As the OT on a treatment team, I am the ADL (Activities of Daily Living) go-to person. Why then, do so few parents ask me what ideas I have about ADLs, especially dental care? Probably because OT as a profession has developed this reputation as either focused on handwriting or sensory processing. Maximizing overall health and building skills by improving ADLs is often pushed to the side. Not today.
People with connective tissue disorders have a greater chance of cavities and more serious dental problems. Knowing what to do for your child and why it is important helps parents make changes in behavior with confidence and clarity.
Here are my suggestions to support a child that has been diagnosed or is suspected of having Ehlers-Danlos hypermobility or any connective tissue disorder:
- Teach good dental hygiene habits early. Why? Habits, especially early habits, seem to be harder to dislodge as we age. Good self-care habits can and should last a lifetime. Automatically brushing and flossing gently twice a day is cheap and easy. Make it routine, not optional. I know how this can become a fight for young children. This is one of those things that is worth standing your ground on and making it fun (or at least easy) for children to do. Brush together, use brushes and pastes with their favorite characters, pair it with something good like music or right before bedtime stories, but don’t think that dental care isn’t important.
- Research on people with typical connective tissue suggests dental care reduces whole-body inflammation. Inflammation seems to be a huge issue for people with connective tissue problems, and no one needs increased inflammation to add to the challenges they have already. Enough said.
- Tools matter. Use the softest toothbrushes you can find, and the least abrasive toothpaste that does the job. Tooth enamel is also made from the same stuff and skin and bone, and so are gums. Treat them well. Water-powered picks and battery-operated brushes may be too rough, so if you want to try them, observe the results and be prepared to back off it becomes clear that your child’s tissues can’t handle the stress. Toothpaste that is appealing will be welcomed. Taste and even the graphics/characters on the tube could make the difference. My favorite strategy is to give your child a choice of two. Not a choice to brush or not.
- Think carefully about acidic foods. Lemonades, orange juice, energy drinks, and those citrus-flavored gummies all deposit acids on teeth that are also mixed with natural or added sugars. Those sugars become sticky on teeth, giving them more time to irritate gums and soften enamel. Easy hack? Drink citrus/acidic drinks with a straw. Goes to the back of the mouth and down the hatch. At the very least, drink water after eating or drinking acidic foods to rinse things out.
- Baby teeth count. Because your young child hasn’t lost even one baby tooth, you may think this doesn’t apply to you. Those permanent teeth are in there, in bud form. Children can develop cavities in baby teeth as well as permanent teeth. Gum irritation is no different for young children, and they are less likely to be able to tell you what they are feeling. Sometimes the only sign of a cavity in a young child is a change in eating habits. This can be interpreted as pickiness instead of a dental problem.
- Consider sealants and fluoride I know…some people are nervous about the composition of sealants and even fluoride, which has been in the public water system here in the US for a long time. I would never criticize a parent who opted out of either. It is a personal decision. But be aware that they don’t increase tissue irritation, and they protect tender enamel, tooth roots and the surrounding gums. At least have an open discussion with your pediatric dentist about the pros and cons. I am mentioning sealants here specifically because some parents aren’t aware that this treatment option can reduce cavity formation and gum deterioration.
Looking for more information about ADLs and hypermobility? Take a look at Easy Ways to Prevent Skin Injuries and Irritations for Kids With Connective Tissue Disorders and Teach Spoon Grip By Making It Fun And Sharing a Laugh With Your Child and Low Muscle Tone and Dressing: Easy Solutions to Teach Independence.