Dental Care for the “Special Needs” Child


“Special Needs” is a term in which a staggering array of diagnoses can be wedged. Children with special needs may include having a mild learning disability or profound mental retardation; food allergies or terminal illness; developmental delays that catch up quickly or remain entrenched; occasional panic attacks or serious psychiatric problems.

“Special Needs” are commonly defined by what a child can’t do-by unmet milestones, banned foods, avoided activities, and denied experiences. These things hit families hard, and make “special needs” seem like a tragic designation. Some parents will always mourn their child’s lost potential, and many conditions are more troubling over time. Other families may find their child’s challenges make triumphs sweeter, and that weaknesses are often accompanied by amazing strengths.

Most special children have special dental needs. Some special children are very susceptible to tooth decay, gum disease or oral trauma. Others require medication or diet detrimental to dental health. Some of the medications that could possibly cause problems are:
1. Clonidine
2. Ritalin
3. Risperdal
4. Valproic Acid
5. Tegretol
6. Prozac
7. ReVia
8. Zyprexa
9. Zoloft

Still, other children have physical difficulty with effective oral habits at home. The good news: dental disease is very preventable. If dental care is started early and followed consistently, every child can have a healthy smile. You can prevent dental problems in your special needs child by attending regular dental checkups.

Preventive dentistry will benefit any child, with regular brushing, flossing, moderate snacking, and adequate fluoride. Homecare takes just a few minutes out of the day and prevents needless dental problems. Regular professional cleanings and fluoride treatments are also very beneficial, and even placing sealants to prevent tooth decay can do a world of difference.

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, a pediatric dentist may provide care at a local hospital, and they have extensive education in behavior management, sedation and anesthesia techniques. They will select a technique based on the specific needs of your child, then discuss the benefits, limits, and risks of that technique with you.

Even though new experiences can cause problems for some children with special needs, dental visits don’t need to be a problem, if properly planned. Here are some tips on how to prepare yourself and your child for a dental visit:
1. Be sure to contact the dental office before the first visit.
2. A slow introduction over a period of time will help the patient get used to the unfamiliar surroundings and gain confidence.
3. Ask the dental staff if you can visit the office before the main appointment.
4. Prepare and explain to all concerned about what is going to happen and make sure that they come with someone they who well.
5. Use dental pictures or photos, books, or toys to familiarize that patient before their visit.
6. Discuss previous appointments with the dental staff and let them know of any helpful tips or if it is necessary to put instruments away.

Providing important information to the dentist about what things make your special needs child more sensitive is very important in providing your child with the most comfortable appointment. Some of these things are:
1. If they cannot wait, and must see them promptly.
2. Frightened of strange environments and this may show with unusual or challenging behavior.
3. Loud noises cause distress.
4. Bright lights are disturbing and this influences their behavior.
5. Finds smells, textures or tastes upsetting.
6. Can’t always tell you where they are hurting.
7. May not respond to pain or may respond in an unusual manner.
8. Doesn’t like to be touched, but may touch others.
9. Does not like the dental chair to be laid back.
10. Does not like the dental chair moving.
11. Also, please let us know how the child will be communicating with us. (examples: certain words or hand movements and what they mean)

Some helpful hints in looking after their teeth:
1. Reduce sugar intake-especially between meals
2. Check labels for hidden sugars.
3. Always ask your doctor, dentist or chemist for sugar free medicines when these are required.
4. Don’t give sweets as a reward- use alternatives such as a favorite object or activity.
5. Avoid fizzy drinks and juices and replace with water or milk if possible.
6. Give support for tooth brushing by demonstrating each step and taking each stage, one step at a time.
7. Ask a dental professional for advice about diet and dental health.