Children are the most beautiful creation of nature. A child with it’s smile can win over hearts. Children need constant care and attention. But unfortunately, some of these precious beings may sometimes need extra care and affection. These are our special needs children. However, most of the times their needs are neglected either due to the caretakers fatigue or ignorance. Of all the care required, dental needs and care of these children is often overlooked.
Dr Arun Jacob Silas, Senior paediatric Dentist, American Mission Hospital, Bahrain, talks to us and tells us the importance of caring for the dental care routine of these special needs children.
“ Patients with special needs are those who due to physical, medical, developmental or cognitive conditions require special consideration when receiving dental treatment. Compassion and understanding are the key to treatment approach in these children. Dental care starts with awareness and education of the caretakers about oral an dental health in these children. Most of the time the parents are ignorant or hesitant to talk about the dental care procedures in these kids.”
How can I take care of a special needs child?
The first part in the process is Parent education or counselling. The most important aspect the care taker has to understand is that regular dental check up helps both the patient and the dentist to identify issues and fix them immediately. These pointers can be helpful to you in understanding the requirements of a special needs child.
- Regular visits to your dentist once in 6 months. This helps the child get accustomed to the dental setup and reduces any apprehensions during treatment procedures at a later date. Please ensure the follow up procedure is done even if you think your child does not have any significant dental problems.
- Your child may not be able to express his discomfort and tooth pain very well. Observe your child when he eats food. If he refuses to eat particularly hard food, or is unable to chew on a particular side of the mouth or whines while offered food, he could be in pain. Talk your child to the dentist for an evaluation.
- Examine your child regularly yourself first for any signs of decay like a black spot in the mouth or bleeding gums while brushing. If you notice any changes in your child s mouth, please take him to the dentist.
- Encourage good oral hygiene habits in your child. Tooth brushing for your child will be done under your supervision. So it is important for you to understand the correct brushing technique.
Says Dr Jacob—“ Keep you child in front of the mirror. Give him another brush or a toy to keep him occupied. Stand behind the child and support the child’s lower jaw with your palms. With a toothbrush, preferable the powered brush, use light rotating movements to clean the child’s teeth. Give him water to rinse the mouth. If the child does not have the cognitive skills to do this you can use a wet cotton swab to clean the paste off the teeth.”
Since most children are on meds for their conditions, the saliva in these children are more acidic. This makes their teeth more prone to a decay. Hence, meticulous oral hygiene procedures is the key to a healthy mouth. Regular topical fluoride application by your dentist and also using a fluoridated paste for your child helps in preventing tooth decay.
How can my dentist help in the care of a special needs child?
A good dentist-parent interaction is the key to achieving the dental health goals for your child. The treatment of a special needs child is a multi sitting procedure. As the child can have a short attention span or can be irritable or can get tired easily, all the procedures cannot be done in one sitting. Patience by both the parents and the dentist is of paramount in treating the child.
The first sitting issued by your dentist to evaluate the child and mark all the treatment needs of the child. If the child is in pain then your dentist can prescribe meds for the infection and pain.
Your dentist will schedule the next appointment. Ensure that you take to your dentist or the receptionist about the child’s eating and sleep patterns before scheduling an appointment. It is best to take your child for treatment when he is in the most relaxed time of the day. In the subsequent appointments your dentist will do the following procedures as required
- Scaling using either hand instruments or an ultrasonic scaler.
- Fillings of both the milk teeth and the adult teeth.
- Tooth removal as required and done only after a medical evaluation.
- Chair side sedation with nitrous oxide to carry out any procedures, only if the child has significant cognitive skills.
- Procedures under a GA is indicated if the child lacks cognitive capacity and is impaired due to un-coordinated motor skills. This procedure under a GA is done only after the anaesthetist and the pediatritian evaluates your child. This is a day care procedure wherein, the child will be admitted in the morning. All the required procedures will be done and the child is discharged by afternoon.
Dr Jacob concludes-“Patience and empathy are required in treating a special needs child. A joint effort by the parents and the dentist will help the child have pleasant and comfortable childhood.”