Developmental Disabilities and Oral Health

How Can Disabilities Impact Oral Health?

Developmental disabilities can impact a person’s general and oral health standing. This is because certain disorders impair learning, physical, language, and behavioral capabilities. In addition, practicing good oral hygiene at home may be difficult, which can lead to serious oral health issues over time.

Dental Conditions Associated with Developmental Disabilities

Developmental disabilities are typically life-long conditions that make it more challenging to complete simple daily activities. For example, a person may not be able to bathe, dress, or feed themselves on their own. As a result, disabled people have a higher risk of developing health issues, which also includes oral infections. 

Common developmental disabilities that may lead to adverse oral health outcomes include, but are not limited to:  

Down Syndrome

Down syndrome is a common disability when a person is born with an extra chromosome. In short, chromosomes make up your genes, which determine how your body develops, functions, and forms in the womb and after birth.

In most cases, a baby is born with 46 chromosomes. Although, a baby with Down syndrome is born with an additional copy of chromosome 21. This extra chromosome changes how a child’s body and brain develop, which creates both physical and mental challenges throughout life. 


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Down syndrome impacts a person’s general health and also makes it challenging to complete daily activities. Additionally, Down syndrome can also affect an individual’s oral health.

In particular, they commonly develop oral health issues, such as:

gingivitis gum disease
Periodontal Disease (PD)

This is the most prevalent oral health issue diagnosed in patients with Down syndrome. In short, PD is the most severe form of gum disease that results in permanent bone loss. It is caused by the long-term buildup of plaque and tartar (hardened plaque).

Since people with Down syndrome tend to neglect oral care, this disease often spreads rapidly. As a result, many people begin losing permanent anterior (front) teeth during their teenage years. 

trauma
Other Contributing Conditions

These include cavities, conical-shaped tooth roots, malocclusion (misaligned teeth), dental trauma, and bruxism (teeth grinding).

Autism

Autism spectrum disorder (ASD) impairs a person’s ability to talk and interact. Children with severe autism may also have trouble cooperating in a dental office, which makes routine oral care difficult to accomplish every six months. However, most people with mild or moderate autism can be treated normally in a dental setting. 

It is also common for those with autism to develop inconsistent at-home oral care routines, which increases the risk of cavities and other dental infections. Lastly, certain medications taken for autism can cause generalized gingivitis (mild gum disease). 

Cystic fibrosis (CF)

Cystic fibrosis (CF) is a chronic and genetic respiratory disorder that results in poor lung function. The condition is present at birth but is not considered a physical disability until the child is older. Common symptoms of CF include coughing up mucus, frequent lung infections, and breathing difficulties. Over time, the lungs become permanently damaged. The pancreas, livers, and kidneys may be affected as well.

Additionally, an individual may experience oral health complications, such as:

  • Enamel defects, particularly enamel opacities, that appear as white spots in the middle of tooth crowns. Risk factors of opacities include dental erosion and cavities. 
  • Increased calculus (hardened plaque) buildup that results in cavities and periodontal issues. 
  • High risk for cavities due to dry mouth, which is a common complication of inhaled breathing treatments that treat CF.

Resources

Children with Cerebral Palsy - Dental School Seattle WA. dental.washington.edu/wp-content/media/sp_need_pdfs/CP-Dental.pdf.

Delwel, Suzanne, et al. “Oral Hygiene and Oral Health in Older People with Dementia: a Comprehensive Review with Focus on Oral Soft Tissues.” Clinical Oral Investigations, Springer Berlin Heidelberg, Jan. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5748411/.

“Developmental Disabilities and Oral Health Information and Resources.” National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services, www.nidcr.nih.gov/health-info/developmental-disabilities/more-info.

“Facts about Down Syndrome.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 5 Dec. 2019, www.cdc.gov/ncbddd/birthdefects/downsyndrome.html.

Kalyoncu, Işıl Özgül, and Ilknur Tanboga. “Oral Health Status of Children with Autistic Spectrum Disorder Compared with Non-Authentic Peers.” Iranian Journal of Public Health, Tehran University of Medical Sciences, Nov. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5696703/.

Narang, A. “Oral Health and Related Factors in Cystic Fibrosis and Other Chronic Respiratory Disorders.” Archives of Disease in Childhood, vol. 88, no. 8, Jan. 2003, pp. 702–707., doi:10.1136/adc.88.8.702.

Practical Oral Care for People With Autism. www.nidcr.nih.gov/sites/default/files/2017-09/practical-oral-care-autism.pdf.

Practical Oral Care for People With Cerebral Palsy. www.nidcr.nih.gov/sites/default/files/2017-09/practical-oral-care-cerebral-palsy.pdf.

Practical Oral Care for People With Down Syndrome. www.nidcr.nih.gov/sites/default/files/2017-09/practical-oral-care-down-syndrome.pdf.

Updated on: May 22, 2020
Author
Alyssa Hill
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Medically Reviewed: January 30, 2020
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Lara Coseo
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