Physical Disabilities and Oral Health

Dental Conditions Associated with Physical Disabilities

Physical disabilities limit a person's mobility, stamina, and physical functioning. These disabilities make it difficult for patients to complete daily activities independently.

This includes getting dressed, eating, and even moving around. Many people with physical disabilities either have limited mobility or cannot walk. As a result, they may need a wheelchair, crutches, or additional assistance. 

People with physical disabilities are more likely to develop oral health complications, including:

• Cavities
• Gum disease
• Other dental defects 

Common physical disabilities that may lead to adverse oral health outcomes include:

Spinal Cord Injuries (SCI)

Up to 500,000 people suffer from spinal cord injuries (SCI) worldwide every year. The injuries are typically caused by trauma, such as falls, sports, or car accidents.

Many people with an SCI are partially or completely paralyzed, making performing daily activities extremely difficult. 

Due to these limitations, patients may also experience oral health complications.

Arm weakness and impaired mobility cause poor hand function, so they rely on others to care for their teeth.

Many SCI medications cause dry mouth (xerostomia), increasing the risk of cavities and gum disease over time. 

Cerebral Palsy

Cerebral palsy (CP) is a physical disorder that affects muscle coordination and body movement.

It forms due to irregular brain development and typically originates before birth. Although, it can develop in the prenatal period, perinatal period, or during infancy.

Characteristics of this disorder include:

• Slow or involuntary muscle movement
• Exaggerated reflexes
• Low muscle tone
• Poor coordination

People with cerebral palsy have a higher risk of developing oral health issues due to poor oral hygiene.

Conditions may include:

• Delayed eruption of permanent teeth
• Gingivitis and periodontal disease
• Dental caries (cavities)
• Mouth breathing, which can lead to cavities and bad breath
• Dental erosion, due to gastroesophageal reflux (GERD)
• Tongue thrusting, which can lead to malocclusion (misaligned teeth)
• Enamel hypoplasia (defective enamel) that can lead to dental decay 
• Bruxism, which is excessive teeth grinding (typically during sleep)
• Increased risk of dental injuries or trauma

Muscular dystrophy

Muscular dystrophy is a rare group of genetic diseases. It causes severe muscle weakness and, eventually, muscle loss.

Over time, people with this disability cannot walk and need a wheelchair as the muscles deteriorate. Besides extreme muscle weakness, other symptoms of this condition include trouble swallowing and breathing. 

Patients with advanced muscular dystrophy cannot brush or floss their teeth without help. They have a higher risk of developing oral health conditions. This includes increased calculus buildup, dental caries, gingivitis, and periodontal 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, lung infections, and breathing difficulties.

Over time, the lungs become permanently damaged. The pancreas, livers, and kidneys may be affected as well.

People with CF 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. 

Other Physical Disabilities

Other common physical disabilities that can negatively impact a person’s oral health due to limited mobility include:

Amputation

This is the removal of a limb due to an illness, accident, injury, disease, or surgery. It can make it difficult to perform daily activities, such as walking or eating.

Brushing your teeth regularly may also be difficult. This increases the risk of cavity formation and other oral infections. 

Back Injuries

Similar to spinal cord injuries, people with back injuries may become partially or completely paralyzed. Often, other people are in charge of their at-home oral care routine.

Some medications for these injuries can also cause dry mouth and cavities. 

Multiple Sclerosis (MS)

This disease damages the brain and central nervous system (spinal cord).

Over time, people with MS may become disabled. Symptoms include fatigue, impaired coordination, severe pain, and even vision loss.

Due to these limitations, people with MS have a higher risk of developing cavities and gum disease.