Oral conditions in children with special needs

Oral Development

Tooth eruption

Tooth eruption may be delayed, accelerated, or inconsistent in children with growth disturbances. Gums may appear red or bluish-purple before erupting teeth break through into the mouth. Eruption depends on genetics, growth of the jaw, muscular action, and other factors. Children with Down syndrome may show delays of up to 2 years.

Malocclusion

Malocclusion, a poor fit between the upper and lower teeth, and crowding of teeth occur frequently in people with developmental disabilities.

Nearly 25 percent of the more than 80 craniofacial anomalies that can affect oral development are associated with intellectual disability.

Muscle dysfunction contributes to malocclusion, particularly in people with cerebral palsy. Teeth that are crowded or out of alignment are more difficult to keep clean, contributing to periodontal disease and dental caries.

Tooth anomalies

Tooth anomalies are variations in the number, size, and shape of teeth. People with Down syndrome, oral clefts, ectodermal dysplasia, or other conditions may experience congenitally missing, extra, or malformed teeth.

Developmental defects

Developmental defects appear as pits, lines, or discoloration in the teeth. Very high fever or certain medications can disturb tooth formation and defects may result. Many teeth with defects are prone to dental caries, are difficult to keep clean, and may compromise appearance.

Oral Trauma

Trauma to the face and mouth occur more frequently in people who have intellectual disability, seizures, abnormal protective reflexes, or muscle incoordination. People receiving restorative dental care should be observed closely to prevent chewing on anesthetized areas. If a tooth is avulsed or broken;

• Take the patient and the tooth to a dentist immediately.
• Counsel the parent/caregiver on ways to prevent trauma and what to do when it occurs.