A disability that affects the normal development of a person is called as developmental disabilities. These disabilities affect both the cognitive functioning, physical functioning or sometimes both the areas are affected. These would appear before a person is around 20-23 years of age. Physical and mental capabilities do not develop to their full potential, the problems can be life long and affect daily functions of a person. Reasons for these developmental disabilities can be due to chromosomal anomalies or exposure to certain substances like drugs or alcohol by the mother during pregnancy.
All areas of a person’s life get affected, Oral health also gets affected. Daily tasks that a person needs to do – like personal hygiene or self-care – all these are affected. Mental and physical disabilities act as a huge hindrance in achieving good oral health. These disabilities would result in a person having limited mental capabilities. This will affect a person’s abilities in understanding instructions. It can bring about more problems if the person is blind or having hearing loss.
Some would have behaviour problems- resulting in a person not willing to follow instructions. Some would experience seizures – that can result in a person falling and injuring themselves and teeth getting broken during the accident. Health also gets affected as some would have gastro reflux – this will affect the health of the teeth.
Oral health concerns
As discussed earlier, developmental disabilities bring in a lot of concerns with regard to oral health. The situation worsens further as there are physical disabilities along with it. Some of the common oral health concerns are discussed.
1. Tooth decay
Tooth decay is seen in almost all individuals with developmental disabilities. Reduced ability to take care of one’s personal hygiene can be considered one of the main reasons. Brushing and flossing are not possible and food debris would remain in the mouth. These would invite bacteria to act on the food and release acid. This acid would then eat into the dental enamel and then bring down the protection of the teeth. Slowly decay would set in and teeth would fall out. This can also be due to the gastric reflux and the special medicines they consume. Another reason that is often seen is the reduced amount of saliva in the mouth. Dry mouth is a good environment for bacteria to act on teeth and cause decay.
2. Gum diseases
Periodontal disease is also seen among people with developmental disabilities. Inadequate personal hygiene and the reduced immune system are seen as one of the causes of gum disease. Improper cleaning can lead to plaque and tartar build up on the teeth. These can irritate the gum lining. Reddening and inflammation of the gums are noticed in many. Bleeding from the gums can also be seen. Being unable to care for oral hygiene and reduced ability to convey dental issues with care givers often act as a hindrance in seeking proper care.
3. Trauma and Injury
Developmental disabilities manifest in various ways. Mental retardation, attention deficit disability, cerebral palsy are some of them. This can be accompanied by visual and hearing issues. Some of them also experience seizures. This can result in them falling down and hurting themselves. There are chances of teeth being chipped or fractured. Injury to the soft oral tissues is also possible. It is important that they are provided with proper care and medical help. Making sure the chipped teeth are protected with proper dental procedures and fracture in teeth is managed so it does not affect other neighbouring teeth and oral tissue is crucial.
4. Poor oral habits
People with developmental disabilities often exhibit destructive oral habits. Teeth grinding, tongue thrusting, clenching etc. are seen. Grinding of teeth can lead to teeth losing their rough edges. The grooves will level out and it becomes difficult to chew food. Teeth grinding can also lead to pain in the jaws. Some would clench their jaws- this force can put pain and pressure on the mouth and jaw bones. Disabilities often interfere with their food habits and this way the general health of the person can also be affected.
5. Delay in teeth development
Delay in teeth eruption is seen in many with developmental disabilities. It is mostly noticed in people with mental retardation. The teeth erupt quite late- often when the child is around 2 years of age. Discolouration of teeth and difference in the structure of teeth is also noticed. Gums and jaw bones will also develop improperly and change in the jaw and facial structure is also seen. It is not just delay in teeth development that affects oral health, but the teeth that erupt is not strong and might not be able functionally good.
6. Misalignment of teeth
Malocclusion is a feature commonly seen in people with developmental disabilities. Misaligned upper and low teeth and overcrowding of teeth is often a problem, this comes with additional dental problems like tooth decay and tooth loss, cavities, bad breath etc. Breathing and speech disorders can also be noticed because of this dental issue. Seeking proper treatment for dental issues is important if oral health is to be maintained.
Dental consultations is a definite way to maintain oral health. This is especially true in the case of people with developmental disabilities. Understanding the different dental concerns that are common among people with developmental disabilities and learning how to provide adequate care is important. Making sure that brushing and flossing are done every day is imperative. If they are not able to take care of their personal dental hygiene needs, then care givers should take the main role. How to tackle their behavioural issues and how best to communicate to them the need for dental care is something every care giver should learn and teach people with developmental disabilities. Routine dental consultations are essential to understand the different dental needs of people with developmental disabilities. If possible, time should be spend to teach people with developmental disabilities the basics of oral hygiene.