Oral Health for Children with Special Health Care Needs

Dental 2: Who are children with special health care needs?


The federal Maternal and Child Health Bureau has defined children with special health care needs as those “who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition, and who require health and related services of a type or amount beyond that required by children generally.” These children may have developmental disabilities, such as autism, mental retardation, cerebral palsy, epilepsy, or other incurable neuropathies. Or, they may have chronic conditions, such as rheumatoid arthritis, scleroderma, HIV, or leukemia. They may have other health-related problems that can impair their ability to function, such as spina bifida, or muscular dystrophy.

Fifteen per cent, or 1.9 million of U.S. children ages five and under have a chronic condition or disability. Among this population, the most prevalent unmet need is dental care. This is probably due to several factors. For instance, since a special needs child has a number of needs, such as physical, developmental, or emotional, oral or dental health may not be regarded as a priority. Many parents of children with special needs may lack the confidence in performing oral care for their child due to a lack of information of oral growth and development. They may not have the education necessary for the oral health of their own mouth.

For the patient/child, however, the disability provides enough of a burden without thinking about additional oral problems. And, unfortunately, many people, including parents and caregivers, do not recognize the mouth-body connection. They do not realize that what goes on in your body affects your mouth, and what goes on in your mouth affects your body. However, by focusing on each person’s specific needs, we can achieve better oral health.

Dental caries (cavities) and gum disease is more prominent in people with disabilities than in the general population. Therefore, it is recommended that an infant or child with special health care needs should be seen by a dentist six months after the first tooth erupts, or by age 12 months, whichever occurs first. Additionally, depending on the risk factors, children with special health care needs may need to visit their dentist more often, about every two to three months. It is preferred that children with special needs be under the care of health professionals and office staff who have experience in working with this population.

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