“Special care” children or children with impairments or disabilities have as much right to optimal dental care as normal children. They often have extensive problems that require specialised knowledge and treatment.
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Parents of these children sometimes find it difficult to get optimal treatment from private practice, as dentists are often unwilling to treat them due to a lack of knowledge regarding the specific condition. Certain precautions might also need to be taken before treatment can commence.
Parents often do not realise the importance that dental care should start at an early age. Prevention of dental problems is of cardinal importance, especially in handicapped or disabled children. Most of these patients will never be able to cope with dentures or other prosthetic devices. Nutritional problems and problems with chewing are common in these children and these problems will worsen if teeth are lost. Speech problems could also be exacerbated by the loss of teeth. The emotional aspect of tooth loss should also be borne in mind. Prevention is therefore the key to avoiding future dental problems.
Psychological and physical barriers
Physical and psychological limitations make effective oral health care difficult. If the patient’s disability is of such a nature that he or she cannot care for their own teeth, someone else has to accept responsibility for maintaining their oral hygiene. In such cases, an electric toothbrush may be of value.
Regular dental check-ups and professional fluoride application are very important. Fluoride helps to harden early cavities and potential problems can be spotted and addressed at an early stage. Diet is also another aspect that requires special attention. Overprotective parents of children with disabilities tend to overindulge them when it comes to sweets and other sugar-containing foods. The incidence of caries is usually higher amongst these individuals as oral hygiene is poor and they tend to favour soft diets. Consumption of sugars should be limited and should only be restricted to mealtimes.
“Special care dentistry” also includes children whose medical condition is of such a nature that their general health or even their lives could be put in jeopardy by dental treatment. Children with heart problems, haemophilia, leukaemia (or other cancers) and diabetes fall into this category. Dental abscesses in these children could be potentially life-threatening. Extra care should therefore be given to the oral health of these children as they are regarded as being “high risk”.
Good dental health improves overall well-being and with early intervention, the need for complicated dental procedures can be avoided. - Dr Nadia Mohamed, B.Ch.D, BSc Hons/ MSc Dent Sc
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