Training materials for teachers of learners with severe, profound and complex learning difficulties: level C

Good oral health

Good oral health is essential for speech, communication, enjoyment of food, good nutrition, social integration and can improve self-esteem and dignity. It can lead to the reduction or elimination of dental disease, which may cause pain, discomfort or distress from the teeth and mouth, most of which is usually preventable.

Bellis, 2008

Oral care

People with learning disabilities have the same rights as all other members of society.

Dental services should be provided in a way that:

Recognises that they are individuals.
Recognises their right to participate in decisions that affect their lives.
Provides the amount of support necessary to enable everyday living, including adequate health care.

Oral health and quality oral health care contribute to holistic health. It should be a right not a privilege.

British Society for Disability and Oral Health (2001)

PMLD and oral health

People with PMLD experience more problems with their oral health than the general population for a number of reasons. These may include: oral and facial developmental abnormalities; various medical conditions; the effects of medication; and the consequences of challenging behaviour. Poor oral hygiene further exacerbates these inherent problems.

PAMIS, 2011

Cerebral palsy and oral health

Scope (2010) identifies possible issues in oral care for people with cerebral palsy, caused by:

Being unable to clean teeth.
Having to eat soft food.
Difficulty in chewing or swallowing.
Not being able to communicate sensation in the mouth.
Fear of having the mouth examined.
Behavioural problems caused by not being able to communicate toothache or other sensations.

Reducing anxiety around dental appointments

The National Institute of Dental and Craniofacial Research (2009) advises the following strategies to help reduce anxiety around dental appointments:

Brief the whole dental team (eg nurses, receptionist, etc.) about the child or young person's needs.
Arrange for a pre-appointment to familiarise the child or young person with the environment.
Awareness of the child or young person's communication needs, interaction styles, and difficulties.
Presence of familiar people and the child or young person's favourite item during the appointment.

Making appointments short.
Providing only treatment that the child or young person can tolerate.
Praise and reinforce good behaviour.
Try to end each appointment on a good note.
Use immobilisation techniques only when absolutely necessary to protect the patient and staff.

Find out more

The National Institute of Dental and Craniofacial Research (2009) publishes a series of copyright free booklets for dentists including:

Continuing Education: Practical Oral Care for People With Developmental Disabilities
Practical Oral Care for People with Autism
Practical Oral Care for People with Cerebral Palsy

Practical Oral Care for People with Down Syndrome
Practical Oral Care for People with Intellectual Disability
Wheelchair Transfer: A Health Care Provider's Guide
Dental Care Every Day: A Caregiver's Guide

All of these booklets are available on the NIDCR website.

Find out more