Dental patients with Special Needs

Paediatric Dentists are trained to provide comprehensive examination, diagnosis and dental treatment as well as individualized preventive care for patients with special health care needs.

This group of children often presents problems like anomalies in eruption, shape, size and number of teeth as well as anomalies in the quality of dental tissues and complex orthodontic problems. Moreover gingivitis or periodontitis, as a result of their medical condition or chronic intake of certain medication together with poor oral hygiene, are very often. Medical conditions like seizure-disorders or motor skills/coordination deficits predispose to dental trauma. Guidance about the risk of trauma and what to do in an emergency should be given to parents /caregivers. Custom-fitted mouth-guards should be provided to these patients to prevent dental and soft tissue trauma.
Children affected by neuro-developmental disorders (e.g. autistic spectrum disorders or attention deficit hyperactivity disorder) can be treated successfully by the Paediatric Dentist in the dental office using appropriate psychological approaches and behavior management techniques. Sessions of short duration are usually applied in order to desensitize the child and create a feeling of comfort in the practice.

The Paediatric Dentist's office is designed in such a way as to offer high quality dental care in a comfortable and pleasant environment. Very often, because of the child's medical history the paediatric dentist has to cooperate with other medical specialties or work together with speech therapists or other specialists in order to improve communication. Sometimes patient’s condition, as well as the anxiety that may accompany his/her physical and/or developmental disabilities, present additional challenges, which may result in the need for sedation or general anesthesia in order to provide dental treatment.

Effective management of special needs patients also includes educating health care providers, parents, and other professionals about the management of oral health care needs. The Paediatric Dentist has the responsibility to provide appropriate advice and instructions for:

a. Daily oral care

Many children and teenagers with special needs cannot manage their daily oral care by themselves and they need assistance from parents and/or caregivers.

Children with limited coordination and limited motor skills often find toothbrushing difficult. Some of them may resist mouth cleaning by biting on the toothbrush. Similarly, some children with neuromuscular problems may bite during toothbrushing and therefore a tooth rest or mouth prop should be used. Some tips for better toothbrushing include:

  1. Use of an electric toothbrush or regular tooth brush with small or medium head size
  2.  Use of a bulky handle on a normal toothbrush.
  3.  Specially designed toothbrushes or single use disposable sponge brushes may sometimes make cleaning easier.

Special needs patients may have particular difficulties in controlling their food intake or some of them may be very slow to swallow as they are eating. Food retention and food pouching increase the contact time between the natural sugars in food and the teeth and increases the risk of tooth decay. Therefore, sugar containing food rewards used to help control behavior should be avoided.

c. Regular dental visits

It is important that children with special needs visit their Paediatric dentist on a regular basis. Oral health is an important part of general health and regular dental visits ensure prevention and early intervention when dental problems are early diagnosed. Also, routine visits build familiarity with the dental staff and dental environment improving patient cooperation.

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