Pediatricians receive guidance on dental treatment for children with developmental disorders


A child watches as his teeth are brushed. (Eric Albrecht/Columbus Dispatch/TNS)

Children with developmental disabilities often struggle to get dental care despite being at higher risk for cavities and other problems. Now new guidelines detail what pediatricians should do to help.

In a 20-page clinical report released this week, the American Academy of Pediatrics highlighted the unique situation faced by people with autism, cerebral palsy, intellectual disabilities, Down syndrome and other developmental disabilities when it comes to oral health.

These people are at increased risk of dental disease “due to unique aspects of their medical condition, their associated treatments, or both,” the guidelines note.

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For example, bruxism, the voluntary or involuntary grinding or clenching of teeth, is common in this population, and certain factors, such as seizures and the use of psychotropic medications, may increase the risk of dental trauma.

Pediatric groups also note that people with developmental disabilities face additional barriers to accessing care, making it difficult to find dental providers who are ready or willing to treat them.

The guidelines explain how to manage self-harm, the advantages and disadvantages of sedation and general anaesthesia, and also outline considerations for people with adaptive behaviours such as chewing or excessive drooling.

The pediatric groups said primary care providers should identify and refer patients to dental professionals who can care for children and adolescents with developmental disabilities. Pediatricians are encouraged to encourage children to have a dental appointment by age 1 and to communicate with dental providers about an individual’s intellectual and functional abilities.

“Children and young people with developmental disabilities may have difficulty communicating their needs or may require special assistance with caring for their teeth,” said Dr Elise Salvas, lead author of the report. “It is important that paediatricians and dentists identify oral health needs and communicate with families and among themselves about how to best serve children.”

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