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At the beginning of 2010, as many as 17 percent of children in the United States were reported as having special health care needs. Behavioral issues, developmental disorders, cognitive disorders, genetic disorders and systemic diseases may increase a child's risk of developing oral disease, according to an article published in the May/June 2010 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry (AGD). For a child with special health care needs, special diets, frequent use of medicine and lack of proper oral hygiene can make it challenging to maintain good oral health.
"By the time these children are 12 months old, they should have a ‘dental home' that will allow a dentist to administer preventive care and educate parents about good oral health habits tailored to fit their child's needs," says Maria Regina P. Estrella, DMD, MS, lead author of the article.
For example, some parents may not know that special diets for children with below-average weight or unique food allergies can unintentionally promote tooth decay. Underweight children may be directed to consume drinks containing high amounts of carbohydrates, which can cause demineralization of teeth. Medications can also be a source of concern. Because children often find it difficult to swallow pills, many of their medicines may utilize flavored, sugary syrups. When parents or guardians give these syrups to a child, especially at bedtime, the sugars can pool around the child's teeth and gums, promoting decay.
"Children should continue with the diet and medications as directed by their physician, but a dentist may recommend more frequent applications of fluoridated toothpaste and mouthrinse and rinsing with water to decrease the risk of decay," says Vincent Mayher, DMD, MAGD, spokesperson for the AGD.
Additionally, adults will need to help children who lack the dexterity to brush their own teeth. When brushing a child's teeth, it may be helpful for caregivers to approach their child from behind the head, which will provide caregivers with good visibility and allow them to control the movement of both the child's head and the toothbrush. This approach is especially helpful with wheelchair-bound children.
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