Dental problems of the disabled child

IT IS like an eclipse that casts a shadow on the mind. Parents of disabled children are so caught up in the condition troubling their child that dental problems seem unimportant. That the child is unable to express things clearly adds on to the misery. Disabled children present challenges that require special preparation before the dentist can provide acceptable care. The first week of December being ‘World Disability Week’, we now look at the awareness and significance of specialised and customised dental care for disabled children.

Home dental care

We begin with a few simple measures that parents can help a disabled child do at home to prevent dental decay and establish good oral hygiene.

1.Home dental care begins in infancy, the parents should gently cleanse the incisors daily with a soft cloth or infant toothbrush.

2.The horizontal scrub method is the best tooth brushing technique recommended and consists in gentle horizontal strokes on cheek, tongue and biting surfaces of all teeth. Electric toothbrushes have also been used effectively by disabled children. Although independent brushing is not contra indicated, unsupervised oral hygiene procedures in disabled children can have serious dental consequences.

3.A diet survey with the parent is made. Conditions associated with difficulty in swallowing, such as cerebral palsy, requires the patient to be on a pureed diet and these dietary modifications are noted. Particular emphasis is placed on the discontinuation of the nursing bottle by 12 months of age and cessation of at will breast feeding after teeth begin to erupt, to decrease the likelihood of nursing caries.

At the dental office

A disabled child is one who has a mental, physical, medical of social condition that interferes with his normal functioning. Some of the disabling conditions of children are mental retardation, cerebral palsy, autism, deafness, blindness, Down’s syndrome among others. Parental anxiety concerning the problems associated with a disabled child frequently delays dental care until significant oral disease has developed. The child requires dental treatment no matter how serious the disability is.

Physical restratints for dental care: Parents are given a careful explanation about how restraints allow the needed dental care work to be done while minimising the possibility of accidental injury to the patient. The mouth prop is identified as a ‘tooth chair’, the Pedi-Wrap as a ‘safety robe’, and a restraining strap as a ‘safety belt’, allowing the patient to feel secure rather than threatened.

General anaesthesia for dental care: If a child requires extensive dental treatment and cooperation cannot be achieved by routine measures, the use of general anesthesia in a controlled atmosphere is recommended.

Dental care for blind children :

An in-depth understanding of the patient’s background along with a team approach in a cheerful, relaxed atmosphere smoothens out the ordeal for both the child and parent. Audio tapes and Braille dental pamphlets are used explaining specific dental procedures.

Dental care for deaf children : The patient and parent are asked to determine in the initial appointment how the patient determines to communicate. Visual aids are used and the patienshown and demonstrated the instruments and how they work.

Dental care for children with mental retardation, autism : By thoroughly understanding the patient’s degree of mental retardation and abilities, the dentist delivers treatment with patience and understanding putting to rest all apprehensions of parents. Frequently patients confined to wheel chairs (as in cerebral palsy) are treated in the wheelchair if they express such a preference.

Parents of disabled children need to realise that they need not shy away from bringing their child to the dental clinics. The dentist is eager to become familiar with a disabled child’s special needs and with the parent’s concerns, as the dental management of the child is quite gratifying.

The author is a dental surgeon and can be contacted at ALL SMILES DENTAL CLINIC 6673439, 9845085230