Dental Care for Children with Special Needs

Oral health care for children is a crucial step for proper growth and development of the mouth and oral tissues. This practice becomes challenging with a special need child. Balancing the dental requirements for children with special needs require extra precautions and care. Often oral health is left out while concentrating on the health issues of children with special needs. Moreover, it acts as an add on to the imperfect oral condition present already.

Children with special need rely on their parents and caretakers to achieve and maintain good oral and general health. Studies have shown that children with special need are twice as likely to suffer from dental problems as compared to children without special need. Having a clean mouth is essential for their health advancement, and it can be done only by a little bit of support and care.


Today’s article is an overview of oral health care for children with special needs. It is precisely for parents who are willing to get educated to be able to pay attention to their child’s dental health.

Who are the children with special needs?

Children at an increased risk of chronic developmental, physical, and emotional conditions are considered as children with special needs. Often they require assistance and support for proper health maintenance. (1) Special need children have limitations to daily activities. Moreover, they require extensive dental and health services round the clock. Some of the universal health conditions may include –

  • Down’s syndrome
  • Cleft lip and palate
  • Neurological disorder
  • Vision impairment
  • Hearing impairment
  • Cerebral palsy
  • Learning disabilities
  • Developmental disabilities

What is the cause of poor oral health among children with special needs?

Children with special needs have impaired cognitive and behavioral patterns. This is one of the reasons why these group of children is at a higher risk of tooth decay and gum disease. (2) Some of the factors that contribute to poor oral health among special needs children are –

Genetic disorders or developmental defects

Conditions like Down’s syndrome often makes the child susceptible to enamel erosion, tooth loss, missing teeth, malocclusions, and gum diseases. All of these oral health issues contribute to difficulty in maintaining good oral health. Moreover, it increases plaque accumulation. Some physical limitations affect the movement of the tongue in the mouth and decrease its ability to clean the tooth surface naturally.

Limited manual dexterity

Often special need children have poor motor coordination. Spinal cord injuries, cerebral palsy, and muscular dystrophy further reduce the motor ability in special needs children. In such situations, tooth brushing and flossing becomes difficult and merely is left undone. Its consequences include poor oral health and tooth decay.

Reduced salivary flow

Water intake in children with special needs is less as compared to children without special need. It, in turn, affects the fluid balance of the body and results in decreased saliva production. This is one of the reasons why children with special needs suffer from dry mouth more frequently.

Diet restrictions and medications

Since children with special needs find it difficult to chew or swallow food, they are often fed with pureed food. Pureed food easily sticks to the surface of the teeth and contributes to poor oral hygiene. Moreover, some anti-seizure medications can cause inflammation and bleeding of gums.

Common oral health issues among children with special needs

Typical oral health issues among special needs children may include – (3)

  • Delayed tooth eruption – genetic disorders, delayed bone growth, impaired muscle activity, and medications can affect the eruptions rate of tooth among such children. Sometimes, the first primary tooth may erupt at the age of two years.
  • Tooth decay – continuous poor oral hygiene and lack of manual dexterity to regularly brush and floss the teeth can contribute to tooth decay.
  • Gum diseases – anti-epileptic medications have known to have a gum overgrowth as a common side effect. Moreover, these medications can cause bleeding of the gums. Poor oral hygiene is another contributing factor that may lead to severe periodontal breakdown.
  • Malocclusions – misaligned teeth, crowding, spacing, increased overjet, and crossbite are some of the common dental findings among special needs children. These malalignments cause occlusal problems and contribute to food lodgement, which is difficult to clean by the child.
  • Oral habits – often children with special needs develop teeth grinding, mouth breathing, and tongue thrusting habits as a result of malocclusions.

Dental care of Children with special needs

The best way to help children with special needs is to prepare a proper oral health care plan. Additionally, professional care is required to take care of dental problems like correction of occlusion, oral prophylaxis, and tooth decay. (4)

Following are the tips to keep in mind while taking care of the child’s oral health –

  • Do not share a spoon as it may transfer bacteria from your mouth to the child’s oral environment.
  • For infants, start the oral health care routine by wiping the gums with a wet gauze pad.
  • When the teeth begin to erupt switch to tooth brushing with a soft-bristled toothbrush. Floss at least once daily. Toothbrushes with specifically designed handles are available in the market. These can aid in providing self-control to the child for tooth brushing.
  • Fluoridated toothbrush helps to reduce cavities.
  • Maintain a balanced diet for the children. Avoid sweet food and acidic drinks as they may damage the tooth enamel.
  • Encourage the child to drink plenty of water to maintain fluid balance in the body and to eliminate the occurrence of dry mouth.
  • Regular dental visits are a must. It helps to keep a check on any dental developments or problems. Dentists specialized in special care dentistry are more preferred as they are accustomed to handling situations sensitively.

Take away message

Children with special needs are the ones who suffer from certain genetic and developmental disorders. These children have altered physical, and emotional reflexes. In such delicate situations, it becomes difficult for them to take care of their oral health needs alone.

It is therefore essential for parents or caretakers to become aware of the situation and get educated on how to help and maintain the health of the child. Children with special needs are twice more prone to developing dental problems. Proper planning and routine follow-up can take you a long way to maintaining good oral health for special needs children.


Furthermore, a dental professional can guide the parents and help them to increase the efficiency of oral hygiene maintenance.


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