Parents of children with disabilities often have a difficult time when taking their children to dental visits, even at a pediatric dental office. Unfortunately, the result is that many children with special needs do not get regular dental care. Children with cerebral palsy, autism, cleft lip & palate, diabetes, epilepsy and other disorders often have specific dental problems due to their health issues that must be addressed with regular dental care. As your child’s dentist, I want to be certain that all children have the best dental care available. As a rule, an early morning appointment seems best for children with special needs and, of course, any medications required for a child’s condition should be given prior to the appointment to make it as pleasant an experience as possible for all.
Here are some specific issues by diagnosis that may help parents with special needs children:
Children with ADHD often find it difficult to sit through a dental exam or treatment. It’s recommended that appointments be scheduled in the morning, when the child is rested and potentially most attentive. Sometimes, breaks during treatment help a child with ADHD to better sit still for the exam and/or treatment. If your child has a great deal of difficulty, conscious sedation is an option we can discuss.
As you know, there’s a great range of behaviors among autistic children. In our office, we find that it often helps if the child is able to visit the office prior to the actual appointment, to help him become familiar with the office and our staff. As with any child, bringing a toy along can sometimes support that feeling of familiarity. We will discuss with you your child’s sensitivity to physical contact, as well as level of cognitive abilities so that we speak with your child at a level that she understands. Starting the oral exam with our gloved fingers prior to introducing a dental instrument is often helpful, as well as keeping the instruments out of the child’s line of vision to reduce stress. If essential for the child’s safety, oral sedation may be recommended.
Cerebral Palsy or Down’s Syndrome
As with children with autism, it’s helpful for us to understand your child’s intellectual and speech capabilities, so we can best communicate with him. If there are specific gestures or words that your child uses to indicate discomfort, it would be helpful for you to share them with us. If your child has a hyperactive gag reflex, this can be accommodated with a mouth prop. As with all children, it can be quite comforting to have parents present during the exam or treatment, so that we can be made aware of needs as they arise.
Cleft Lip and Palate
Dr. Kherani is specifically trained to assess dental needs in these children, particularly in the area of missing or malpositioned teeth, and the extra care needed in the sensitive palatal area. When you make your appointment, it would be helpful for us to know the history of your child’s previous surgeries and whether more are planned. We can work with your plastic surgeon to make a plan for orthodontic treatment, which is almost always necessary.
Diabetes and Epilepsy
These two are grouped together primarily because these children require medication for stabilization of their condition. Please time your dental appointments so that medication has taken full effect to limit the risk for low blood sugar or a seizure during the appointment. Do let us know if your epileptic child has reactions to lights or noise, so that we can minimize them where possible.
Our New York City pediatric dental office staff believes deeply that all children deserve the best dental care for a lifetime of health. Please feel free to communicate thoroughly and openly with us about your child’s needs. We’re here to make whatever accommodations possible to ensure a safe and comfortable experience for your child.