GASTROINTESTINAL REGURGITATION
It causes an acidic environment in the mouth which leads to the loss of Calcium and other metals from the teeth. There are special high Fluoride based toothpastes and Calcium with Phosphorus toothpastes that can help in the re-metallization of the teeth.
FOOD ACCUMULATION IN THE MOUTH
Some children hold the bolus of food in the mouth or delay their swallowing, resulting in fermentation of food by the microbes, increased acid production and loss of calcium from the teeth.
BRUXISM OF TEETH
It is especially intense in children with Cerebral Palsy. This causes wearing and flattening the occlusal surfaces of the teeth to a high degree. Special splints are often used which are cemented on the teeth in order to protect them.
HALITOSIS (bad breath)
Some causes of halitosis are due to food retention and decomposition in the mouth, stomach problems, poor digestion, chronic sinusitis, poor oral hygiene, mouth breathing. There are special toothpastes and mouthwashes to combat halitosis.
XEROSTOMIA
It is common either because of the medical condition of the child or due to the medication they are taking. Drugs that can cause dry mouth are Antihistamines, Antidepressants, Antiepileptics, Tranquilizers, and medicines which treat Gastroesophageal reflux disease (GERD). Dry mouth can cause Gingivitis, Dental caries and oral infections. There are special products that treat Xerostomia.
ANTIEPILEPTIC MEDICATION
Some antiepileptic medication cause severe hypertrophy and inflammation of the gums, with severe bleeding even during the act of mastication. Sometimes, the hypertrophy of the gums is so severe that it can cover almost all the surface of the teeth!
However, without any bacterial plaque on the teeth, these antiepileptic medications cannot cause such severe problems. Proper brushing and special antiseptic sprays and gels can help reduce the problem.
Trauma
The chances of injury are increased (epileptic seizures, falls, spasms, etc.). It is very important to contact the Dentist DIRECTLY if your child injures either their primary or their permanent teeth. If the permanent tooth falls out whole with the root following a trauma, place it back in the cavity (that is, in its place) by holding it from the crown rather than the root; this way the root cells are not destroyed or if you fail to put it in place at least put it in milk (not in water) and run to the Dentist. Direct placement of the tooth back into the cavity (tooth position) is of great importance for better transplantation prognosis. If the tooth breaks, find the broken piece, put it in milk and call the Dentist. THE BROKEN TOOTH CAN BE REATTACHED ONLY IF THE PIECE IS INTACT AND NOT DEHYDRATED.
Orthodontic treatment
Unfortunately, due to the heavy medical history and the lack of cooperation, it is usually not an option for this group of patients to undergo any Orthodontic treatment and that is why we solely focus on prevention.