Cerebral Palsy & Oral Health: Common Challenges to Look For

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Table of Contents

  1. Quick Facts
  2. 4 Common Issues
  3. What Causes Issues?
  4. Other Issues
  5. Daily Dental Care
  6. Treatment Options
  7. How to Protect Oral Health

Cerebral palsy (CP) doesn't cause oral issues like thin enamel, missing teeth, or susceptibility to the disease. But life with cerebral palsy can put a child's dental health at risk.

Children with cerebral palsy can find it hard to clear food from their teeth, and they may not brush appropriately. Medications used to treat the condition can further worsen oral health, as can damage caused by seizures.

Crafting an appropriate at-home care program is crucial for children with cerebral palsy. Parents should also partner with a dental health professional who can offer oral care therapies, including sealants and tooth straightening options.

Quick Facts about Cerebral Palsy & Oral Health

About one child in 345 in the United States has been diagnosed with cerebral palsy, making this the most common motor disability seen in children. 

In a study of children with CP, more than half had dental cavities. 

A person with cerebral palsy expends three to five times more energy to move than someone without CP. Brushing and flossing can be very taxing for someone with this movement disorder. 

Only 25 percent of people with CP have severe intellectual disabilities. Most can communicate, learn, and advocate for their bodies, including their oral health.

4 Common Oral Health Issues in Children with Cerebral Palsy

Cerebral palsy doesn’t cause oral abnormalities. But people with CP often have difficult or painful conditions that impact oral health. While each person is different, most of these issues stem from the same causes.

The human mouth is home to a dazzling number of bacterial cells. They lean on sugars to survive, and a combination of poor oral health and a sugary diet could allow them to thrive. 

Bacterial infections can cause the following:

  • Bad breath

  • Bleeding gums

  • Oral pain 

  • Loose teeth 

  • Oral sores

Researchers say many children with CP have some kind of dental trauma.A chipped tooth can cut sensitive tissues inside the mouth, including the cheeks and gums. A significantly cracked tooth can be painful, especially if the child eats hot, cold, or sugary foods. Broken teeth can also impede a child’s clear speech.

Gums keep teeth securely in space and protect a child’s sensitive tooth roots. If plaque builds up, plaque colonies erode gums, leaving roots exposed and a child’s smile in danger.

While anyone can develop gingivitis, it’s more common among children with cerebral palsy.

Researchers say children with CP often have misaligned teeth, including open bites. The issues tend to worsen with age.

Children with CP may suck their fingers, grit their teeth, and otherwise engage in habits that push teeth out of alignment. And the further apart their teeth, the more likely it is that they’ll cause trauma with each bite.

What Causes Oral Health Issues in Children With Cerebral Palsy?

While cerebral palsy doesn't change the structure or content of a child's mouth, you may notice the impact of the disease on your child's smile. The causes are varied, but often, families struggle with the same culprits.

Some children with cerebral palsy take medications to ease seizure frequency or improve mood. Often, these prescriptions can reduce saliva production.

Teeth and gums need a coating of saliva to stay healthy and free from infection. Your child's therapy could make this saliva coating thinner or less effective.

Children with CP may struggle to chew and swallow quickly. Food lingers in their mouths during mealtimes, and when the meal is through, some children may have remnants stuck in their teeth or next to their gums.

Brushing and flossing require fine motor skills, which are often lacking in people with CP. Caretakers can help, but some children clench their teeth or purse their lips during cleaning, making bacteria or food removal more difficult.

What Other Issues Can Make Oral Health Worsen?

Cerebral palsy is an individualized disorder, and many people have secondary conditions that can further worsen their oral health. These are a few of the conditions often found in people with CP:

Researchers say gastroesophageal reflux is the most important cause of dental disease in people with CP, and it's found in about 55 percent of patients. Digestive juices are incredibly toxic to dental tissues and can cause damage to both teeth and gums.

Children with reflux may have just one or two episodes weekly, but some experience symptoms every day. The more frequently the child has symptoms, the bigger the impact on oral health.

A child needs control over facial muscles to eat, drink, and clean. Children with pseudobulbar palsy have little control over these delicate muscles. They struggle to protect their oral health as a consequence.

Up to 30 percent of children with CP have excessive drooling. This issue can be related to the following:

  • Dental cavities

  • Throat infections

  • Some medications

When drool spills from a child's mouth, little is left to protect the teeth and gums. Excess fluid can also allow bacterial colonies to grow.

Up to half of all children with cerebral palsy have seizures. During an episode, a child might clench the teeth tight, causing cracking or fissures to form. Children can also bite their tongues or cheeks during a seizure, causing painful lesions that harbor bacteria.

Daily Dental Care for Children With Cerebral Palsy

Oral health is critical for everyone, including children with cerebral palsy. Setting up a routine now could help set a child up for a lifetime of good health.

Follow these tips to help you get started:

  • Question your child. Don't assume all children with cerebral palsy need their parents to handle all of their oral health steps. Some children are perfectly capable of following clear directions carefully explained by their parents. Determine where your child falls on this spectrum and plan accordingly.

  • Invest in equipment. Items like custom-made toothbrushes and specially handled flossing devices make cleaning easier.

  • Talk with your dentist. Some children with CP need toothpastes low in fluoride, as they tend to swallow products. Others need more powerful toothpaste, as their parents can't use very much in each session. Ask your dentist to guide you.

  • Teach as needed. Some children with cerebral palsy can use a toothbrush. Show your child how it's done, and stay on hand to answer questions or adjust techniques as needed.

  • Step in to help. Some children with CP can't handle their own oral health steps. Angle your child's head back, and stabilize their head as you brush.Some parents find it's easier to stand behind the child during sessions. Others prefer to lay the child on a bed.

  • Inspect often. After each meal, ask your child to open wide and look for trapped or hidden food.

  • Rinse well. If your child takes medications, use water to wash away any residue left behind.

In general, your child's teeth should be brushed twice per day. Rinses and inspections round out a daily routine.

But the schedule your family follows is deeply influenced by your child. Work together to find a plan that is ideal for everyone. This process may take some trial and error.

Treatment Options for Children with Cerebral Palsy

A dentist is a great ally for families raising a child with cerebral palsy. Together, you can come up with a plan to keep your child's smile healthy.

Typically, your treatment plan will vary depending on the problems your child is facing. But these are typical issues dental professionals address in children with cerebral palsy:

A dentist can offer advice on how to brush the child's teeth. The right product mix could help a child to avoid dental cavities.

Some children also benefit from dental sealants that fill cracks deep inside back teeth. Smoother teeth are less vulnerable to decay.

Crooked, gapped teeth can collect bacteria, and issues like an open bite can make eating very difficult. Orthodontists have used tools like braces to fix crooked teeth in children with cerebral palsy. 

If your child can work with you, follow directions, and maintain control over jaws, clear aligners may be a good option. But children with poor motor skills and seizures may be at risk of choking on the trays.

Some children with cerebral palsy benefit from night guards and other protective devices. Often, these devices must be made to fit a child’s specific face and teeth.

How to Protect Oral Health Issues at Home

While regular dental appointments are crucial for a child's oral health, there's a lot parents can do at home to keep things healthy. These are three important at-home steps:

Communicate with your child regularly. Explain why it's so important to keep teeth and gums healthy.

If your child has moderate or advanced motor skills, your child can tackle brushing and flossing without your help. But even a child with few motor skills can be encouraged to cooperate while you brush and floss.

Encourage your child to break complicated tasks, like brushing, into smaller steps that are easier to manage. Talk about what tools might make the job easier. Maybe your child needs a wider toothbrush handle or less fragrant toothpaste.

If your child takes medications that reduce saliva production or harm enamel, take a few extra steps:

  • Offer plenty of water throughout the day.

  • Ask for sugar-free medication options, as needed. 

  • Rinse with water after each dose. 

Remember, don’t quit medications without talking to your doctor first.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.