Special needs dentist: How dental care works in Down Syndrome, Cerebral Palsy, and other conditions

As discussed earlier, a special needs dentist has a higher degree of training from a regular dentist. A special needs dentist is a professional who opts for special needs dentistry as their major in specialisation, allowing them to understand the various mental and physical issues and how to navigate them carefully to get a good dental outcome for clients.

For example, people with Down syndrome may be prone to certain specific oral issues, and a special needs dentist will be trained on how to manage these appropriately.

They also have a specific skill set that enables them to communicate with them better and allows them to craft a specific tailor-made dental plan to suit their unique needs.

Dental care is a fundamental part of personal wellbeing; however, it can be different for people with Down syndrome. They require special attention, and due to their disease, can come across various dental issues.

As the basic oral structure and its function is altered in patients with Down syndrome, it further leads to compromised speech, mastication, suckling, and swallowing.

A special needs dentist has experience in addressing these issues. They are also fully trained in the dental management of Cerebral palsy patients, Down syndrome teeth grinding, and dental care for patients with autism.

Here we discuss some of the dental health issues and challenges that patients of Down syndrome might face:

Unlike others, children with Down syndrome might face a delay in the eruption of primary and permanent teeth. Children with Down syndrome typically get their first teeth between the ages of 12 to 14 months. However, it can even be as late as 24 months. Kids without Down syndrome get their baby teeth between the ages of 6 to 12 months.

Apart from delay, children with Down syndrome may also face an issue with their teeth alignment and order. It is common for their teeth to erupt in a different order than children without Down syndrome. Hence, their parents must be referring to a special needs kids' dentist from an early age.

Smaller than average and missing teeth It is also common for people with Down syndrome to have smaller than average teeth. It is further noticed that most of them experience missing teeth while having roots shorter than average is also a common occurrence among them.

They can have larger than average tongues Individuals with Down syndrome may have tongues larger than average size. Their upper jaw is smaller than average too, which makes their tongue larger for their mouths as well. Thus, it is also common for people with Down syndrome to have grooves and fissures on their tongues.

One of the problems a special needs dentist might need to deal with in people with Down syndrome is the bite and Down syndrome teeth grinding. They have smaller than average teeth, so they have unusual spacing between the teeth in most cases.

Moreover, their smaller upper jaw may cause crowding of the teeth. This can impact their permanent teeth as they have no room to grow properly.

Due to the smaller jaw, the top teeth may not cover the bottom teeth in the manner they are adequately supposed to. The bottom teeth might be out further than the top of the teeth (in the front of the jaw), back of the jaw, and in some cases both. Hence it is common among people with Down syndrome that their upper and bottom teeth do not touch.

In such a situation, referring to a special needs dental clinic at an early age, or consulting a specialist pediatric dentist is beneficial. Down syndrome in pediatric dentistry is a niche area where it's not too difficult to find the right specialists in Australia. They know how to assist children with special needs from a young age.

To make sure that the teeth are properly aligned, the specialist will suggest orthodontics (braces). However, as braces require a lot of patience, maintenance, and cleanliness, it is good to wait until the kids are in their late teen years.

Another reason to delay the orthodontic treatment till the child is mature enough to understand the situation is the challenges with speech. While a kid without Down syndrome may quickly adapt to it, a Down syndrome child is most likely to struggle with speech with metal appliances inside their mouth.

Even when people with Down syndrome do not have a lot of plaque or tartar on their teeth, they are still more prone to getting gum diseases. As people with Down syndrome have a compromised immune system, they are prone to getting gum diseases (periodontal disease) more commonly and their biological system cannot naturally protect against diseases.

Hence it is vital for people with Down syndrome to refer to a special needs dental clinic regularly.

Cavities

Cavities are common among people with Down syndrome, just like everyone else. However, taking proper care of oral health, regular checkups, proper brushing, flossing, and adopting healthier eating habits with minimal use of processed sugar helps keep them at bay.

Treating individuals, especially children with Down syndrome, can be a challenge at times. People with mild or moderate Down syndrome can even be treated in a general hospital setting. However, a special needs dentist can assist in taking good care of their dental health in the following ways:

• They guide the best oral health practices and supervised tooth brushing techniques

• A specialist pediatric dentist will guide the dental health of children with Down syndrome

• They educate on dental health and suggest therapies if needed

• A team of professionals at a special needs dental clinic assists in suggesting diet, overseeing the development of communication, and the use of oral muscles.

• A multi-disciplinary team of dental health practitioners will help you in the management of malocclusion. They will carry out diagnosis and provide a treatment plan. The plan may refer the patient to other specialists like Oral Maxillo-Facial surgeons and Orthodontists.

If you need to refer to a dentist for an autistic child, a specialist pediatric dentist with expertise in dental management of ADHD will assist you better because of their specialised experience.

People with autism face some unusual problems when it comes to dental care. Although the frequency of getting periodontal diseases among them is the same as others, the medications, damaging oral habits, behavioural challenges, and communication issues pose challenges.

A dentist for an autistic child must be proactive, compassionate, and able to communicate and create an aura of comfort.

People with autism may have some unconventional damaging oral habits like biting lips, bruxism, and biting on hard objects.

To protect teeth from these damaging habits, the use of dental guards is recommended. Other than that, regular checkups, tooth brushing, flossing, and avoiding sweet foods can increase the life of teeth.

Although Cerebral Palsy does not cause any specific oral health challenges or abnormalities, just like dental management of ADHD or Down syndrome teeth grinding, a few damaging habits may cause unconventional challenges.

Children suffering from this condition may have issues with misalignment of bite (malocclusion); the size of the teeth may vary and might look crowded, and they may face bruxism (teeth grinding). They are also prone to periodontal disease, bacterial infections, gingivitis, or redness.

Due to some aspects of Cerebral Palsy, the child might become more vulnerable to developing dental health challenges. For example, if they experience frequent seizures, they are more prone to mouth and head trauma, biting cheeks and lips, and grinding teeth.

If the child cannot control their facial muscles and have trouble swallowing, the child may have "dysphagia". They may also face difficulty performing oral health tasks like brushing, clearing food pouches, flossing, etc.

Children with Cerebral Palsy, especially gastroesophageal reflux, are prone to get cavities as well. As they cannot easily swallow, the food particles can stay on the teeth, forming plaque and tartar. However, with proper oral hygiene care prescribed by a children's dentist at a special needs clinic, cavities can be avoided.

To maintain a special child or person's oral health, getting in touch with a special needs dentist is highly recommended. A dentist for an autistic child will know better about how to take care of them. Similarly, a specialist pediatric dentist has vast experience in issues like dental management of ADHD and Down syndrome teeth grinding. These highly-trained specialists know exactly what they are doing!