Dental Care for the Disabled Child and Adult:

Ask your Dentist to give you a referral to a particularly skilled / experienced dentist in treating disabled patients.

Most severely disabled people need some type of special help to cooperate. For some, this is just knowing the dentist and having some level of trust and comfort. It depends on the individual patient's needs.

1. Intravenous Sedation in the hospital or a private office. Many states require a special permit to do this. Your physician should give an okay before this is done in a dentist's office, as an extra precaution.
    
2. Nitrous Oxide (laughing gas) and oral sedation together: This is safe for many patients.
    
3. Local Anesthetic (Novocain) by Itself:
    

Tooth Brushing For Disabled People:

All people with teeth need brushing. Brushing followed by flossing is better if possible. If your child will not let you near his mouth due to fear, unfamiliarity with the brush or tactile defensiveness around the face, here is how you may desensitize the child or adult. Start with just some wet gauze or a washcloth wrapped around your finger and move it around the lips until the child or adult will accept this. Use a massaging motion. When the child or adult gets accustomed to this and seems to like it (this may take quite a few sessions), start to go inside the mouth. The back teeth  in most cases seem to be less sensitive than the front ones on most defensive people, so start on the back ones. Be very patient. Use a soft or ultra soft bristle brush. Warm the bristles in warm water to soften them further, anything to get the child or adult to take that first step. If the person is gagging, stop immediately. You may give the person an old brush and let him play with it and chew on it before or after the tooth brushing session.  This systematic desensitization program may take several weeks but it is well worth the effort. Do it in the same place and at the same time daily. You may give the child or adult a reward after the session is over.

Mechanical toothbrushes are all right only if your child or adult will accept something like this in the mouth and they have learned to accept a regular brush first (NOTE: The parents of Children with seizure disorders should consult their physician before using any electric tooth brush as in some cases this may trigger seizures). Use toothpaste sooner or later in this series of steps but remember it is supposed to feel and taste good, so don't use anything that will turn your child or the adult off. The only real value of toothpaste is the fluoride in it. A pea-sized drop of toothpaste is sufficient.

One of the favorite flavors of toothpaste for kids to use may be Oral-B Bubble Gum. Use water or fluoride rinse if they won't use toothpaste. Don't feel bad if your child or adult never gets accustomed to toothpaste. Most people with significant physical or mental disabilities need someone else to brush and floss their teeth for them.