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Oral Health Challenges for Children with Disabilities

Some children with disabilities have challenges that affect their oral health. These challenges may include:

Children with physical disabilities, such as cerebral palsy, may not have the motor skills needed to use a toothbrush safely or to sit still in a dental chair during dental visits.
Children with intellectual disabilities may not know how to brush their teeth, protect their teeth from injury, or cooperate with dental office staff while getting oral health care.
Children with communication disorders, such as delayed speech and language development, may not be able to tell their parents that their mouth hurts or they have a toothache.
Children who get frequent medical care, such as having many doctor visits or hospital stays, may be afraid of the dental office and may not cooperate during visits.
Children who take medicines with added sugars or that cause dry mouth are at high risk for tooth decay. Sugar is added to some medicines to make them taste better. Other medicines used to treat cerebral palsy, seizures, and depression can cause dry mouth by lowering the amount of saliva in the mouth. Saliva plays an important role in preventing tooth decay. Medicines given to children with medical diseases or disorders, such as asthma or allergies, can also cause dry mouth.
Children on special diets may be at high risk for developing tooth decay. Foods that are soft or high in starch (for example, potatoes or corn) stick to children’s teeth and give caries-causing bacteria in the mouth more time to cause tooth decay.

Additional Information:

Continuing Education: Practical Oral Health Care for People with Developmental Disabilities (NIH.gov)

Last Updated: 11/21/2015

Source: Brush Up on Oral Health Newsletter (Copyright © 2013 The National Center on Health)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Mouthguards: Information for Parents

Mouthguards can help protect your child from a dental emergency. They should be worn whenever your child is participating in sports and recreational activities.

Benefit of Mouthguards

Mouthguards, also called mouth protectors, help cushion a blow to the face, minimizing the risk of broken teeth and injuries to your lips, tongue, face or jaw. They typically cover the upper teeth and are a great way to protect the soft tissues of your tongue, lips and cheek lining. Knowing how to prevent injuries like these is especially important if your child participates in organized sports or other recreational activities.
When it comes to protecting your mouth, a mouthguard is an essential piece of athletic gear that should be part of standard equipment from an early age. In fact, studies show that athletes are 60 times more likely to suffer harm to the teeth if they are not wearing a mouthguard. While collision and contact sports, such as boxing, are higher-risk sports for the mouth, you can experience a dental injury in non-contact activities too, such as gymnastics and skating.

Three Types of Mouthguards:

Custom-fitted. These are made by your dentist for you personally. They are more expensive than the other versions, but because they are customized, usually offer the best fit.
Stock. These are inexpensive and come pre-formed, ready to wear. Unfortunately, they often don’t fit very well. They can be bulky and can make breathing and talking difficult.
Boil and bite. These mouth protectors can be bought at many sporting goods stores and drugstores and may offer a better fit than stock mouth protectors. They are first softened in boiling water, then inserted and allowed to adapt to the shape of your mouth.

The best mouthguard is one that has been custom made for your mouth by your dentist. However, if you cannot afford a custom-fitted mouthguard, your child should still wear a stock mouthguard or a boil-and-bite mouthguard from the drugstore. If your child wears braces or another fixed dental appliance on your lower jaw, your dentist may suggest a mouth protector for these teeth as well.

A properly fitted mouthguard may be especially important for people who wear braces or have fixed bridge work. A blow to the face could damage the brackets or other fixed orthodontic appliances. A mouthguard also provides a barrier between the braces and your cheek or lips, limiting the risk of soft tissue injuries.

Talk to Your Child’s Dentist or Orthodontist

Talk to your dentist or orthodontist about selecting a mouthguard that will provide the best protection. Although mouthguards typically only cover the upper teeth, your dentist or orthodontist may suggest that your child use a mouthguard on the lower teeth if you have braces on these teeth too.
If your child has a retainer or other removable appliance, do not wear it during any contact sports.

Tips for Caring for a Mouthguard:

Rinse before and after each use or brush with a toothbrush and toothpaste.
Occasionally clean the mouthguard in cool, soapy water and rinse thoroughly.
Transport the mouthguard in a sturdy container that has vents.
Never leave the mouthguard in the sun or in hot water.
Check for wear and tear to see if it needs replacing.

Additional Resources:

Prevention is the Best Medicine: Sports Safety Guidelines
Dental Health and Orthodontic Problems
Custom Mouthguards (Video) (MouthHealthy.org)

Last Updated: 11/21/2015

Brushing Up on Oral Health: Never Too Early to Start

As the American Academy of Pediatrics (AAP) and other children's organizations report, tooth decay (also called early childhood caries, or ECC) is the most common chronic children's disease in the country. As a result, it is very important that parents work with their pediatrician to establish good oral health care from the first weeks of their baby's life. Although most of us think of dental care in relation to our own dentists, parents will be working closely with their pediatrician even earlier than with a dentist.

Since pediatricians see young infants and children frequently for preventive health care visits, they are in an excellent position to identify children at risk for dental health problems, coordinate appropriate care and parent education, and refer affected and high-risk children to pediatric dentists.
The Centers for Disease Control and Prevention (CDC) has stated that dental caries is five times more common than asthma and seven times more common than hay fever in children. More than 40 percent of children have tooth decay by the time they reach kindergarten. Children with dental caries in their baby teeth are at much greater risk for cavities in their adult teeth.
Health care professionals know that tooth decay is a disease that is, by and large, preventable. Because of how it is caused and when it begins, however, steps to prevent it ideally should begin prenatally with pregnant women and continue with the mother and young child, beginning when the infant is approximately 6 months of age. Pediatricians have become increasingly aware that their own proactive efforts to provide education and good oral health screenings can help prevent needless tooth decay in infants.

For parents who wish to establish good dental health for their infants, the following general guidelines may be of help:

Fluoride and Your Child: Fluoride is a naturally occurring mineral that is found in many foods, and it also is added to the drinking water in some cities and towns. It can benefit dental health by strengthening the tooth enamel, making it more resistant to acid attacks that can cause tooth decay. It also reduces the ability of plaque bacteria to produce acid. Check with your local water utility agency to find out if your water has fluoride in it. If it doesn't, ask your doctor if you should get a prescription for fluoride drops or chewable tablets for your child.
Check and Clean Your Baby's Teeth: Healthy teeth should be all one color. If you see spots or stains on the teeth, take your baby to your dentist. As soon as your child has a tooth begin to use a smear (size of a grain of rice) of fluoride toothpaste. Clean the teeth at least twice a day. It's best to clean them right after breakfast and before bedtime. Once your child turns 3 you can begin to use a pea-sized amount of fluoride toothpaste. When your child is able, teach him to spit out the excess toothpaste, but don't rinse with water. As your child gets older let her use her own toothbrush. It is best if you put the toothpaste on the toothbrush until your child is about age 6. Until children are 7 or 8 years old, you will need to help them brush. Try brushing their teeth first and then letting them finish.
Feed Your Baby Healthy Food: Choose drinks and foods that do not have a lot of sugar in them. Give your child fruits and vegetables instead of candy and cookies. Be careful with dried fruits, such as raisins, since they easily stick to the grooves of the teeth and can cause cavities if not thoroughly brushed off the teeth.
Prevent Tooth Decay: Do not put your baby to bed with a bottle at night or at naptime. (If you do put your baby to bed with a bottle, fill it only with water). Milk, formula, juices and other sweet drinks, such as soda, all have sugar in them. Sucking on a bottle filled with liquids that have sugar in them can cause tooth decay. During the day, do not give your baby a bottle filled with sweet drinks to use like a pacifier. If your baby uses a pacifier, do not dip it in anything sweet like sugar or honey. Near his first birthday, you should teach your child to drink from a cup instead of a bottle.
Talk With Your Pediatrician About Making a Dental Home: Since your pediatrician will be seeing your baby from the first days and weeks of life, plan to discuss when and how you should later develop a "dental home"—a dentist who can give consistent, high-quality, professional care—just as you have a "medical home" with your pediatrician. Usually, your dentist will want to see a child by his first birthday or within six months of the first tooth's emergence. At this first visit, your dentist can easily check your child's teeth and determine the frequency of future dental checkups.

Last Updated: 10/3/2014

Source: Adapted from Healthy Children Magazine, Winter 2007