Developmental disabilities put strain on a person’s capacity in everyday tasks. People who have autism, Down’s syndrome, cerebral palsy, hearing and vision impairment etc. suffer from deficiencies in cognitive development and will find it increasingly difficult to engage in personal self-care. That is also the case for people who have a hearing impairment, depression, muscular dystrophy etc. Oral health is affected due to the person’s decreased capacities. These dental problems can escalate into other diseases and affect the general health of the person.
Disability and Oral Health in Children
The problem among children is varied and it affects the dental health of children in several ways:
Delay in tooth eruption
Children who have disabilities have difficulties pertaining to tooth eruption. In the case of children with Down’s syndrome, teeth eruption is delayed – sometimes even till the age of two years. Some even experience difficulty while teeth are erupting, often causing inflamed gums.
Tooth decay
This is commonly seen in almost all who have developmental disabilities. Many reasons can be attributed to this – could be special diet some are required to follow or medicines they need to take. Some will experience gastric reflex, this could cause the acid to act on the teeth and bring about tooth decay.
Irregular size/shape of teeth
Children with disabilities have problems with the number and size of the teeth. Some children would develop overcrowding teeth. Lack of proper hygiene can lead to plaque build-up in the teeth and cause teeth decay. Malocclusion is also a common feature – in this condition there is an improper positioning of the upper and lower jaw and this can lead to related dental conditions.
Trauma/Teeth grinding
Most children who have developmental difficulties experience seizures. Teeth can get affected if proper attention is not paid to teeth when they have seizures. Trauma to the oral region is also caused when children fall down and injure themselves. Teeth grinding is also seen among many children with disabilities. Due to this the function of the teeth can get damaged as constant grinding can lead to a smooth flattened teeth surface.
Cavities
This is one of the commonest dental problems in children with developmental disabilities. This can be due to different reasons such as medications, diet and also lack of personal hygiene. Some medicines can cause dry mouth condition and some medicines would have more sugar content in them. If care is not taken to rinse after each medication, these sugar rich medicine can get stuck to the teeth and bacteria can act on the teeth and cause cavities. Reduced intellectual capacities also add on to getting cavities as they are unable to comprehend the cleaning process completely.
Gum diseases
Reduced capability in performing daily oral hygiene practices contribute to the development of gum diseases. If the lining of the gums is not cleaned properly, food debris will be deposited there while consuming food. When they are not removed properly bacteria will act on this food and release acids which will cause irritation in the gums and cause inflammation.
Challenges affecting Oral Health
Developmental disabilities affect the overall functioning of a person. This will also affect the oral health and hygiene.
Developmental disabilities affect the mental capacity of a person. They are unable to comprehend the importance of oral hygiene and oral health and it can suffer due to lack of understanding.
Some of them have visual and hearing impairments or even motor impairment – this can act as a hindrance in oral health care. They are unable to perform all the necessary activities to have good oral health. It is important that caregivers are aware of the special needs of those in their care and take steps to make oral hygiene an important part of general health.
Behavioural problems also are known to affect oral hygiene. Some of the patients would not fully understand the importance of dental care and would be anxious to go through different procedures for dental hygiene. Those who suffer from depression due to their disability also would not be able to give proper attention to oral health.
Support from Caregivers
Immense support is needed from caregivers as people with disabilities are unable to manage personal care on their own. Caregivers must either assist people with disabilities in daily brushing or take up brushing their teeth as some are unable to hold their brushing. Besides brushing, flossing must also be included as an important part of oral hygiene. If the person you are caring for is a young child, you can try and involve them in simple steps in everyday brushing.
Praising them for their effort and breaking down the instructions in easy to follow steps and practice it every day with them will help them be more independent in personal oral care. Staying calm and supporting those in your care is very important when one is going through different actions in dental care. Besides this a very important part is not forgetting dental consultations. Scheduling consultation with a dentist is essential as it would guide you in knowing which areas to focus for your patient.
Dentist for disabled people
While you are planning for a consultation, also check on the ‘disabled friendly’ nature of the clinic. If your child/family member uses wheelchair, then need to check if they are accessible for wheelchairs. Dentists and their support team need to be attuned to the needs of the disabled people as they might not be able to communicate clearly. If they are hearing impaired and have speech problems, then there would be limitations there as well. Check with the dentist on their experience in dealing with disabled people before you fix an appointment.
Provide all the information connected with your family member to the dentist. Medical history is one of the important information that needs to be shared with the dentist. Also provide any information that will help the dentist while they plan the dental consultations and procedures. What causes your family member to be anxious, what can be done to calm them – all these would be helpful when conducting consultations.