Cerebral Palsy and Oral Health Issues

Fact Checked

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

Facts About Children With Cerebral Palsy and Oral Care

Researchers have proven that children with cerebral palsy are at an increased risk for poor oral health compared to children without CP.

In one study, researchers found that in a group of participants, children with cerebral palsy were less likely to:[1]

• Maintain their own oral hygiene practices
• Brush teeth regularly
• Receive regular dental care

These children were more likely to have malocclusion, misalignment of the teeth, and gingivitis.

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.[2] 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 independently due to jaw muscles that can’t sufficiently relax, mouth and tongue sensitivity, and problems holding a toothbrush or floss.

This can lead to a higher rate of dental caries, also known as cavities, in children with cerebral palsy.

Oral Treatment for Children with Cerebral Palsy

Parents may be hesitant to get dental care and treatment for a child with cerebral palsy for fear that the visit will be difficult or go poorly. However, many 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 working with special needs kids, including training in CPR, supporting children with involuntary bodily movements, and 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.[3] 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 is best for children with 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 oral issues and teach parents how to help their child care for their teeth at home.

Oral Care at Home for Children with Cerebral Palsy

As a parent, guardian, or caregiver, you will supervise 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.

Research suggests that early oral care and dental hygiene at home are vital for good oral health later in children with cerebral palsy. Parents play a significant role in this.[4]

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

• Purchase toothbrushes and floss that are 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, speak with your child’s dentist or even a speech therapist who can help you ensure your child is swallowing correctly, making it easier to keep their mouths clean.

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.