Consultant Physician, Dentist, Maxillofacial Surgery, Works at King’s College Hospital Dubai



Those infants and adults that are Profoundly Retarded, are totally dependent on others for their personal needs and are usually institutionalized. These individuals usually have multiple dental manifestations.

Gum infection and Periodontal disease; is the most common dental problem associated with mental retardations. The periodontal disease is not primarily due to disability and is usually the result of dental neglect.

Dental caries; especially untreated carious lesions are a common finding in these children. Dental caries in these children are also a result of dental neglect.

Structural abnormalities; are related to disturbances in growth patterns in many of these children.

Malocclusion; of some form is frequently found in retarded individuals with craniofacial syndromes

Destructive oral habits; such as tongue thrusting, bruxism, clenching, and drooling are frequently found in these individuals.



both baby teeth and permanent teeth, may come in late


Frequently, have smaller than average teeth and missing teeth.


may have large tongues or they may have an average size tongue and a small upper jaw that makes their tongue too large for their mouth.  It is also common to have grooves and fissures on their tongues.


may have small or larger teeth, which can cause spacing between the teeth or crowding.

They also tend to have a small or big upper and lower jaw.  This may cause crowding of the teeth and may result in the permanent teeth being “impacted” because there is no room in the mouth for them to come in.  The small upper jaw may create a situation where the top teeth do not go over the bottom teeth the way they are meant to; instead, the bottom teeth may be out further than the top teeth in the back of the jaw, the front of the jaw, or both.  It is also common that the front teeth of people with Down syndrome do not touch.


What Can I Do to Prevent Cavities and Gum Disease?

Brush teeth twice daily with a soft toothbrush and fluoride toothpaste.  Children less than 2 years should get a thin “smear” of fluoride toothpaste, and children 2 to 5 years should get a small “pea-sized” amount.

If the gums bleed that means that they are inflamed. Brushing and flossing should not be stopped because of this.  In fact, brushing and flossing will keep the gums clean and help to minimize the inflammation

Limit the frequency of sugar and cracker/bread-based snacks.


Do People with Mental retardation Need to Take Antibiotics Before Going to the Dentist?

People who have, or have had, certain kinds of heart defects need to take antibiotics before their dental appointment.

What Can I Do About My Child Grinding His or Her Teeth?

It is very common for children to grind their teeth.  Typically it does not cause dental problems, and children tend to grow out of it on their own. However, sometimes children with neurological disabilities do not outgrow it or they do it so severely that it causes damage to the teeth.

People with mental health problems are entitled to the same standards of care as the rest of the population. Oral health has a significant impact on holistic health. Health professionals should therefore be aware of the impact of mental illness and its treatment on oral health.

Special oral health programs to motivate and educate the children and their guardians should be carried out at regular intervals.

Patients with special needs may exhibit poor oral hygiene due to difficulty in performing self-care and because many take medications that cause negative oral health side effects, such as the dry mouth.

Clinicians can modify self-care devices to improve the effectiveness of oral hygiene regimens. For patients who have difficulty grasping, the use of a wide-handled power toothbrush is recommended. The addition of bicycle grips, tennis balls, or soft plastic to toothbrush handles may also make them easier to hold. An extender (ruler, rod, or wooden spoon) can be taped to the handle of a toothbrush to provide assistance for patients with a limited range of motion.



Dental treatment need is high for people with disabilities requiring treatment under General Anesthesia. The main indication for treatment under GA is suspected or confirmed pain or dental complaints.

Dental care can be successful, for the benefit of patients with special needs, if all carers work together. The caregivers have to be trained in nutrition control limiting the intake of cariogenic and erosive food, as well as in oral hygiene. The cooperation of caregivers and the dental team helps to avoid dental emergencies in patients who are difficult or very complex to treat


About Professor Dr. Luis Gavin

Prof. Dr. Luis Gavin is a leading international Speaker, from Spain, based in Dubai, Consultant Physician& Dentist, and Maxillofacial Surgery

IG @dr.luisgavin

Facebook: Dr Luis Gavin

Email: [email protected]

WhatsApp: +971 567048581



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