Treating pediatric dental patients with special health care needs

The American Academy of Pediatric Dentistry (AAPD) defines special health care needs (SHCN) as any physical, developmental, mental, sensory, behavioral, cognitive or emotional impairment or limiting condition that requires specialized medical management. Some examples are autism, Down syndrome, and sensory processing disorder. Oral health is an important part of a child’s general health and overall quality of life. When scheduling a dental appointment for a child with special needs, it is important to seek out the care of a pediatric dentist. These dental specialists have received specific training in a variety of behavior management techniques and are best equipped to provide safe, effective, and efficient treatment.

When scheduling a dental appointment, it is important to identify the child as special needs in order to allow the dental team to properly prepare an appointment that is uniquely catered to your child. At the initial dental appointment, it is essential to share all aspects of your child’s medical and dental history. Behavior guidance will be easier when the dental team is aware of the child’s favorite food, friends and activities as well as common negative triggers that can cause anxiety and/or fear. Resistant behavior in the dental chair is expected and normal. Have no fear, there is no such thing as an untreatable child! If the child is unable to cooperate for treatment, the dental team can utilize one or more adjuncts to ensure a safe and positive experience. The most common adjuncts include protective stabilization and sedation. Protective stabilization is a blanket utilized to comfortably immobilize the arms and legs and help the child remain still. Sedation in the form of Nitrous Oxide (laughing gas) and/or oral sedation in office or general anesthesia in the operating room may also be utilized.

The first step to prevent dental decay in your child is to brush your child’s teeth twice a day with a small amount of fluoridated toothpaste. If your child doesn’t spit yet, just use a smear of toothpaste to prevent excessive ingestion. Flossing before bed helps immensely to prevent the development of dental cavities between the teeth. If you feel you are not able to easily accomplish these tasks, talk to your dentist about alternative approaches. Oral hygiene techniques can be modified to meet your child’s specific needs.

Lastly, do not forget to focus on a healthy diet! Children with SHCN can be finicky when it comes to the foods they are willing to eat, but steering clear of large amounts of sugary beverages, carbohydrates and candies will help greatly with the prevention of dental cavities.