However, people with disabilities are at a particular disadvantage in this area, with oral health care considered the most unmet health need among those with intellectual and developmental disabilities.1
Parents can help their children with disabilities minimize these challenges by cultivating good oral health habits at a young age, and working collaboratively with dental health providers to make visits to the dentist a less stressful experience.
Basic Tips for Good Dental Health
These basic tips may be all that most people need to maintain good dental health throughout life.
- Brush after eating or drinking, at least twice a day for at least two minutes. Be sure to brush all of the tooth surfaces, including the back and sides of the teeth. It’s also a good idea to finish by brushing your tongue, which can harbor harmful bacteria and food debris. Many people with neuromuscular challenges have a tendency to “pouch” food in their cheeks and collect food on their tongue for quite a long time after meals. The longer food stays in the mouth, the higher the incidence of dental cavities.
- Don’t forget to floss at least once a day. Flossing cleans between your teeth.
- Eat a healthy, balanced diet with limited sugar intake, and drink plenty of water.
- Replace your toothbrush every three to four months, or when the bristles start to flare out or lose their shape, which can cause damage to the gums and diminish the overall effect of the brushing process.
- Visit the dentist twice a year for regular check-ups and professional teeth cleaning.
- For adults, don’t smoke. Smoking increases your risk for all types of oral cancers, as well as periodontal (gum) disease.
Note: Many individuals with disabilities have sensory issues or other impairments that make it difficult to perform dental care without assistance. Having one’s teeth cleaned by someone else, whether parent or other caregiver can be difficult for some to tolerate. Here are some ways to make the process more comfortable.
- Use a non-foaming, unflavored toothpaste. Unflavored varieties tend to encourage a person to spit, rather than swallow the toothpaste.
- Be sure you don’t use too much toothpaste. A pea-size amount should be enough.
- Using a soft-bristled brush, make small and gentle circular motions away from the gumline.
- Explore floss-holders or inter-dental brushes, if traditional flossing isn’t feasible.
- If regular brushing and flossing are not possible, ask your dentist about oral rinses and other alternatives.
Preparing Your Child for Dental Visits
As with general medical visits, parents can help reduce the stress and anxiety of dental visits and procedures by taking some time before and during the visit to help the child become comfortable with the situation and what is going to take place. A recap after the visit is also helpful for future visits.
Pretend play for younger children and role playing for older children before the visit can be very helpful, allowing them to take on the role of the dentist, which might help them feel more in control. Using stuffed animals or dolls can also be beneficial. Visiting the office and/or office staff ahead of time can help familiarize the child with the practitioners who they’ll meet, and the new environment, including lighting, sounds and smells.
The less time you have to spend at the dental office, the lower the stress will be for both parent and child, When scheduling, ask for the first appointment of the day. This will usually ensure your child is seen on time, without the delays that often arise later in the day for busy dental practices.
Good Oral Care Begins During Infancy
Dr. Richard Mungo, DDS, a pediatric dentist specializing in caring for those with disabilities, notes that many parents don’t begin thinking about dental care until their child has a full set of teeth. He urges parents to get connected with a pediatric dentist well within the child’s first year, since the mouth is always creating bacteria whether or not teeth are present. Many cavities can be prevented and other dental problems addressed with early intervention.
A pediatric dentist can counsel parents on how to keep their baby’s mouth clean, which helps prevent infections that can affect other areas of health. He also emphasizes the value of working with a dentist whose office regularly serves those with disabilities, and is familiar with the particular challenges for those with conditions like: cerebral palsy, Down syndrome, autism and others. These conditions can make some dental care more challenging and/or make a person more prone to certain dental maladies. For example, the mobility challenges a person with cerebral palsy may have could put that person at greater risk for falls that can break teeth and affect the tongue, gums and cheeks.
Since some dental procedures can’t always be performed in an office, he encourages parents to “interview” each prospective dentist, and to find out if the doctor is affiliated with a hospital, in case that is needed later on for general anesthesia and other medical services that might require a hospital to safely perform those dental procedures.
Brushing Up : Additional Resources for Parents
In addition to your trusted pediatrician and other parents in your network, there are several organizations in the United States and internationally that may help you locate dental care professionals serving patients with disabilities. Here are some to consider:
UNITED STATES RESOURCES
American Dental Association
www.ada.org
American Academy of Pediatric Dentistry
www.aapd.org
Special Care Dentistry Association (SCDA)
www.thescda.org
Dental Lifeline Network (DLN)
www.dentallifeline.org
INTERNATIONAL RESOURCES
International Association for Disability and Oral Health (iADH)
Visit their website to find member societies in your country or region
www.iadh.org
FDI World Dental Federation
www.fdiworlddental.org
Reach out to your country’s main professional organization for dentists (similar to the American Dental Association in the U.S.) and ask about their special needs or disability dentistry specialists.
Collaboration is Key to a Good Experience
Bruce Hall, an internationally recognized photographer and father of twin sons with autism, is a particularly passionate advocate for appropriate dental care for those with disabilities. Having chosen to use his own family’s traumatic experiences to help transform dental care systems in his Orange County, California community, and ensure better dental experiences for his now 24-year-old sons, Bruce has tips for other parents advocating for children with significant challenges.
- Ask other families, as well as doctors and nurses you know, to locate dentists with expertise in serving patients with disabilities. You never know who might know somebody who will take a genuine interest in how to make things better for your child.
- Get established with a good pediatric dentist early on, since those in pediatrics often tend to be good at dealing with frightened patients with and without disabilities. If you have a good relationship with that person, they can sometimes keep your child as a patient, even when they might otherwise transition to a regular dentist. Such continuity can be invaluable.
- Learn the most effective techniques to prepare your child for dental visits, and equip your providers with details about your child’s condition and sensitivities, so they’re prepared to meet your child’s needs. It could make all the difference in the world, for example, you can arrange to wait in your car, rather than in a loud or unfamiliar waiting room.
- Don’t lose your temper when dealing with dental and other healthcare professionals who aren’t responding in an appropriate way. Instead, listen and seek to have an exchange with them. It’s hard and it’s frustrating, but you need their help to enact systemic change and make future experiences positive for your child.
You are your child’s best advocate and you should work in harmony with the oral healthcare providers in formulating and developing the very best personal plan for successful dental visits.
ABOUT THE AUTHOR:
A clinical psychologist, Bonnie Ivers, M.A., Psy.D., is Clinical Director for Regional Center of Orange County, the private, nonprofit organization contracted by the State of California to coordinate lifelong services and supports for more than 28,000 Orange County residents with developmental disabilities and their families. The Regional Center is the first stop for those seeking to obtain local services and supports to help them live safely and with dignity in the community. Developmental disabilities include intellectual disabilities, autism, epilepsy and cerebral palsy. Learn more at www.rcocdd.com
Read the article here.