Physicians who care for children need to be comfortable with the basic oral examination of a child with special health care needs. It is similar to the routine child oral examination in many ways, but practitioners should take care to examine the following areas and document the presence of abnormalities.

Consider the following oral health issues that are more common in the special needs population:

		Oral-facial anomalies. This includes a general examination for Cleft Palate: Congenital fissure of the roof of the mouth produced by failure of the two maxillae to unite during embryonic development and often associated with cleft lip. cleft palate, micrognathia, and oral injuries.
		Teeth. Dental caries and its severity should be documented. Practitioners should also examine for Enamel: Intensely hard calcareous substance that forms a thin layer partly covering the teeth; the hardest substance of the animal body; consists of minute prisms arranged at right angles to the surface and bound together by a cement substance. enamel Hypoplasia: A condition of arrested development in which an organ or part of an organ remains below the normal size or in an immature state. hypoplasia or demineralization, Malocclusion: An abnormality in the coming together of teeth. malocclusion, or missing or abnormally shaped teeth, and evaluate the pattern of tooth eruption.
		Gingiva. Poor gingival health can be identified by examining for erythema, swelling, bleeding, and Hyperplasia: An abnormal or unusual increase in the elements composing a part (as cells composing a tissue). hyperplasia.

Oral defensiveness, increased gag reflex, and oral motor hypotonicity may make examination more difficult and should be documented.