroundings with regards to those children with special needs.
4. Appropriate and essential management skills in order to stabilize, communicate and manage these patients during the course of the treatment.

Here is a guide to the different oral conditions in special needs children and also the treatment that is given by the dental doctors in Pune.

Oral Development

Tooth Eruption: Special needs children may have inconsistent, delayed or accelerated tooth eruption. The gums may appear bluish purple or red before the eruption of the teeth. Tooth eruption depends on the following

• Growth of the jaw
• Genetics
• Muscular action
• Other factors
It is noticed that tooth eruption in children with Down syndrome can be delayed up to 2 years.
Dental Treatment: Information about the variability in the pattern of tooth eruptions should be provided to the care giver and parent.

Malocclusion: In special needs children poor fit between the lower and upper teeth and crowding of teeth may occur. Muscle dysfunction leads to malocclusion especially in children with cerebral palsy. Crowded or misalignment of teeth causes difficulty in cleaning. This contributes to dental caries and periodontal disease.

Dental Treatment: This can be handled by a pediatric dentist or an orthodontist for evaluation and specialized instruction with regards to the oral hygiene.

Tooth anomalies: These are variations in the shape, size and number of teeth. Children with Down syndrome, ectodermal dysplasia, oral clefts or other conditions may experience extra, misaligned or missing teeth.

Dental Treatment: It is very important to consult a dentist for proper dental planning treatment during the child’s growing years.

Developmental defects: This refers to the appearance of lines, discoloration or pits in the teeth. High fever or certain medication can tend to disturb the formation of tooth which will result in tooth defects. Defected teeth make cleaning difficult and also may compromise its appearance. This will lead to dental caries.

Dental Treatment: An oral health care provider will evaluate the various treatment options to overcome the defects and will also advice the ways in keeping the child’s teeth clean.
Oral Trauma

Trauma: People who have abnormal protective reflexes, improper muscle coordination, seizures or intellectual disability may experience trauma to the face and mouth.

Dental Treatment: The dentist will counsel the caregiver or the parent on the ways to prevent and the trauma and what needs to be done when it occurs. It is best advised that if a tooth is broken or avulsed, the patient and the tooth has to be taken immediately to the dentist.

Bruxism: This refers to the habitual grinding of teeth and is frequently seen in children with severe intellectual disability or cerebral palsy. In extreme cases, bruxism will also lead to flat biting surfaces and tooth abrasion.

Dental Treatment: It is ideal to refer to a dentist who will evaluate the problem. The dentist might recommend a bite guard or behavioral techniques.

Oral Infections

Dental Caries: This refers to tooth decay and may be linked to the following:
• Gastro esophageal reflux
• Frequent vomiting
• Less than normal amounts of saliva
• Special diets which require prolonged snacking or bottle feeding

Dental Treatment: The dentist will counsel the caregiver or parent on oral hygiene which will include rinsing frequently with plain water, using fluoride containing toothpaste or using mouth rinse. The will also explain the need for supervising children to avoid children swallowing fluoride. In certain cases a gastroenterologist will also be referred for prevention of any infections and also the treatment. Sugarless medication will also be prescribed.

Periodontal (gum) disease: This can occur in children with connective tissue disorders, impaired immune systems or inadequate oral hygiene. It is a severe infection and will lead to loss of tooth if not treated.

Dental Treatment: The dentist will treat this disease by professional cleaning, antibiotics and instructions about home care to stop the infection. Brushing twice daily and flossing is a must. In some cases frequent sitting with an oral health care provider will also be required.

Gingival Overgrowth: This is side effect which is caused by certain medications. Also, poor oral hygiene will aggravate the condition leading to superimposed infections. This will result in severe overgrowth which can affect chewing, tooth eruption and appearance of tooth.

Dental Treatment: Frequent visits to the dentists will be required wherein a preventive regimen of antimicrobial rinses will be done.

Tips for the dentist while treating a special needs child
• It is always ideal to take time to listen and talk to both the caregivers and the parents.
• Advice the parents and caregivers to seek dental consultation before or not later than the child’s first birthday.
• The dentist needs to seek advice on behavior management techniques and early intervention.
• Thorough evaluation and proper treatment of the orthodontic problems is required in order to minimize any complication or risk.
• Advise the caregivers and parents to follow good oral hygiene and avoid serving snacks at bed time.
It is very important for both the health care providers and the dentists to effectively handle the problems of the special needs child with patience, love and care.