Tuesday, June 16, 2009

A Visit to the Dentist

Dental care for the patient with Down syndrome can be achieved in the general practitioner's office in most instances with minor adaptations. Although this population has some unique dental care needs, few patients require special facilities in order to receive dental treatment. Adequate dental health care for persons with developmental disabilities is a major unmet health need.

- From Dental Care for the Patient
with Down Syndrome

by Dr. Elizabeth S. Pilcher

I've read a few things recently about children with Down syndrome needing sedation for routine dental exams, including basic, preventative care. I've been wondering how it would go with Bridget, how she would do at the dentist's office, and what we would find out about her dental health. (By I've been wondering I really mean, I've been worrying. Not a ton, but some.)

I was so glad to find an explanation of the unique dental care needs and considerations specific to the patient with Ds that encouraged practitioners, parents and patients to expect comprehensive care in a traditional setting (with minor modifications, if necessary). Here's a link to Dr. Pilcher's article.

This morning Bridget had her first dental appointment, and she did great! She's been giving me a run for my money recently with her curiosity, energy and general willfulness (she's so TWO! and she woke up at 5:30 a.m. today--much earlier than usual), so I was a little concerned about how cooperative she would be with the dentist. The issue was more the waiting room than the actual exam, but that is another story all together :).

Our pediatric dentist was wonderful with her. He talked to her in just the same way he talked to our other children when they were her age. He was patient and deliberate, and knew just how to get the job done quickly and without upsetting Bridget. She sat in my lap (with her chest against mine) and he sat across from me. He leaned her head back onto his lap, which provides the best vantage point to view all the teeth.

He doesn't know Bridget at all, but he didn't seem to have pre-conceived notions about how she would behave, whether she could understand what he was saying, etc. In fact, he seemed to presume competence...which is absolutely the right way to go. Kudos to Dr. Wenger!

He explained that teeth (and gums) are a big issue in children with Down syndrome. I already knew that the teeth in people with Ds are often delayed coming in, arrive in an unpredictable order, and come in all shapes and sizes. I have not researched dental issues in-depth until just recently. I knew that I needed to pay special care to cleaning Bridget's teeth, but she hasn't had them all that long :). I figured I'd deal with other issues as they arrive, which has been my approach with most things related to Bridget having Down syndrome.

Today I learned that people with Down syndrome are especially prone to gum disease and are sometimes missing baby teeth or permanent teeth. Bridget does not have her eye teeth yet. Apparently, they may never come in. The dentist said while it is possible that they just haven't erupted yet, he thinks it is more likely that they are missing. He must have noticed the concerned look on my face, because he quickly followed by saying that it is something that can be taken care of fairly easily in an orthodontic setting. He feels that Bridget is doing great, that we are doing a good job of cleaning her teeth, and that her teeth look very healthy.

As with everything else, there is a huge range in the dental health of individuals with Ds. Proper preventative care and appropriate treatment are hugely beneficial for anyone.

We had a positive experience today, which is a huge relief...and another reason to be grateful for compassionate, skilled health care providers and another reason to never underestimate my youngest child...


  1. Great info... thanks for sharing. And hurray for a successful first visit!

  2. That's great! I'm so impressed! We just did our first trip to the dentist too, at 3 1/2 Chelsea was not quite as cooperative! You lucky girl!

  3. I'm glad you posted this--it is important for parents of children w/Ds to be aware of dental issues and how regular, preventative care is necessary! We took Sammi for the first time at 12 months, since she had her first tooth or two then. We took her again at 2, and are due for a 3rd visit now that she's 3. She totally surprised us with how cooperative she was. I think it's got so much to do with the manner of the dentist, and how they can relate to the child. I'm so glad it went well for Bridget!

  4. That's fantastic! I've been putting off taking the kids to the dentist because I didn't like the last guy we went to. Greg wasn't as cooperative as I would have liked either. I need to get with it and get Leah checked.

  5. Very informative post. John Michael hates with a capital H having me brush his teeth. So I usually let him hold his own brush ins one hand while I try to brush w/ another brush. I find it very difficult to reach up to his gums to keep the teeth clean. I'm hoping that his first dental visit in 6 months won't be too difficult! Maybe he'll be used to the brushing by then. Glad things went well with Bridget.

  6. SOunds like a great dentist. At 9 mine has been going awhile but she has major anxieties about Dr's so we had to take extra care to ease her in. We made many visits and did nothing but practice and several friends let us join them when their kids went to the dentist. SO far it's all worked out fine. Mine doesn't have incisors next to the front teeth. I'm told that is hereditary! Great info!

  7. And your daughter's awesome, too.

  8. We are patiently waiting to back to the dentist. because of chemo and low counts we can't take Kristen in for her long over due check-up. There is this amazing mouthwash called Bio-tene that the doc reccommended we use while Kris was on chemo and We love it. Bridget is darling!