Cerebral Palsy and Oral Health Issues

Fact Checked

Although cerebral palsy doesn’t cause oral deformities or abnormalities, many of its symptoms lead to oral problems. Patients with cerebral palsy are at a greater risk of dental issues. With diligence and regular dental checkups, however, your child can maintain healthy teeth and gums.

Why Are Children With Cerebral Palsy At Risk for Oral Health Issues?

Some children with cerebral palsy have gastrointestinal reflux and tend to reflux or vomit frequently.[1] Increased drooling also causes an increased risk of dental caries, as well as some of the medications taken for cerebral palsy, may contain high amounts of sugar. All of these factors can lead to a heightened risk of children with cerebral palsy developing tooth decay.

Other issues that heighten the chance of oral problems in children with cerebral palsy include:

• Trouble chewing and swallowing
• Lack of control when using a toothbrush and floss
• Malalignment of the upper and lower teeth
• Excessive gagging
• Gingivitis due to seizure medications
• Having food in the mouth for long periods
• Lip, tongue, and cheek biting

Children with cerebral palsy often have problems cleaning their teeth on their own due to jaw muscles that can’t sufficiently relax, mouth and tongue sensitivity, and problems holding a toothbrush or floss.

Oral Treatment for Children with Cerebral Palsy

Parents may be hesitant in getting dental care and treatment for a child with cerebral palsy for fear that the visit will be difficult or go poorly. However, numerous oral health professionals specialize in working with children with special needs and make great options for these children.

Safety training is required for all oral health professionals who work with special needs kids, including training in CPR, training in supporting children with involuntary tremors and bodily movements, and training on how to successfully clear breathing passages.

Oral professionals for special needs children are also trained to accommodate patients in wheelchairs while providing a calm, child-friendly environment.

Furthermore, oral professionals working with children with cerebral palsy must be trained to monitor breathing properly. This is especially important for children who cannot communicate or have challenges expressing discomfort and pain.

Other qualifications that oral care professionals who work with children with cerebral palsy should have, include:

• Ability to establish a trusting relationship with the child
• Ability to give commands in a friendly yet understandable manner
• Ability to effectively communicate non-verbally (if needed)

The American Dental Association (ADA) suggests that children should start receiving oral health care before they have teeth by wiping their gums down with a warm cloth.[2] This not only cleans their mouth, but it helps them get used to having their mouth cleaned, something that some children with cerebral palsy have difficulties with when they get older.

Once teeth have erupted, regular twice-daily cleaning with a non-fluoridated toothpaste is recommended. Once children are old enough to spit, fluoridated toothpaste is recommended. Ask your dentist which type of toothpaste would be best for children who have difficulty spitting due to cerebral palsy.

Between 18 months to 2 years of age, a child should have their first professional dental visit. The dentist will generally check the child’s teeth for any oral issues and teach parents how to help their child care for their teeth at home.

Oral Care at Home

As a parent, guardian, or caregiver, you will be responsible for supervising daily oral hygiene at home. Brushing, flossing, and rinsing should be a daily habit. This includes brushing, flossing, and rinsing after meals and after the medication intake.

“Home dental care and hygiene should be promoted from early on,” the National Institutes of Health reports.[3]

Consider the following to help you become successful with home oral health care for your child:

• Purchase toothbrushes and floss that is easier to use, such as an electric toothbrush and toothpick floss sticks
• Buy toothpaste made for children with sensitive teeth and gums
• Make teeth-cleaning time a fun activity with various child-friendly games and positive reinforcement
• Oral care should be done at a time when the child isn’t tired or angry
• If your child refuses to use a toothbrush, consider using a cotton swab or a warm cloth (consult with your child’s dentist first)

If you need assistance, be sure to speak with your child’s dentist or even a speech therapist who can help you ensure your child is swallowing correctly, which makes it easier to keep their mouths clean.

Facts About Children With Cerebral Palsy and Oral Care

• Children with cerebral palsy are less likely to receive oral care than children without disabilities. While 40% of the participants’ children without the disorder had regular dental visits, only 23.6% of the children with cerebral palsy had seen a dentist.
• Parents of children with cerebral palsy assisted their children with at-home dental care much more often than the parents of children without the disorder.
• Both parents of children with cerebral palsy, as well as parents with children without the disorder, had the same general attitude and knowledge regarding oral care and dentists.

Dental health is a concern for all children, but those with cerebral palsy have a greater risk of several oral health problems. Parents should stay on top of dental care and regular dental hygiene.