Cerebral Palsy and Oral Health Issues
This article has been fact checked by a Board Certified Pediatric Nurse Practitioner. Sources of information for the article are listed at the bottom.
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Although cerebral palsy itself doesn’t cause oral deformities or abnormalities, many of its symptoms lead to oral problems and patients with CP 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 on a frequent basis. 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 of time
- 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 and/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, there are numerous oral health professionals who 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 required 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 on how to accommodate patients in wheelchairs while providing a calm, child-friendly environment.
Furthermore, oral professionals working with children with cerebral palsy must be trained in how to properly monitor breathing. This is especially important for children who are unable to 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. 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. For children who have difficulty spitting due to cerebral palsy, ask your dentist which type of toothpaste would be best.
Between 18 months to 2 years of age, a child should have his/her 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 medication intake.
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 certain to speak with your child’s dentist or even a speech therapist who can help you with ensuring your child is swallowing correctly, which makes it easier to keep their mouths clean.
Facts About Children With Cerebral Palsy and Oral Care
According to the American Academy of Pediatric Dentistry, a major study on children with cerebral palsy and oral care indicated that:
- 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.