By: Kristina E. Malik, MD, FAAP & Elise W. Sarvas, DDS, MS, MPH
Children with
developmental disabilities—including physical, learning, language or behavioral health challenges—often have unique
oral health needs. This can make it harder for families to find the care that works best for their child.
That's why the American Academy of Pediatrics encourages parents of children with developmental disabilities to talk with their pediatrician about
oral health care and resources.
Here are some ways you can help keep your child's teeth healthy and support their oral health.
Ask about your child's oral health
Pediatricians regularly check for the
risk of cavities during health visits. They can also offer advice on how to prevent tooth decay.
Children with developmental disabilities are at higher risk for dental disease. There are some common reasons for this, including:
Using medication that has a high sugar content or causes a dry mouth. The bacteria that cause dental disease thrive in dry mouths and are fueled by sugars.
Eating a special diet of food that is soft, pureed or high in starch. These foods more easily stick to teeth and can be harder to remove.
Being unable to participate in regular brushings at home or the dentist. This may be because of physical limits or behavior challenges.
Toothbrushing tip
If your child can spit, use a pea-sized amount of toothpaste that has fluoride. If your child cannot spit, use about the size of a grain of rice. This tiny amount is okay to swallow if they cannot rinse after they brush.
Following a regular dental routine at home that includes brushing twice daily and drinking
fluoridated water can help.
Fluoride is a natural mineral that helps fight tooth decay.
Most kids get plenty of fluoride from tap water and fluoride toothpaste. Applying fluoride varnish to the teeth is another way to help prevent cavities. It is covered by most insurance plans. Your pediatrician or dentist can apply it to your child's teeth two to four times per year, depending on their risk of getting a cavity.
Find a dentist
Most children can be treated in a dental office, but some are unable to cooperate due to special health care needs. For example, a child may require anesthesia or other care that is hard to access. There might be other obstacles like long wait times, or the family might have to travel to a dental clinic far from home.
Ask your pediatrician if they can recommend a dentist for your child. Many pediatricians keep a list of
pediatric dentists, family dentists,
public health dental clinics and programs that donate time.
Ask the pediatrician or contact the
dental provider directly to find out details such as:
Ages of patients they care for.
How soon a child can be seen for a routine visit.
If the office has any special accommodations available such as wheelchair accessible treatment areas, sensory play objects or private rooms.
If
sedation or anesthesia are offered.
Whether the dentist can also see patients in a hospital setting when needed.
What forms of insurance are accepted, including
Medicaid.
Whether they can provide care for patients with severe chronic oral health conditions.
If they have experience caring for children with conditions that require a feeding tube or have complex medical conditions.
Plan for the dentist visit
A dentist who is experienced caring for children with developmental disabilities will provide equipment and modifications to make your child's visit as comfortable as possible.
When scheduling an appointment, tell the dental office about your child's special needs. Let them know about:
Any fears or sensitivities your child has.
What can make your child more comfortable during the visit.
The time of day that is best for your child.
Whether your child uses a wheelchair or has physical needs.
Before the visit, talk with your child about what will happen. At home, you can practice examining their mouth and teeth, so they are more comfortable with it during their visit with the dentist.
Make brushing a habit at home
Your child's dentist can share ideas to do at home—such as using special grips or
adaptive toothbrushes to improve brushing and rinsing with a mouthwash—to keep your child's teeth and gums healthy. They can also recommend
mouth guards and other tools to protect your child's teeth from injury.
Make it a goal to follow a
dental routine for your child. This includes brushing twice a day with fluoride toothpaste, having your child drink fluoridated water and making sure that your whole family visits the dentist for regular check-ups.
More information
About Dr. Malik
 Kristina E. Malik, MD, FAAP, is a board-certified pediatrician. She practices at Children's Hospital Colorado where she cares for children with disabilities and complex medical conditions in the Special Care Clinic and is an Assistant Professor of Pediatrics at the University of Colorado School of Medicine in Aurora, Colorado. Within the American Academy of Pediatrics, Dr. Malik is a member of the Section on Home Care executive committee, the Council on Children with Disabilities and the Section on Oral Health.
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About Dr. Sarvas
 Elise W. Sarvas, DDS, MS, MPH, is a board-certified pediatric dentist. She practices at Mayo Clinic in Rochester, Minn., where she cares for the oral health of children and adolescents with complex medical conditions. Dr. Sarvas is an Assistant Professor in the Department of Dental Specialties and within the American Academy of Pediatrics, she is a member of the Section on Oral Health.
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