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Children with special needs thrive on the same kind of oral care that benefits all children: regular brushing and flossing, a healthy diet, and biannual dentist visits. 

Why are healthy habits so important?
Healthy habits are important to stress because they can either prevent the onset or reduce the severity of most dental problems.  Some children with special needs may be more susceptible to dental disease or oral injury. Others may require medications or special diets that can be detrimental to dental health.  Children with special needs are particularly at risk for tooth decay and cavities, gum disease, and gingival overgrowth (when gums grow over teeth) because it can be harder to give them good dental care.  Parents and caregivers should consult a dentist before their child's first birthday.

Malocclusion: People with developmental disabilities may have a poor fit between the upper and lower teeth, or experience the crowding of teeth.  Children with mental retardation are at particular risk for having teeth that don’t fit properly, which gets in the way of healthy oral development.  Muscle dysfunction can also contribute to malocclusion, particularly in people with cerebral palsy.  Teeth that don’t fit together well are more difficult to clean.  Dentists can offer tips for this task.

Tooth anomalies: This refers to variation in the number, size, and shape of teeth.  Children with Down's syndrome, oral clefts, ectodermal dysplasia, or other conditions may be born with missing, extra, or malformed teeth. These anomolies are not noticeable until the teeth start coming through the gums.

Developmental defects: This includes pits, lines, or discoloration of teeth. Very high fever or certain medications can disturb tooth formation and cause defects. Many teeth with defects are difficult to clean and tend to get cavities. Ask your child's dentist for tips.

Bruxism: This is the term for habitual teeth-grinding. It is often seen in children with cerebral palsy or severe mental retardation. In extreme cases, bruxism leads to scraped teeth and flat biting surfaces. Your dentist can recommend behavioral techniques or a bite guard.

Gingival overgrowth: This refers to gums growing over teeth. This may be a side effect from medications such as channel blockers, phenytoin sodium, and cyclosporine.

Dealing with chipped teeth and dental work
Children who have mental retardation, seizures, abnormal protective reflexes, or muscle incoordination are more likely to have accidents that result in trauma to the face and mouth.  If a tooth is chipped or broken during such an accident, take the child and the tooth to the dentist immediately.  Ask your dentist about how to prevent trauma and for more information on what to do when it occurs.  If your child does need dental work done, make sure she doesn't chew or bite on anesthetized areas of her mouth that are temporarily numb.

For more information, please visit:

About Smiles
About Smiles gives specific dental care tips to caregivers for children with special needs.
http://www.aboutsmiles.com/specialg.htm

The American Academy of Pediatric Dentistry (AAPD)
This link takes you to the section on dental care for children with special needs.
http://www.aapd.org/publications/brochures/specialcare.asp

Illinois Department of Public Health
This link takes you to the fact sheet on cleft lip and cleft palate.
http://www.idph.state.il.us/HealthWellness/oralhlth/oralcleft.htm

The Kids Dentist
This link takes you to the section called "Dental Care for the Special Child."
http://www.thekidsdds.com/spec.htm

National Institutes of Health
This web site contains a listing of problems associated with children with special needs.
http://www.nohic.nidcr.nih.gov/pubs/oral_conditions/index.htm