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Why People with Special Needs Have More Oral Disease & What to Do About It

Why People with Special Needs Have More Oral Disease & What to Do About It

When you hear the term “special needs,” you likely don’t immediately jump to dental care– but we do. We know that no matter the specific diagnosis, people with special needs tend to have more oral disease overall.

This leads to big questions: why is this link between special needs and poor oral health happening, and what can be done?

Whether it’s brushing at home, preparing to visit the dentist’s office, or overcoming dental fears, you’re not alone. There’s clear science to explain this common problem, and there are measures you can take toward a healthy, sparkling smile today.

Why are people with special needs more likely to suffer from cavities and gum disease?

So, does arthritis directly affect your teeth? Does cerebral palsy conspire with your cavities?

Actually, the reasoning is different than you might expect. The greater burden of oral disease that people with special needs face is often not a direct symptom of their condition. Instead, it is often a sign of the mental and physical challenges of oral hygiene in these cases.

Firstly, those with intellectual disabilities are more likely to have both untreated cavities and severe gum disease. Those who are unable to cooperate with brushing are especially at risk. Behavioral needs can also make oral care more difficult.

When patients are unable to value or participate in their daily dental care, teeth can pay the price.

Secondly, children who are more severely affected by special needs can have insurance lapses, no insurance, or categorized as lower income, and are all more likely to suffer from unfulfilled dental care.

Having special needs is costly, there’s no doubt, and paying for dental care may fall to the wayside when expenses are high.

Finally, these individuals can require specialized dental care plans in order to accommodate any medical and behavioral needs. Without proper support — like help with brushing and flossing at home, or appropriate care in the dental office — these patients can fear and avoid dental care altogether.

More unfortunate factors are the lack of training, no clinical confidence, or even unwillingness of some dentists to treat patients with special needs. Dentists are prepared only for what they know and, without proper training, they will continue to deny access to care because they are afraid.

Up to 20% of patients with special needs were reported not to have a dentist.

In fact, many dental school students feel unconfident in their training level for treating special needs patients. (Thankfully, these standards are changing as we speak at dental schools).

Whether disabilities prevent people with special needs from participating in their dental health, oral problems left untreated due to finances, a lack of specialized treatment, and home care plans, can be accompanied by oral disease.

The good news: as we evolve in our understanding of special needs and oral care, these statistics no longer have to be the case!

By the Numbers: Special Needs Individuals and Dental Problems

As the saying goes, numbers don’t lie. These figures on special needs individuals and dental problems may surprise you when you see just how linked these two issues are:

  • Severely affected, low-income children with special needs are 13.4 times more likely to have unmet dental needs as other kids.
  • 21% of children with special needs required “intense behavioral interventions” around dental care.
  • In the previous study, 20% still had an unmet dental need, though 90% had been to a dentist in the past year.
  • 60% of caregivers for children with autism reported moderate to severe difficulty during teeth cleaning at the dentist’s office, often due to sensory sensitivities.
  • One study found that 43% of patients with special needs reported dental fear.

It’s plain that patients with special needs face a wide range of dental issues. Thankfully, there’s support and stories to help these families along their journey.

If You’re Facing These Problems, You’re Not Alone.

Each individual matters. We have been fortunate enough to hear stories about people’s dental journeys directly from those being affected. The results of excellent dental care can be life changing for families and individuals living with special needs.

  • “My 21 year old son is disabled and cannot brush his teeth properly.” Tammy T. Thankfully, Tammy told us that our Triple Bristle Original Sonic Toothbrush “makes it easy for me to do a good job of getting his teeth clean.”
  • “For anyone with executive functioning issues, remembering to take care of basic hygienic needs like dental care is going to be difficult. The sensory input issues involved with ASD are difficult, and my special needs family member doesn’t like brushing.” -Casey S.
  • We’ve heard so many stories of people with developmental or medical disabilities struggling to brush their teeth — like our Triple Bristle user’s sister. “Love this toothbrush for my sister who has a disability and cannot brush her own teeth. Her dentist appointments are so much better now.”

Remember, it’s common to experience oral hygiene issues when navigating special needs, and it certainly doesn’t mean you’re doing a poor job caregiving. However, there are some positive, proactive steps you can take to help your amazing loved ones.

How to Help People with Special Needs Improve Dental Health

Simply because special needs are present doesn’t mean that an individual can’t have thriving dental health. Here’s what you can do to help people with special needs turn the corner on their care.

At home…

At home, the number one way to improve oral health is consistent, effective brushing. Unsurprisingly, the availability of child-friendly supplies for toothbrushing is a major factor in how frequently caregivers are able to assist with brushing.

For those with behavioral or medical special needs, biting down on the hand while brushing can be problematic. That’s why we created the Brush and Bite Handle with a built-in bite block. It not only prevents injuries, but also keeps the mouth open without using unnecessary force.

One of our reviewers told us, “My older son who has a developmental disability has found this brush very easy to use. It has helped his dental hygiene.”

Setting a comforting atmosphere, keeping a clear routine, communicating and moving slowly can help put your loved one at ease if you need to brush for them.

At the dentist…

The best thing you can do for your child at the dentist actually starts at home. Practicing for dental procedures ahead of time can help reduce that difficult dental fear in those with special needs. Setting expectations is a great way to calm nerves and prepare for your visit.

Perhaps you can use a tongue depressor to gently practice opening the mouth or talking through the steps of the visit — start to finish. We created the Brush and Bite Starter Kit full of disposable items used at a dental office to practice everything from x-rays to routine cleanings.

How to Find a Dentist Sensitive to Special Needs

It’s also imperative to find a dentist who feels comfortable and confident treating your loved one with special needs. It is illegal for dentists to turn away special needs patients, but you want someone who doesn’t just tolerate, but is attentive to the individual needs in your situation.

To that end, the Special Care Dentistry Association has created a searchable database to find a dentist that fits your needs and insurance. These dental professionals are passionate about “promoting oral health and well being for people with special needs.”

For those seeking a cost-effective solution, many local dental schools run clinics treating individuals with special needs. It’s worth contacting a few nearby universities to inquire.

When evaluating if a dentist is the right fit for you, look for someone who is interested in a detailed medical history, has specialized equipment to treat cases with special needs, and a sensitive staff to your loved one’s condition.

In Summary

  • There is a well-established link between special needs and a higher rate of cavities and gum disease.
  • This may be due to physical inability to brush, cost of care, unprepared dentists, or behavioral issues, among many other causes, but is typically not directly tied to the condition.
  • While statistics can be gloomy, with higher rates of unmet needs and dental fear, many other families have experienced and overcome these issues.
  • At home, consistent brushing with specialized equipment (like the Brush and Bite Collection) can lead to lessened dental decay and gum disease.
  • Practicing at home for the dentist’s office and selecting a well-equipped dentist can also reduce the chance of meltdowns when it’s time for a checkup.


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