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Special Educational Needs (SEN)

Key Takeaways

  • Children with SEN may have a higher risk of oral health problems.
  • A consistent routine is key to establishing good oral hygiene habits.
  • Specialist toothbrushes and techniques can make brushing easier.
  • Preparing for a dental visit can help reduce anxiety for the child.

Identifying SEN(Special Educational Needs) Children

  • Trouble with swallowing and /or eating
  • Trouble eating wide variety of foods ( eat less variety of foods)
  • More anxiety in new surroundings
  • Trouble understanding what they are being told or asked to do
  • Trouble with speaking
  • More plaque around teeth and swollen or red or bleeding gums
  • Trouble with mouth movements
  • Dry mouth due to some medications your child might be taking

Trouble with:

bright lights, strong smell, loud sounds, Busy or crowded surroundings

Look out for upcoming oral health events or workshops in your borough

Your local borough usually has a dedicated oral health promotion team and gives your child extra support and resources to maintain good oral health.

✨🦷✨ Start Early!

diabetes

Permanent Teeth Development

Mixed dentition phase

  • Permanent teeth start to replace baby teeth as they start falling out.

Keep an eye out for any issues with the alignment teeth like

  • Crowding
  • Spacing
  • Missing teeth
  • Bite

Consider & Discuss with the dentist

  • Fissure sealants
  • Fluoride varnish
  • Mouthguard for contact sports
Oralhealth.info logo
Source: American Dental Association. (2012)

Common Teething Symptoms

  • Decreased appetite for solid food
  • Drooling
  • Ear-rubbing
  • Facial rash
  • Gum-rubbing
  • Increased biting
  • Irritability
  • Mild fever
  • Suckling
  • Wakefulness
  • Gingival irritation

What can you do?

  • Gently rub the gums with a clean finger.
  • Wipe away excess saliva from the face regularly to prevent rashes.
  • Offer cool, clean pacifiers or teething rings for the child to chew on. (Do not freeze them).
  • Administer sugar-free paracetamol if other methods do not provide relief.

Staying Safe

If your child becomes very unwell, has long-lasting symptoms, is unresponsive, or is in severe distress, seek urgent medical advice.

Source: Mamdani, S., Rajan, S. & Bhujel, N. Teething - filling in the gaps…. Br Dent J 237, 262–266 (2024).

Special Brushes, Grips & Pastes

Fluoride

  • No less than 1000ppm
  • 1350-1500ppm if high risk of tooth decay

Toothpaste amount

Pea size

Toothpaste types

  • SLS free
  • Non-foaming/low foaming
  • Flavourless

Brush Type

  • Soft bristle, small head
  • If electric brush – choose small oscillating head

Special Brushes

  • Dr Barman’s superbrush
  • Collis curve brush
  • 360⁰ Brush
  • Sonic super brush

Toothbrush grips – for better grip

  • Foam (slide-on)
  • TePe extra grip
  • Handle grips

When do you change your toothbrush?

  • Every 3 months
  • When worn out
  • After an illness

Some kids are more sensitive to toothpastes

If you are looking for non-fluoride/non-foaming/SLS free/mild flavour or flavourless, ASK YOUR DENTIST

Daily Brushing Routine

Brush 2 times a day for 2 minutes

Once at night and at one other time during the day.

2×2 min

  • Spit out the toothpaste after brushing. Don't rinse with water.
  • Avoid eating or drinking anything (except water) for 15-20 minutes after brushing.

🦷✨ Supervise Brushing

Supervise your child’s brushing until they are at least 7 years old to ensure they are cleaning their teeth effectively.

Tongue Cleaning is Important

Encourage your child to clean their tongue when they brush their teeth.

🦷✨ Interesting Fact

Did you know 2/3 of germs in your mouth live on the tongue?

Orabrush tongue cleaner
Source: Generated with AI

How to prepare your child for Dental Visit

Top tip during the dental visit!

  • Ask the dentist for a less bright light or dimmer light to examine your child's teeth
  • Ask if there are shaded protective eye wear to reduce the brightness
  • Ask if you can take a photo to make a picture memory to help your child familiarise for next dental visit
  • Talk to your child before dental visit and explain what to expect
  • Let the practice know about your child's special needs
  • Choose quieter appointment (less busy) times
  • Introductory HELLO visits and extra time to help your child get used to the dental surroundings
  • Help your child get familiar with sounds, smells & lights in dental visits (Tell, Show, Do)
Dental Visit

Dental Check-ups

Schedule the first dental appointment by your child's first birthday.

Dental Care by 1 campaign logo
Source: BSPD

Why Schedule Early?

Schedule your child's first dental visit by their first birthday. Early check-ups help keep their teeth healthy from the very start. Click here to learn more.

Did you know when a baby's first tooth usually appears?

🦷 Around 6 months! That's why early dental visits are so important!

What's Included

  • Dental check-ups for children are free on the NHS.
  • Regular check-ups are typically recommended twice a year.
  • Includes a dental examination and preventive advice.
  • Topical fluoride varnish may be applied to protect teeth.

Opt for Sugar-Free Medication

If your child needs medication, ask your pharmacist or doctor for sugar-free options to protect their teeth.

Healthy Habits for Happy Teeth

  • Choose water instead of juice or sugary drinks.
  • Avoid frequent snacking throughout the day.
  • Include plenty of fruits, vegetables, and dairy in their diet.
  • Applying topical fluoride varnish to protect teeth from decay.
  • Using fissure sealants to protect the chewing surfaces of back teeth.
  • The need for a mouthguard if your child plays contact sports.

Beware of Sugar

Foods & Drinks with Sugars 🍬

Remember to REDUCE:

  • Amount (how much you eat or drink at each time)
  • Frequency (how often you have sugary foods & drinks)

Healthy Habits:

  • Limit treats to mealtime
  • Only 1-2 times per week
  • Choose healthy alternatives

Milk 🥛

Good Choices ✅

  • Regular dairy milk
  • Unsweetened non-dairy milk

Avoid ❌

  • Sweetened dairy milk
  • Sweetened non-dairy milk
  • These can cause tooth decay!

Sepsis

Sepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs, with the immune system going into overdrive.

Baby oral health
Source: Poster by UK Sepsis Trust

What else can I do to help my child?

Prevent injuries

  • Make home safe to prevent falls
  • Use car seats and safety gear for sports

Help kids with special needs

  • Work with your dentist to make a special plan for kids with health conditions
  • Get help early for any mouth or jaw problems
  • Team up with specialists (like speech therapists) if needed

Watch habits

  • Encourage stopping thumb-sucking or pacifier use by age 4
  • Switch from bottle to cup between 12-18 months
  • Tell your dentist if child grinds teeth often in sleep

Keep an eye on teeth coming and falling out

  • Baby teeth usually start falling out around 5-6 years old

Work with all health providers

  • Keep dentist and doctor informed about your child's health and medicines

Teach your child about mouth health

  • Make brushing fun with songs or games
  • Let your child pick their toothbrush (make sure it's soft)
  • Show good habits by taking care of your own teeth

Get your child checked by dentist if you are concerned or worried about any of the following

Developmental Conditions

  • Cleft lip and/or palate: Visible gap in lip or roof of mouth
  • Tongue-tie: Restricted tongue movement
  • Small white cysts on gums or palate (Epstein pearls, Bohn's nodules, dental lamina cysts)
  • Presence of teeth at birth or within the first month (natal/neonatal teeth)
  • Bluish-purple swelling over erupting teeth (eruption cysts)
  • Delayed tooth eruption or early loss of baby teeth
  • Misaligned teeth or jaw (malocclusion)

Genetic and Systemic Conditions

  • Down syndrome: May have delayed tooth growth, missing teeth
  • Ectodermal dysplasia: Can cause missing or oddly shaped teeth
  • Weak or discoloured tooth enamel (amelogenesis imperfecta, dentinogenesis imperfecta)
  • Ehlers-Danlos syndrome: May affect tooth and gum health
  • Heart conditions: Can impact overall health, including oral care
  • Diabetes: Childhood diabetes can increase risk of gum disease

Infectious and Inflammatory Conditions

  • Oral thrush: White patches in mouth
  • Hand, foot, and mouth disease: Painful mouth sores
  • Herpetic gingivostomatitis: Painful sores on gums and in mouth
  • Teething: Swollen, tender gums when new teeth emerge
  • Gingivitis: Red, puffy gums
  • Periodontal disease: More severe gum infection (rare in young children but possible)

Tooth Problems

  • Cavities in baby teeth
  • Chipped, broken, or knocked-out teeth from accidents
  • Tooth infection (might cause swelling or pain)

Nutritional and Systemic Health Issues

  • Vitamin deficiencies (especially C and D): Can affect gum health and tooth development
  • Iron-deficiency anemia: May make gums & tongue pale
  • Gastroesophageal reflux (GERD): Stomach acid coming up can wear down teeth over time

Neurodevelopmental and Muscular Conditions

  • Cerebral palsy, autism, epilepsy: May affect oral care routines
  • Spinal muscular atrophy (SMA) and muscular dystrophies: Can impact mouth and face muscle control
  • Sensory processing disorders: May make oral care challenging

Speech, Language, and Feeding Issues

  • Can have trouble with mouth movements for speaking
  • Feeding and swallowing disorders: Can impact oral health and development
  • Mouth breathing: Breathing through mouth instead of nose can change how teeth grow