Oral Health Online Tutorial for Children with Special needs James Lin 3 rd year dental student Amir Boules 3 rd year dental student Richard Rubin DDS MPH faculty mentor ID: 913071
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Slide1
The disability experience conference
Oral
Health
Online Tutorial for Children with Special needs
James Lin (
3
rd
year
dental student)
Amir Boules
(
3
rd
year
dental student)
Richard Rubin, DDS MPH (faculty mentor)
School of Dental Medicine
University of Pittsburgh
Slide2Poor Oral Health: Quality of Life Issues
May lead to severe systemic diseases, infection, and pain
Poor
oral health care may lead to decreased:Proper nutrition and feeding habits (selection of
food)
Self-esteem
Concentration for work, school and
playSpeech ability-TasteSocial contact and interaction Sleep
Slide3Example: Autism Spectrum Disorder (ASD)
Dental
cavities (treated and untreated) are more
prevalent in children with ASD than in the general populationDifficult to recognize and perform preventive measures
Difficult to treat due to behavior management and sensory disorders.
Special considerations
Sedation
, time involvement, financial hardship
Slide4Purpose of Oral Health Tutorial:
Improve Oral home care
To help
non-dental
healthcare providers and families recognize signs of
early caries
and understand the importance of
oral home care in individuals with special needs and the associated challenges.Offer solutions for better oral home preventive care, medications, and feeding challenges
Not
all children with ASD tolerate the same things
Provide
a user-friendly,
photographic
online tutorial
Slide5Challenges in preventive care
(I):
Recognition of Early Decay (tutorial)
This stage, called “white spots” stage, can be reversed!
Slide6Detection is key!
Early detection of caries can save the patient from being in pain.
Best stage for prevention is during the “white spot lesion” stage
Discoloration of enamel near gum lineDarker stained areas combined with rough chalkiness on tooth surfaceThis stage, called the “White Spots” stage, can be reversed.
Slide7Challenges to preventive care
(II):
Brushing teeth:
“from their perspective”Toothbrush as a foreign object in their
mouth
Sensitivity to
t
oothpaste or toothbrushAnxiety towards toothbrushing
Slide8Solutions “from
their perspective”
1. Routine
and desensitizationtell-show-do distractions (songs, stories, counting #1-5)
Rewards
2.
Flavored
toothpaste, softer toothbrush fruit instead of the strong mint flavor toothbrushes with softer bristles3. Predictability
Location
time
(frequency, duration, time of day)
Slide9Challenges in preventive care
(III):
coordination of toothbrushing movements
Children
with ASD have a wide spectrum of
functionality
Difficulty
holding the toothbrush and learning brushing motions
Slide10Solution: Use a modified
toothbrush
M
odified toothbrush handleAdd tennis ball to handle
Wrap tape around the
handle
Modified toothbrush head
Surround® Toothbrush has unique heads and multiple sides of bristles
Slide11Challenges in preventive care
(IV):
Meds may cause “dry
mouth”cavities
Slide12Solution for: Dealing
with
Xerostomia
Discuss alternative medications with your child’s physician that do not include xerostomia
as a side effect
If medication with
xerostomia
as a side effect is unavoidable, it is even more crucial to exercise proper oral care preventive measuresApplication of Fluoride varnish by dentist
Slide13Challenges
(V): proper feeding
& nutrition
Children with ASD tend to have stomach or digestive problemsVomiting
, diarrhea,
upset stomach
Brought on by unhealthy
and frequent snacking (junk food and sweets)Subject to:Nutritional deficiencies (food selectivity/restricted diets)
Acid reflux/acid
erosion of
teeth
Slide14Solution to: proper feeding & nutrition
BRAT diet: Bananas, Rice, Applesauce, Toast
Short term
, 2-3 daysPlain foods are easier to keep in stomachMay add yogurt if child had digestive
problems
Hardens stool to decrease diarrhea
Replaces lost potassium from
vomitingConsult a nutritionist for recommendations
Slide15Always remember to reinforce positive outcomes with rewards
Social rewards
verbal praise
positive facial expressionsNon-social rewardsStickersPrizesfavorite TV show
Rewards
junk
food & sweet drinks