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Protecting All Children's Teeth (PACT): A Pediatric Oral Health Training Program
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Preventive Oral Health Practices

Problems with Oral Care
Children with special health care needs may not be able to fully cooperate with oral hygiene practices due to gagging, oral defensiveness, or behavioral issues

They may also have difficulty tolerating fluoride liquid, toothpaste, varnish, sealants, or other caries prevention strategies

Daily Preventive Care
Daily home preventive dental care may have to be tailored to meet the specific needs of the child.

This is often best addressed by the dental health professionals involved in caring for the child.

Patients with SHCN who have a dental home are more likely to receive appropriate preventive and routine care

If there are concerns about swallowing toothpaste, families should minimize the amount of toothpaste used (a smear, less than a pea-sized amount) or use a non-fluoridated toothpaste.

If gagging is triggered by toothpaste, the teeth should be brushed with fluoride mouthrinse.

For older patients with limited dexterity, consider the following options:

  • An electric or battery-powered toothbrush
  • Extending the brush handle with a tongue depressor
  • Widening the brush handle (wrapping it with a sponge)
  • Using a mouth prop for brushing.

For additional suggestions on toothbrush adaptations, flossing tips, and brushing positions, review A Guide to Good Oral Health for Persons with Special Needs.

Fast Facts
Inability to cooperate with oral hygiene practices is very common among children with special health care needs.
The child's therapists and dentist can be a valuable resource for families.
Suggestions to make brushing and flossing easier can be viewed in Special Smiles: A Caregivers Guide to Good Oral Health for Persons with Special Needs.
A complete oral examination is necessary at every routine visit.
Chapter Photo Gallery
View the Chapter 7 Photo Gallery.
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