Dubai: Children with special needs are the highest risk population for dental diseases due to their health condition, according to dentists.
The incidence ties into several issues. Parents of children with special needs tent to focus on immediate health issues and may not prioritise oral care. Further, dental health is challenging for children with mental, developmental or physical disabilities and/or those who do not have the ability to understand preventive dental care routines, resulting in conditions relating to the teeth, gums, and mouth.
Dr Dina Debaybo, dentist at the Paediatric Dentistry Centre in Dubai who has worked with children with autism, told Gulf News that depending on the condition – Down syndrome, autism, and cerebral palsy among others -- dental issues may vary.
“Some conditions affect the way teeth and oral structures grow. Others can result in an inability to produce saliva which is necessary to clear food and protect teeth; brush teeth without help; and chew solid food that stimulates teeth, gums, and muscles of the mouth. Some kids who do not know how to chew or cannot chew, hold food in the mouth for long periods. This condition, known as food pouching, increases the likelihood of tooth decay.” Dr Maximilian Riewer, general dentist at Dubai Sky Clinic, has worked with patients with Down Syndrome and thalassemia, explained that dental concerns could also extend to bruxism or grinding of the teeth that can damage teeth; dry mouth that can lead to tooth decay, gum disease, and mouth infections and bad breath.
He told Gulf News, “In most cases the medication - often liquid syrups and medicines with sugar to help manage the child’s condition for seizure control, sedation, etc, is the main cause of caries [dental cavities]. Medications can also disturb tooth formation causing tooth defects. Patient care has to be tailored to the condition because dental hygiene is important for overall health.”
Speaking to Gulf News, Dr Mark Roseman, associate professor, director of Advanced Paediatric Dental Education, Nicolas & Asp University College, Dubai Healthcare City, elaborated on a few dental conditions common in children with special needs. “Generally speaking special needs children like those with oral clefts and Down syndrome have tooth anomalies - missing, extra, or malformed teeth. Developmental disabilities can result in malocclusion - a poor fit between the upper and lower teeth. There can also be defects in the form of pits, lines, or discolouration in the teeth,” he said. Stressing on the need for good oral health care, he advised parents to reduce the impact of medicine by rinsing and/or wiping the child’s mouth after administering the necessary medication.
“A parent should schedule regular dentist visits preferably every six months. Due to the disabling medical conditions or mental or psychological limitations, the parent should provide the child’s full medical history with details on current medications to decrease the risk of aggravating the medical condition. Parents should also ensure brushing and flossing before bedtime. If the child is unable to spit, parents should use a fluoride-free toothpaste,” he said.