In addition to cognitive and physical limitations, children with developmental disabilities* typically have unmet complex medical problems. Children with developmental disabilities have difficulties performing activities of daily living and access to dental care is challenging.

Examples of developmental disabilities include:

1. Autism Spectrum Disorder
2. Cerebral Palsy
3. Intellectual Disability

Children with developmental difficulties are more likely to have unmet dental needs and are at higher risk for dental disease due to the following:

1. Sugar-containing medicines
2. Impairments to swallowing
3. Altered salivary function
4. Reliance on caregiver for oral hygiene
5. Dietary limitations (pureed or liquid diet; preference for carbohydrate-rich foods)
6. Oral aversion**

Many medications used in children with developmental disabilities affect the oral cavity and dentition. Examples include:

1. Anticonvulsants: gingival hyperplasia, excessive drooling, and stomatitis
2. CNS stimulants: xerostomia, dysphagia, sialadentitis, discolored tongue
3. Anticholinergics: bruxism and xerostomia
4. Antipsychotics: xerostomia, dysphagia, stomatitis, gingivitis, glossitis and tongue edema

Alleviating Measures

• Assess orthodontic needs and refer for correction of malocclusion
• Discourage consumption of cariogenic snacks and beverages
• Encourage routine dental care
• Review use of safety equipment and encourage use of mouth guards to prevent dental trauma
• Review protocol for dental trauma (locate missing tooth, preserve in milk, seek immediate dental care
• Inspect child’s mouth after medication administration to ensure medication
• has cleared the oral cavity
• Chew sugar-free gum to stimulate salivary flow and restore moisture
• Use caries preventive measures (sealants, fluoride supplements, antimicrobial mouthwashes)
• Take all medications as scheduled prior to the dental appointment