Dental Care for Kids with Special Needs


Every child deserves to receive quality dental care, as this sets them on the path towards enjoying optimal dental health throughout the course of their lives. Some dentists are apprehensive about treating children with special needs due to difficulties and the inherent risks involved, however here at Specialist Kids Dentist we are more than happy to accommodate the needs of ALL children. We recognise that parents with special needs children lead busy lives, and at times their child’s dental hygiene may be neglected in favour of more pressing medical issues.

Oral health is important, and by following the below tips you can manage your special needs child’s care in the safest and most efficient way possible.

Common dental concerns in children with special needs

  • GERD (gastro-esophageal reflux disease):  This can cause your child’s mouth to be acidic which can wear down the teeth. We can prescribe pastes to help prevent teeth damage from the acid.
  • Holding food in the mouth:Some children will hold food in their mouth or cheeks much longer than usual. This creates a good place for bacteria that cause cavities to grow.
  • Grinding (bruxism):Your child may grind their teeth while sleeping or during the day and over time, this may damage teeth. Grinding is common and most children outgrow the habit.  Treatments are available if it becomes a problem.
  • Bad breath:  May be caused by some digestive problems, chronic sinusitis, diabetes, and certain medications.
  • Dry mouth:May be a result of your child’s condition or from medication. This can lead to tooth decay, gum disease and mouth infections. Check with Specialist Kids Dentist and your child’s doctor for treatment ideas.
  • Delay in first teeth coming in:This is common in children with Down syndrome.
  • Medicine can affect teeth and gums:Liquid syrups and medicines with sugar can cause cavities. Other medicines can cause dry mouth and reduce how much saliva your child makes.  These may include: antihistamines, antidepressants, anti-GERD medicine, sedatives, and barbiturates.  Some seizure medicines may cause enlarged gums, causing them to bleed.  To reduce the impact of medicine, rinse or spray your child’s mouth with water after each dose.

Toothbrushing positions

There are many ways to position a child for brushing. These may change with a child’s age, and they depend on the child’s physical or medical condition. Try different positions for brushing your child’s teeth to find one that works for your child and you. Brushing does not have to happen in the bathroom-try your child’s room or other spaces.

  • On the floor – Place your child on the floor, sitting up. Sit right behind him or her on a chair or stool. Tip the child’s head back into your lap. If your child will not sit still, gently place your legs over your child’s arms to to keep him or her still. You can also lay your child on the floor, with his or her head on a pillow or on your lap. Kneel or sit behind your child’s head. If you need to, use your arm to keep him or her still.
  • In a beanbag chair –If your child can’t sit up, place your child in a beanbag chair. Use the same position described above for sitting on the floor.
  • On a bed or sofa. Lay your child on a bed or sofa, with his or her head in your lap. Support your child’s head and shoulders with your arm. If your child will not stay still, another person can gently hold his or her hands and feet.
  • In a chair or wheelchair. Stand behind the chair or wheelchair. Use your arm to brace the child’s head against the chair or wheelchair or against your body. You can use a pillow to make the child more comfortable.

Warning: Some children make extra saliva during toothbrushing. To prevent the child from choking on saliva, make sure the child’s head is not tilted far back. Whichever toothbrushing position you choose, hold the child’s head upright or to the side.

  • Make toothbrushing fun. Sing a song while brushing your child’s teeth. Or count or say the alphabet while you brush your child’s teeth. You can also tell a story, say a nursery rhyme, or make animal sounds while brushing.

Toothbrushing Tips

Children with special needs often find it difficult to manage their daily oral care routine, therefore parents and caregivers are required to step in for assistance. It goes without saying that cleaning another person’s teeth is no easy feat, but the most important thing is to have patience, compassion and understanding. During your child’s routine check-up, it’s worth asking your dentist about the best techniques to use. In many cases it is best if two parents/caregivers are available to assist with oral cleaning.

Here are some tips to make the process easier:

  • Electric Toothbrush

It’s worth investing in an electric toothbrush for your special needs child, particularly if their coordination and fine motor skills are compromised. These toothbrushes have a thicker handle which is easier to hold onto, and they also offer a superior clean than a manual toothbrush. This can also help to reduce the time taken to clean your child’s teeth, as electric toothbrushes operate much faster.

  • Toothbrush Handle Modifications

If your child prefers to use a manual toothbrush, you can make the process easier for them by fitting a bulkier handle. The soft and grippy handle will make it easier for your child to confidently manoeuvre the head around their mouth. You can make the handle thicker by putting it inside a tennis ball.

  • Use fluoride toothpaste that your child likes

Fluoride toothpaste comes in different flavours and colours. For children under age 3, use a smear (size of a grain of rice) of toothpaste. For children ages 3 to 6, use a pea-size amount of toothpaste. Encourage your child to spit and not swallow the remaining toothpaste. If your child is sensitive to toothpaste, dip the toothbrush into fluoride mouth rinse and use that instead. If your child cannot spit try wiping their mouth with a cloth after brushing.

  • Special Toothbrushes can sometimes make toothbrushing easier. The Surround Toothbrush has a triple headed bristle pad which surrounds the teeth to provide simultaneous cleaning of all tooth surfaces and gumline with each and every stroke including the front, back and biting surfaces for complete coverage during brushing.

Surround Toothbrush – Toddler and Regular from Scott Wilcox on Vimeo.

  • Issues with Biting on the Toothbrush

It is not uncommon for special needs children to bite down on the toothbrush, particular those who have neuromuscular conditions. To reduce the risk of harm, you can place a piece of gauze on the back teeth prior to commencing the brushing process.

There are also tooth rests and mouth props available which can assist in keeping your child’s mouth open during cleaning. You could also consider using two toothbrushes, allowing your child to bite down on one whilst you clean the other side with the second toothbrush. The toothbrush should have a thick handle with a soft coating to ensure comfort and keep the mouth open whilst your child is biting it.

  • For children who might gag try letting your child get used to a toothbrush slowly.  Let your child “teeth” or chew on a toothbrush or NUK toothbrush trainer for a few weeks to get used to the feel of it in their mouth.  Then slowly take over and work toward the actual brushing.


Other useful aids – MagnusCards App

MagnusCards is a FREE APP that combines a proven method of instruction with elements of game design to help people learn life skills. With Magnus as your guide, you can collect and create digital Card Decks, which provide step-by-step instructions for various social interactions, situations, behaviours, and activities. For example: Going to the dentist, dealing with anxiety, how to brush your teeth, and even what to do when feeling ill, are just a few of the topics within the Health category.

Preparation for Dental Visits

Before visiting the dentist, sit down with your child and discuss the process. Explain to them that the dentist is there to look after their teeth and that there is nothing to be afraid of. At Specialist Kids Dentist, we have a wealth of experience in dealing with special needs children and are fully equipped with comfortable chairs and TV screens displaying cartoons to reduce anxiety and allow your child to relax within a safe and familiar environment.

Regular visits to the dentist can help to reinforce daily oral care techniques and identify any problems before they turn into major issues.


Special Needs Dentist in Liverpool and Summer Hill – Book an Appointment Today

Specialist Kids Dentist has experience treating special kids with:

  • Neurodegenerative disorders
  • Down Syndrome
  • Developmental and Behavioural Disorders
  • Cerebral Palsy
  • Paralysis
  • Brain Injury
  • All other conditions


Contact us today on 02 9600 6848 to schedule an appointment. We look forward to seeing you and your child soon.