Cerebral Palsy & Dental Health

4 Min Read

Child at the dentist getting a checkup.

Cerebral palsy and dental health present a unique set of challenges for families. Depending on the severity of your child’s condition, maintaining proper oral health can feel difficult. Good dental health practices can positively affect the overall quality of your child’s life. Learn more about how you can work with your child’s dental team to create a care plan to fit your child’s needs.

Dental Health Problems in Cerebral Palsy Patients

Cerebral palsy patients are at higher risk for developing dental health problems. In fact, it is so common that dental disease screening is a recommended part of evaluating any child with cerebral palsy.

Dental health problems in cerebral palsy patients occur for many reasons. Firstly, the condition causes difficulty in controlling and moving limbs. This type of movement is necessary to do such routine tasks as brushing teeth.

There is also a greater risk of dental trauma due to some cerebral palsy patients having flared upper teeth. This, combined with a greater tendency towards falls due to motor impairment, can create a dangerous situation for oral health.

Other factors causing dental problems in cerebral palsy patients include:

  • Chewing and swallowing difficulties
  • Chronic vomiting causing dental erosions
  • Cognitive disability
  • Depending on a caregiver for self-care
  • Excessive drooling
  • Gastroesophageal reflux disease (GERD)
  • Inability to control face muscles (pseudobulbar palsy)

Dental health problems can lead to issues with independence, impacting the child’s life. Therefore, it is important to help cerebral palsy patients develop good oral health routines.

Thankfully, you and your child can manage their dental health to prevent issues in the future.

Types of Cerebral Palsy Oral Health Issues

Cerebral palsy is not the direct cause of oral health issues. However, some dental problems are more common in cerebral palsy patients.

Periodontal Disease

Periodontal disease is usually caused by infection or inflammation of the gums. It can also affect the bones that support the teeth.

In the early stages, periodontal disease is called gingivitis, which occurs when the gums are red, swollen, and may bleed.

When the periodontal disease gets worse, it becomes periodontitis. In this stage, gums can pull away from teeth, and bone loss can occur, eventually causing teeth to become loose or fall out.

Hyperactive Bite

An abnormally active bite reflex can create problems with brushing teeth. This is also true with hyperactive gag reflexes. These conditions can interfere with providing proper dental care, leading to oral health issues down the line.

Difficulty Swallowing

Difficulty swallowing (dysphagia) is common in cerebral palsy patients. This can cause food to stay in the mouth longer than it should, increasing tooth decay risk.

Additionally, cerebral palsy patients on a semi-soft diet may run into problems with their food sticking to their teeth and not getting swallowed.

Drooling

Drooling (sialorrhea) occurs in almost 30% of children with cerebral palsy. This can sometimes result from tooth decay, irritating lesions, or throat infection. Drooling can greatly interfere with proper oral care.

Dental Caries

Dental caries (tooth decay and/or cavities) are caused by bacteria from certain foods that produce acids and damage teeth. Children with cerebral palsy are more likely to develop dental caries. This is especially true when cerebral palsy symptoms are more severe, causing greater challenges with brushing the teeth.

Malocclusion

Malocclusion occurs when upper and lower teeth don’t align properly when the mouth is closed. Unfortunately, fixing malocclusion is not always possible for patients with moderate to severe cerebral palsy, making dental health care essential.

TMJ (Temporomandibular Joint) Disorders

The temporomandibular joint (TMJ) connects the jawbone and the skull. It acts as a hinge, and when it doesn’t function properly, it can cause jaw pain, clicking of the jaw, and difficulty chewing.

Children with cerebral palsy have a substantially higher risk of developing TMJ because of the likelihood of having malocclusion and mouth breathing.

Daily Dental Care For Children With Cerebral Palsy

Staying proactive and ensuring your child’s dental health is taken care of can prevent significant issues in the future. Therefore, it is crucial to promote proper oral hygiene as early as possible.

Some tips for managing daily dental care are:

  • Cleaning the four top and bottom front teeth with a soft cloth or toothbrush
  • Laying your child back on a chair or bed to angle their head
  • Monitoring diet to reduce long-term bottle use and sugar intake
  • Stabilizing your child’s head while you brush their teeth
  • Teaching a child with mild cerebral palsy to use an electric toothbrush
  • Using topical fluoride to protect tooth enamel if recommended by your child’s dentist

You should begin brushing your child’s teeth as soon as their first baby tooth appears. Additionally, it is very important to schedule routine dental exams.

Preparing For a Dental Appointment

Preparing for a dental appointment for your child with cerebral palsy can feel overwhelming. It is quite normal for anyone to feel nervous before going to the dentist. Children with cerebral palsy may feel even more nervous and anxious during these visits. Fearing strangers and communication challenges can make the process feel quite traumatic.

The best way to approach trips to the dentist is to develop strategies that work for you and your child. This may include working with your dentist to explain your challenges, figuring out special dental chair adjustments, and scheduling the appointment early in the day to allow for extra time. You should also be sure to tell your dentist about any medications your child is taking to ensure their safety.

Coming up with a care plan with a trusted dentist who is very familiar with the severity of your child’s condition is essential. While cerebral palsy and dental health certainly present unique challenges for families, it is far too important to ignore.

Contact our team to speak to a registered nurse if you have any additional questions about your child’s cerebral palsy.

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View 5 Sources
  1. Centers for Disease Control and Prevention. (2013, July 10). Periodontal disease. Retrieved February 16, 2022, from https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html
  2. Jan, B., & Jan, M. (2016, October). Dental health of children with cerebral palsy. Retrieved February 15, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5224428/
  3. National Institute of Dental and Craniofacial Research. (n.d.). Practical Oral Care for People With Cerebral Palsy. Retrieved February 15, 2022, from https://www.nidcr.nih.gov/sites/default/files/2017-09/practical-oral-care-cerebral-palsy.pdf?_ga=2.156446139.108901503.1561045105-202404550.1514932601
  4. Nicklaus Children's Hospital. (n.d.). Health and Safety Information. Retrieved February 15, 2022, from https://www.nicklauschildrens.org/patient-resources/health-and-safety-information
  5. Oral-B. (n.d.). What are dental caries? treatments, signs, and symptoms. Retrieved February 16, 2022, from https://oralb.com/en-us/oral-health/conditions/cavities-tooth-decay/what-are-dental-caries/