Children with Special Needs

Child Oral Health ECC Prevention Children with Special Needs

Children with special health care needs are a particularly high-risk group for development of dental caries. Additional risk is due to:

Decreased ability to take food or fluids orally- Children with a G-tube often do not have normal oral clearance.
Oral aversion- Children with autism and sensory integration concerns may have difficulty with foods of certain textures or smells, as well as aversion to oral hygiene.
Functional limitations in self-care- Reliance on others for oral care requires all caregivers to understand the importance of proper oral hygiene.
Craniofacial anomalies- Anatomic abnormalities such as cleft lip or palate may interfere with feeding, hygiene, and tooth development.
Chronic dental erosions – Children with special health care needs have higher rates of esophageal reflux and may display maladaptive behaviors of bruxism (teeth clenching and grinding) or biting non-food items that contribute to dental erosions.
Chronic medication usage- Medications created for children are often high in sugar to make them more palatable. Medications may also cause xerostomia (dry mouth) and increase gingivitis risk.

Routine habits, such as brushing and flossing may be more difficult in children with special needs and more intensive anticipatory guidance may be needed at well child visits.

Children with special needs should be seen more frequently in a dental home and have additional attention paid to their daily oral needs.

Children with special health care needs often require specialty dental care which is often more challenging to obtain. Developmental limitations and cooperation may require dental care be provided with sedation or general anesthesia.

References

Chi DL, Rossitch KC, Beeles EM. Developmental delays and dental caries in low-income preschoolers in the USA: a pilot cross-sectional study and preliminary explanatory model. BMC Oral Health. 2013; 13: 53.

Frank M, Keels MA, Quinonez R, Roberts M, Divaris K. Dental caries risk among subgroups of children with special health care needs. Pediatr Dent. 2019; 41(5):3-9

Fenning RM, Butter EM, Norris M, Chan J, Macklin EA, McKinnon-Bermingham K, Albright C, Stephenson KG, Scherr J, Moffitt J, Hess A, Steinberg-Epstein R, Kuhlthau KA. Optimizing Parent Training to Improve Oral Health Behavior and Outcomes in Underserved Children with Autism Spectrum Disorder. J Autism Dev Disord. 2023 Sep;53(9):3683-3699.

Sarvas E, Webb J, Landrigan-Ossar M, Yin L. SECTION ON ORAL HEALTH, COUNCIL ON CHILDREN WITH DISABILITIES, SECTION ON ANESTHESIOLOGY AND PAIN MEDICINE; Oral Health Care for Children and Youth With Developmental Disabilities: Clinical Report. Pediatrics August 2024; 154 (2): e2024067603.

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