The Mighty Logo

Dental Care for Kids With Down Syndrome

The most helpful emails in health
Browse our free newsletters

Having anxiety over visiting the dentist is actually very normal and seen in a lot of people, but it can be more challenging for those who have Down syndrome. Due to sensory issues, patients with Down syndrome may not always tolerate a cleaning or a dentist poking around heir mouth. Being prepared is the best way to ensure that everyone involved will have a good experience. It may be tempting to simply put off dental care due to the complexity of the experience, but in order to avoid an emergency dental situation, it’s important to find a dentist you can trust and who is willing to work with your child.

Dental Issues to Watch For

Children with Down syndrome often get their baby and permanent teeth at a later time. Delayed eruption is common.

Some dental problems can be a result of other factors, such as genetics. This can make it difficult to distinguish what is the result of Down syndrome, genetics, habits or any other factor.

Listed below are the most common dental problems that are seen in patients with Down Syndrome:

  • Malocclusion.
  • Misshapen teeth or microdontia.
  • Congenitally missing teeth.
  • Crowding and/or impacted teeth.
  • Problems with the jaw and bite.
  • Complications with chewing.
  • Inefficient natural cleansing action.
  • Periodontal disease.
  • Cavities.
  • Dental caries.
  • Gingival hyperplasia.

Some patients with Down syndrome may have difficulty communicating, including describing the amount of pain they’re in. As a result, even the most simple of oral health issues can become a major problem if not addressed in time.

Patients with Down syndrome may not understand what is happening at the dentist. For example, if your loved one is wary around new people and does not like to be touched, having a stranger’s hands with tools in their mouth can be a very scary situation for them.

With this in mind, it’s important to help your loved one with their fear and anxieties as much as possible to ensure the visit goes as smoothly as possible. Thankfully, there are a handful of ways to make the visit easier on everyone.

The Question of Sedation

Some patients can benefit from sedation during the appointment. Sedation is sometimes necessary if they must have dental work done because their health is at risk and they cannot cooperate with the dentist.

Many patients opt for sedation dentistry, so having it done for a patient with Down syndrome is not uncommon at all. Sedation dentistry, or “sleep dentistry,” helps to keep the patient calm and in a relaxed state. This type of sedation is nothing close to being knocked out.

Nobody likes having someone poke around in their mouths with tools, so for easing the experience, especially in the case of someone with significant sensory issues, sedation may be an option.

This can be particularly important for major dental work or surgeries, pay particular attention to sedation options in these cases.

Dentists for Patients With Disabilities 

Interestingly enough, there are dentists out there that care for patients with disabilities. Dentists with this specialty are required to have an additional three years of dental training.

Unfortunately, these dentists can be difficult to find. Asking your local dentist office or an advocacy organizations are good places to start.

The National Down Syndrome Society (NDSS) has a number of resources available that loved ones can look into, including a database of health care providers.

Advocacy organizations often have helpful information, representatives you can ask for help, and a number of other relevant resources that can help you give your loved one the proper care they need.

Aside from dentists who specialize in treating patients with disabilities, finding the right dentist for your loved one is extremely important. Finding a dentist who is patient and understanding is the first step to having a smooth experience.

Look for a dentist that has a systematic approach to all examinations and treatments that your loved one will receive. You should also ask if they have any experience in dealing with patients that have disabilities and if they offer sedation dentistry in case your loved one becomes too overwhelmed to safely work on. Flexible appointment scheduling is also worth asking about.

During your search, considering asking yourself the following questions if they are applicable:

  • Were the staff and the dentist interacting positively with my loved one?
  • Will the staff and the dentist be patient, comforting and understanding?
  • Will my loved one feel comfortable here?
  • Have the staff and/or the dentist had any experience or additional training with patients with Down syndrome?
  • Will this office be able to have flexible scheduling for my loved one in case we need to leave and try again another day?
  • Does this practice offer any additional services that are designed specifically with patients with disabilities in mind?

You can look into finding the right dentist by first making contact with the local practices within your surrounding area. If none of them are right for your loved one, try using the ADA’s Find A Dentist search and directory.

You can also ask for recommendations from friends or your family doctor. What’s more, your dental insurance provider may have some great choices for you, as well.

If your loved one has adaptive equipment equipment that must be considered for their visit, make sure you ask while making the appointment. For example, if your loved one uses a wheelchair, make sure that the office meets ADA requirements.

Preparing for the Appointment

If your loved one has never been to a local dentist’s office before, preparing them for the appointment is something you’re definitely going to want to do. Talking to them about what a dentist is, what they will be doing (if you know the specifics), and what it’s like will be a big help.

Social stories are a great ay to help children understand and visualize what happens at the dentist.

Visit the dentist with your child on a day when they will not have any oral work done. This allows them to familiarize themselves with the environment, see the lights and hear the sounds. This may also be a great way to identify potential triggers and find possible solutions or create a plan for the actual appointment. You can also tell your child about your experiences at the dentist, even if it’s not the same one, and explain why it is important to take care of our teeth.

Consider bringing a favorite movie to have playing during their appointment if the dentist has a TV in the room. If your loved one is a child, you could bring their favorite toy for them to hold onto while they are being worked on., it may ease tension and anxiety.

Make sure that you describe a typical appointment at the dentist as a positive one.


Asking for a split treatments is a great way to ease the stress and the anxiety of the appointment, as well. Split treatments can be extremely beneficial for patients with disabilities. They help to ensure that the experience won’t be as prolonged or as stressful.

Practicing Proper Oral Hygiene at Home

Practicing proper oral hygiene at home is just as important as regular visits to the dentist.

If your loved one with Down Syndrome is a child, starting proper oral hygiene early is the best place to start. However, if your loved one is a teenager, adult or a senior, remember that it’s never too late to practice proper oral hygiene.

Starting with brushing is best. Brush your teeth with them or let them watch you while you brush yours. You must show them that brushing their teeth twice is a day is both a regular and important thing to do. Use soft strokes at a 45-degree angle from the gums while brushing the base of the teeth and the gums. Brush up and down in a circular motion along the surface of each tooth.

Flossing may be a more difficult routine to approach. If your loved one wants nothing to do with flossing it’s important that you do not force them. Although, you can also show them that you not only brush your teeth but that you floss regularly, as well. This may be a stepping stone in encouraging them to allow you to do it for them, or for them to do it themselves.

Mouthwash, like flossing, may also be difficult. It’s commonly seen in patients with Down syndrome that spitting can be difficult. If this is the case, and they tend to swallow when they are supposed to spit, do not give them mouthwash.

Once you have established proper oral hygiene habits, it’s up to you to ensure they stick to the routine. Even if they haven’t engaged themselves, but have been watching you brush, floss, etc., keep that routine a regular one. They may eventually want to join in, too.

Be regular, enthusiastic, and always remind them of the importance of proper oral hygiene.

A version of this post originally appeared Dentably.

Getty image by gregorydean

Originally published: December 9, 2018
Want more of The Mighty?
You can find even more stories on our Home page. There, you’ll also find thoughts and questions by our community.
Take Me Home