Everything you need to know about dental hygiene for those with SHCN

While dental care is an integral part of daily life, its importance with respect to Special Health Care Needs or SHCN is perhaps an important, but, lesser known aspect that already plagues a misunderstood minority in society.

Dental care requires specifically tailored instructions for not only the individuals suffering from SHCN but their immediate family/ caregivers as well.

One of the prevalent yet unmet needs for children and young adults with special health care is dental hygiene and care. Speaking about it, Dr Vaibhav Kumar, a dental public health specialist and current faculty at the Department of Public Health Dentistry, Terna Dental College, Navi Mumbai says that lack of awareness is one of the major issues that plagues those with SHCN.

“Apart from these, physical impediments with uncoordinated muscle kinetics, damped IQ and intellectually challenged conditions, improper brushing and compromised oral health related measures are characteristic to individuals with SHCN,” he says.

Dr Kumar with one of his patients with SHCN.

Majority of the people who suffer from SHCN lack adequate motor skills to brush their teeth properly, he further says.

Some of the other issues plaguing children or young adults falling under this spectrum include supernumerary teeth (more number of teeth than usual), cleft lip and palate, malaligned/ crooked teeth and traumatic fractures of front teeth.

Dr Kumar says that a stark increase in cases of tooth decay and gingivitis, coupled with dental anxiety and lack of understanding further adds to their woes.

“A majority of them have sensory issues and accentuated proprioception, hence oral examination and treatment becomes a steep ordeal for them.”

Doctors say that tackling oral health of children or young adults with SHCN has to have preventive and curative measures ingrained for a comprehensive dental environment.

A few pointers one needs to remember while maintaining oral health of those with SHCN are,

• Brushing with a soft bristled toothbrush twice daily with pea sized fluoridated toothpaste is recommended for them. Since they have not so well developed swallowing reflexes, the toothpastes and mouthwashes should be avoided in large quantities and kept away from the reach of the individuals.
• Specially designed motorized brushes with audio enhanced and tactile feedback are being developed to facilitate better oral hygiene performance.
• Mouth rinsing after meals and avoidance of pureed food / sweet syrups and candies and steps towards better oral care.
• The parents are sensitised to get them to visit a dentist at least once a year for preventive measures, including pit and fissure sealants and topical fluoride application.

Special health care needs include any physical, developmental, mental, sensory, behavioral, cognitive, or emotional impairment or limiting condition that requires medical management, health care intervention, and/or use of specialized services or programs.

Dr Kumar mentions that 75000 members of Indian Dental Association opened their doors for a week in July 2017 to welcome people with intellectual disability. This year the ongoing program to celebrate Eunice Kennedy Shriver Day 2018 has resulted in collaboration between IDA and Dental colleges with free oral screening and follow up care for the athletes pan India from 1st June to 30th September.

Not just them, numerous NGO's in the country are working towards health related quality of life of this sector of society.

Furthermore, Special Olympics Bharat, a Sport federation and the India arm of Special Olympics International (a John F Kennedy foundation) is actively working to level inequalities and breaking barriers through a structured programme where 8 disciplines of health are attended by Special Olympics through volunteerism and philanthropic partnerships.

In India, Dr Reena R Kumar, the National Clinical Adviser to the Healthy Athlete Program and Regional Clinical Advisor for Special Smiles Asia Pacific has secured meaningful collaborations with Indian Dental Association, Indian Association of Public Health Dentistry, Pierre Fauchard Academy and numerous universities . Through a directive from the Dental Council of India the doors of every dental college has been thrown open to the athletes of Special Olympics to obtain free of cost quality oral health care.

Terna Dental College, under the enthusiasm of Dr Shishir Singh, has been an active part of such endeavours and committed to imbibe and spread the spirit of inclusion and integration. The Indian Association of Public Health Dentistry has made it their National mission to improve the oral health of people with intellectual challenge by providing free dental checkups at the special schools followed by preventive and curative treatment at various centres.