What do Children with Disabilities do? (at the Orthodontist)

Regular dental care is a vital component of childhood growth and development. This includes regular brushing, flossing, and visiting the dentist or orthodontist for oral inspection and prophylaxis treatment. Oral hygiene is for maintaining good breath, healthy teeth, and a nice smile. However, for children with chronic health conditions or disabilities, oral care is more than that! It plays a critical role in controlling chronic diseases. Bad, germ-infested, and plaque-ridden teeth can exacerbate the symptoms of these chronic illnesses, which make it very harmful for these already sick kids.

What Are Chronic Health Conditions/Disabilities

A chronic condition is actually an umbrella word or an all-encompassing term that refers to any permanent or ongoing health issue or disabilities. Typically, these issues have no cure, only medicines that give relief and alleviate painful symptoms. Examples of chronic diseases are:

• asthma,
• rheumatic heart disease,
• psoriasis,
• cystic fibrosis

These, among many other chronic conditions, affect different parts of the body and have different manifestations. But what they share in common is this: these chronic ailments have a long term impact on a child’s health.

What may work for normal, healthy children cannot be the same standards for kids with chronic health conditions. This includes more visits to the dentist or orthodontist because healthy teeth and gums are critical to maintaining good health.

Remember, there are a lot of bacteria present in the mouth. If the gums and teeth are in bad shape, bacteria can penetrate the bloodstream and the organ system very easily, making septic shock a reality. Here are some areas where chronic health conditions or disabilities affect dental management and treatment:

Dental Caries and Plaque Exacerbate Symptoms

Those kids who are medically compromised are at an increased risk of developing systemic problems and complications from minor dental infections. In normal kids, the effects of these dental issues may be minor, but for immune-suppressed kids battling chronic illness, these issues can be fatal.

Dental caries is an illness of calcified tissues of the teeth. Often, there is a presence of harmful bacterial plaque, such as streptococcus mutans. These bacteria can easily penetrate the gum lining and infiltrate the bloodstream causing harmful effects. For instance, children with rheumatic heart disease will be more prone to infective endocarditis (inflammation of the lining of heart chambers and heart valves due to the presence of bacteria). That’s why it is necessary to continue good oral care and regular dental visits for kids with chronic diseases.

Taking a Prophylaxis Before Oral Treatment

Kids who are at risk for infection are required to take an oral antibiotic prophylaxis. Some medical conditions really predispose patients to bacteremia-induced infections, so medical practitioners prefer to stand on the side of precaution.

Because no accurate prediction can be made when a susceptible patient will develop the said infection, antibiotics are prescribed before undergoing procedures that increase the risk of bacteria production. Oral procedures are part of that list because the gums often bleed with oral procedures, and these open wounds are exposed to the bacteria in saliva. Kids who have heart disease need to take low dose, non-potent antibiotics before undergoing oral treatment.

Teeth are Vital for Mastication and Digestion

Good oral health is necessary not just for smiling but for mastication (chewing). Kids suffering from chronic illness need a good set of teeth, so they can eat and their food properly. Remember the first phase of digestion begins in the mouth.

If they can’t chew their food properly because of painful teeth, then they are more prone to indigestion, acid reflux, constipation, and host of other stomach problems. Chronically ill kids already have a hard time with their other health issues. Taking care of the teeth equates to one less problem to worry about.

Ineffective Oral Hygiene Needs Follow Up

Some chronic conditions like Down’s Syndrome, ADHD (attention deficit and hyperactivity disorder), or autism affect cognitive functions. These in turn affect the child’s behavior. Sometimes, a kid’s ability or willingness to brush and floss the teeth is compromised. Although they do, it is not enough to take out harmful plaque.

In some cases, there really is a physical limitation to do these tasks, so the kids have to rely on a busy adult who can forget the task. Although adults and caregivers have been given proper training to carry out these tasks, compliance is still often an issue. Thus, regular follow up with an oral health provider is crucial to ensure that the teeth and gums remain healthy.

Developmental Delays and Defects

Some kids with chronic issues are more likely to have developmental delays or defects. For instance, those with Down, Turner, or Treacher-Collins Syndrome have a predisposition to a defect called enamel hypoplasia.

Enamel is the top covering that protects the teeth. Malformed enamel leads to tooth decay and gum gangrene. Those with enamel hypoplasia do not have enough tooth enamel. Kids with this defect must be monitored more frequently to help them catch tooth decay and gum issues, so they can be nipped in the bud before they get worse.

Special Diet and Medication that Impact the Teeth

More often than not, a child with a chronic health ailment needs to eat a different diet as a part of their treatment plan. Sometimes, this includes nutritional shakes or it can mean more frequent feeding to amplify calorie intake. These types of diet plans increase the chance for tooth decay and plaque formation.

In the same token, there are some medicines taken by these chronically ill kids that have a side effect of inhibiting the flow of saliva. Once again, this increases the risk of tooth decay and gum problems.

Vigilance and proper monitoring of the teeth are necessary for patients with special diets and regular maintenance medications. Always ask your health care provider what the possible side effects of their proposed treatments are so you can keep an eye out for them.

Many chronic conditions increase the risk of dental issues, but the prognosis isn’t too bad if parents keep a watchful eye. It is vital to work with your dentist to ensure that problems are kept at bay and there are no painful complications. Most of all, good oral hygiene habits at home for your child with special needs are necessary in maintaining healthy teeth and gums.