Oral Health Tips for Damaging Oral Habits, Tracheostomy and Oral Traumas

Information in this article was made available from a guide for parents and dental providers of children with special needs developed by the Oklahoma Dental Foundation in partnership with several funders.  The entire guide is available for download at: Oral Health Care For Children With Special Health Care Needs.

The following is an excerpt from page 12 of the guide.

Some children can display damaging oral habits. Many types of disabilities are accompanied by
behavior issues, difficulty in movement and/or seizures which can often lead to oral trauma or
damage to the face or mouth. Some will have congenital issues such as cleft lip or palate. Following are some things to consider as you plan your dental appointments.

Physical/Behavioral Concerns Strategies for Care

Tooth loss

• Helmets and/or mouth guards
• Expect oral aversion
• Tooth saving kits
Picking at teeth or gums • Soft gloves
• Keep hands clean and nails trimmed
Mouth breathing

Pouching (storing food in the mouth)

Tongue thrusting

• Frequent rinsing with water to reduce dry mouth and
prevent damage to tongue and lips
• Lip balm to soothe dry lips
• Thorough inspection of mouth after meals/snacks
• Avoid sugary snacks
• Rinse after sugary medicines. Use sugar free medicines
• More frequent brushing/flossing and dental visits
Bruxism (grinding teeth) • Mouth guards
Pica (eating non-food items, such as gravel) • Mouth guards
• Frequent oral inspection
• Prevention
Reflux (Stomach acid that splashes back up)

Rumination (throwing up food to re-chew it)

• Rinse mouth frequently
• Place child in a more upright position to keep acid down
• Sealants
• More frequent brushing/flossing and dental visits
Cleft Lip

Cleft Palate

• Expect aversions
• Keep feeding bridges clean
• Modify rubber dams to fit and use suction frequently
Tracheostomy • Expect aversions and a hypersensitive gag reflex
• More frequent brushings and dental cleanings
• Use a rubber dam if tolerated
• Do not block or cover an uncapped tracheostomy as this may cause CO2 build-up or suffocation