Caring for the Teeth and Gums of Children with Down Syndrome (Pt. 2)

Early Preventive Dental Care

Early preventive dental care is very important to the health of children with Down syndrome. A child's first dental visit can cause anxiety for parents, the child and dentist alike. The purpose of this article is to explain why early dental care is important for children with Down syndrome, to describe the typical first dental visit for young children, and finally to give suggestions about what can be done to make a child's initial visit to the dentist a positive experience.

The purpose of early preventive care

Proper care for the teeth and surrounding structures can prevent dental problems from developing. Children with Down syndrome have unique medical and dental concerns that make them more susceptible to diseases of the teeth and gums. These patients tend to have reduced immune responses that can exacerbate conditions in the oral cavity. It is important to develop good habits early in life so they become part of the daily routine of self-care.

The American Academy of Pediatric Dentistry recommends that children see a dentist within six months of the eruption of their first tooth. Early visits to a dentist serve many purposes. The treating dentist will identify the risk of the patient developing dental cavities and gum disease. In addition, the dentist will instruct the patient and family in the most appropriate ways to care for the child's teeth at home. Parents will be able to address specific concerns they have about their child. The dentist and family will put together a plan to address urgent dental needs and active disease. Finally, a long-term plan for care will be implemented. Most people are instructed to visit the dentist every six months, but this may not be appropriate for everyone. Some patients with Down syndrome may benefit from a more frequent schedule of visits to prevent as many dental problems from developing as possible. For these reasons it is important that you visit a dentist that has experience treating patients with Down syndrome.

The first office visit

The dentist and staff should make the patient as comfortable as possible at a child's first visit. It is important that your dentist establish a positive rapport with all patients before beginning an examination or treatment. This can be difficult to accomplish with very young patients, but for older children it can be a very effective tool to set the tone for an appointment. Often patting a child gently on the shoulder or arm before an invasive examination of their head and mouth can warm the patient up to having a stranger in their personal space. Each child is unique, and their specific needs should be addressed during their visit.

Your child's teeth will be examined and probably cleaned at the first visit. Additional services like x-rays and fluoride treatments may be accomplished, depending on the age and cooperation level of your child. Nearly all children under age two will require a parent to help with a dental examination. Sometimes young patients will cooperate while in a parent's lap. But often at an early age the parent or caregiver will need to help the dentist with examining the child by reclining the child in their laps and holding the patient's hands.

After information has been gathered, the family and dentist will decide if any dental treatment is needed at that time. They will discuss what medical concerns may be interacting with the teeth and mouth and what needs to be done, or what further tests are needed. The dentist will anticipate what problems the patient and family may encounter in the near and long term and counsel them on ways to deal with the concerns.

Many patients with Down syndrome have a very relaxed approach to medical settings and have positive experiences at the dental office. Often these patients can be treated very easily in the traditional dental setting. Usually all that is needed is a little more time and attention to make them comfortable. The patient and dental staff will have to exercise patience with one another to make the first visit a successful one.

Preparing your child

The key to positive dental visits for children with Down syndrome and children in general is to start at a young age. Patients will get more comfortable with new experiences after more exposure to them.

Children with Down syndrome tend to get their teeth later than average and because of this some parents may feel that visiting the dentist is not a priority. Because the permanent teeth tend to come in later as well, it is very important to maintain the baby teeth as long as possible and early preventive care can help accomplish this.

Communication between the family and dental staff is extremely important. Often children with Down syndrome understand what they hear better than is realized. Because their expressive language may not be as developed as their comprehension, parents and caregivers play a critical role in explaining their child's language skills to the dental office staff.

Some parents may be apprehensive about how their child or the dentist will react to the office situation. You should choose a dentist who has experience working with children with Down syndrome and who has a warm office environment to ensure the best experience possible for your child. Because children react better to dental visits in the morning when they are fresh, it's a good idea to schedule your child's first dental visit in the morning.

Books and videos are available that can expose your child to what to expect at the dentist's office. A calm, relaxed approach by parents and caregivers also sets a positive tone for the appointment. Children can sense if parents and the dental staff are uncomfortable and that may cause some apprehension for them. Parents can calm nervous children by clearly explaining in non-threatening language what to expect at the dental visit. For example you can say, "The dentist will count and clean your teeth. After that, he will take some pictures of your teeth to make sure they are healthy."

If you pick the right office for your family, get your child comfortable at an early age and schedule morning visits, the dental office does not have to be a source of anxiety for you or your child.

Planning leads to positive experience

With the right planning, preparation and office environment, children with Down syndrome can have positive initial dental visits. Early preventive dental care must take into account the unique medical and dental concerns of all patients. A comfortable dental environment makes for a happy patient and allows the dentist and caregivers to focus on the medical concerns of the patient rather than the anxiety often associated with a trip to the dentist.