Excerpt: There are various reasons why obtaining proper oral healthcare for special needs children has been facing an uphill ride for a long time. Find out the top reasons behind this and how much we have improved today.
Pediatric dentistry can be a challenging occupation by itself, for it’s quite rare for a child to anticipate a visit to a dentist’s office, nevermind sitting through the various dental treatments and procedures that may take place while being there. This challenge is somewhat amplified when it comes to dental treatment for children with special needs. Nevertheless, appropriate dental care is no less crucial for a special needs child than it is for a normal one.
Special needs children are just that - in need of special care due to their physical/ mental handicap or medical issue. It’s all too easy to overlook oral healthcare in this group of children when so many of their other healthcare needs have to be sorted out daily. Obviously, oral self-care can prove to be difficult for special needs children to carry out and that’s one of the main reasons why they have a higher risk of developing dental diseases. Hence, it all goes back to parents and caregiver to prioritise the unique dental care needs of this group of children for the sake of preventing oral and dental diseases.
Special needs children in this regard (i.e those who require special needs dentistry), can be from any of the following:
- Children with severe medical problems (chronic asthma, heart diseases, oncology and transplant patients, etc)
- Mentally challenged children(Down's Syndrome, ADHD, etc)
- Physically challenged children (cerebral palsy, and also visual, hearing and speech impairment)
- Children with adverse dental behaviour
- Children with adverse attitudes towards dental treatment.
- Very young children with early childhood caries or rampant caries
- Children with dental anomalies in size, shape and/or number of teeth
Back in 1987, a survey of the dental health status of 116 handicapped subjects at the Selangor Spastic Center, revealed that a large number of them, around 85%, had decayed teeth due to lack of dental care with almost half of them in need of urgent treatment.(1)Many had such poor oral hygiene that it led to oral diseases such as moderate to intense gingivitis.
There are a number of reasons why obtaining proper oral healthcare for special children proved to be an uphill ride in the past, and to some extent, may still be so today. The following are the top reasons behind this:
- Public awareness is somewhat lacking when it comes to the oral care needs of special children
- Special needs children are unable to convey their dental needs and issues to their parents or caregivers, and so in many cases, treatment may be sought way too late.
- These children usually have medical problems associated with their respective conditions, and these may complicate and/or hamper dental procedures
Special Needs Dental Care Should Not Be Neglected
It’s an underrated fact that special needs children are more prone to have dental decay compared to normal children. Many of them are on prolong sweetened/flavoured medication and most of them have difficulty even in simple tasks such as brushing their teeth, or are uncooperative in doing so. The results are poor oral hygiene as well as compromised oral health.
The teeth of some special children may be abnormal in shape, extra in numbers or even missing due to their respective syndrome, or, teeth that tend to overlap due being to extra in numbers or from being retained in the mouth for too long.
Special needs children who have poor coordination of the oral musculature, such as those with cerebral palsy, tend to habitually grind or clench their teeth together. Habits such as these may be unintentional, but they nevertheless cause the teeth to become flat and in turn, make eating difficult. They also tend to food pouch ( keeping their food in the mouth for a certain period of time before swallowing), which on the long run leads to tooth decay.
Self-inflicted injuries such as from extracting their own teeth is also not uncommon among children with cerebral palsy and incidences such as these require professional dental treatment. For obvious reasons, special needs children require more regular check-ups than their normal peers. - They are advised to visit the dentist three to four times a year.
What Special Needs Dentistry Entails
While some special needs children can be treated the same way as their normal peers, many require extra attention and various methods to administer the proper treatment. They may need to be physically restrained to prevent possible injuries to themselves or to the staff in duty.
In many cases, sedative medications is necessary to help calm or sedate the child while treatment is being carried out. In complex cases or if the child is very uncooperative, a general anaesthesia may be needed.
Dental Care For Special Children: Where It's at Today
Locally, pediatric dentistry for special needs children has actually come a long way and has seen marked improvements. For instance, the Department of Paediatric Dentistry in Hospital Kuala Lumpur provides preventive, curative and rehabilitative dental treatments to children below the age of 16 with priority given to the special needs group. The dental clinic is open daily from 7.30am to 5pm. There is a combined Paediatric Dentistry and Orthodontic clinic once a month, while orthodontic services and combined arteriovenous malformation clinic with interventional radiologists are offered three times a year.
Special needs dental care and treatment may also be sought at private clinics, although not all offer this specialised service. The best way to go about it is to call up a clinic’s office and make an inquiry.
A child with special needs will have to be accessed before a dentist decides on the treatment and/or procedures. If the condition can’t be handled due to the limitations at the clinic or the complexity of the child’s dental issue, the case will be referred to a clinic that is more capable, a specialist or hospital.
Here are some suggestions for parents seeking dental care and treatment for a special needs child:
Pristine Dental @ Midvalley Megamall. Tel: 03-2287 3782 / 03-2284 3482
Jason Cheong Dental Surgery, Bangsar. Tel: 03-2287 9187
Dental Dental Specialist Center Kuala Lumpur. Tel: 603 20943333
Reference: 1. (page 3)
