American Academy of Pediatrics Updates Recommendations on Providing Oral Health Care for Youth with Developmental Disabilities

An updated clinical report highlights the oral health needs of children and youth with developmental disabilities and calls for coordinated care  
  
ITASCA, IL--Children with developmental disabilities are more likely to experience tooth decay and unmet oral health needs than other children. Research shows that dental visits can be challenging due to behavior, sensory sensitivities and neuromuscular defects, and difficulty finding providers who can accommodate them. 
  
The American Academy of Pediatrics in an updated clinical report, “Oral Health Care for Children and Youth With Developmental Disabilities,” provides evidence-based guidance on assessing unique risk factors and providing proper care. The report, published in the August 2024 Pediatrics (published  online July 22), was written by the AAP Section on Oral Health, Council on Children with Disabilities, and Section on Anesthesiology and Pain Medicine. 
  
Clinical reports created by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics. 
  
“Children and youth with developmental disabilities may have a harder time communicating their needs or need extra help in caring for their teeth,” said Elise Sarvas, D.D.S, M.S.D., M.P.H., lead author of the report and an associate member of the AAP Section on Oral Health. “It’s important that the pediatric medical and dental clinicians can identify oral health needs and communicate with families and each other about how to best provide services to a child.” 
  
The report guides pediatric clinicians on the unique oral health needs of this population. This includes the assessment and control of dental pain, self-injurious behaviors, dental trauma, and common adaptive behaviors such as chewing on objects and excessive drooling. It highlights special considerations for dental treatment provided under sedation or general anesthesia, which many of these patients may need. Other recommendations:  

• Assess dental and periodontal health at least annually.
• Use structured screening instruments to assess and identify risk factors consistently.
• Provide anticipatory guidance on oral hygiene, diet, habits, trauma prevention and malocclusion.
• Recommend use of fluoridated toothpaste.
• Assess community water fluoridation; apply fluoride varnish as appropriate; determine sources of fermentable carbohydrates and aim to reduce consumption.
• Consider transition to adult dental care as part of the adolescent health care transition.  

“If possible, children should begin seeing a dentist by age 1, as preventing tooth decay is always best,” Dr. Sarvas said. “Oral health is important for overall health and quality of life.” 

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.