Special Needs Dentistry in

Bethesda

What is special needs dentistry?

Special needs dentistry is the practice of caring for individuals with special health care needs. 

Patients with special health care needs have physical, medical, developmental or cognitive conditions that require specialized care from a trained dentist and dental team. Compassion and understanding is required of these medical professionals as they navigate and accommodate each special needs patient, catering treatment and service to their particular needs. 

Special needs patients can include people who use wheelchairs or walkers, people with conditions like autism or Down syndrome, or people with injuries such as spinal cord injuries that require more than just standard protocol. 

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You can plan a visit to our office prior to any treatment being performed to acclimate your child to their new dental home.

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What to expect at your child’s exam

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Scheduling Your Child’s Appointment 

When you call our office to schedule your child’s first appointment, let our front desk person know that your child has special health care needs. Depending on your child’s needs, we can schedule extra time, specific rooms, and better prepare for your arrival on the day of their appointment. 

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Meeting You & Your Child

It may be helpful for your child to come to the office and meet the doctor and the team before scheduling an appointment for treatment. If you believe your child would benefit from a visit, feel free to ask and our front desk person will arrange a visit so your child can feel comfortable at our practice. 

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Oral Health History

The dentist will need as much information about your child’s dental and overall health as you can provide, such as when their first teeth came in and their current oral care routine. Any dental records from a previous office will also be helpful and allow us to provide more accurate diagnosis and treatment.

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Sedation Options

Whether to avoid trauma or unnecessary complications, sometimes it's easier for children with special needs to receive treatment under sedation. If you think your child will be better served and treated using sedation, we can discuss options at this time.

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Cleaning & Exam

When your child feels comfortable and we have all the information we need, their dentist will perform a thorough cleaning and exam. Plaque and tartar are removed, then the teeth are then buffed, polished and flossed. Then your child’s dentist will examine their mouth thoroughly, looking out for signs of cavities, gum disease, and other oral health issues.

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Treatment Recommendation & Follow Up 

After the cleaning and exam, your child’s dentist will discuss their findings with you. If their teeth are healthy, you’ll schedule another visit in six months. If there is an issue, your child’s doctor will provide treatment options and recommendations, and help you schedule a follow-up appointment to address the issues.

Care Strategies for Patients with Special Needs

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Establish a Dental Home

Patients with special healthcare needs are more likely to receive appropriate dental care when a dental home is established early. Finding a dental home when your special needs child is still young ensures that they get comfortable with their dentist from an early age. This comfortability allows the team to become familiar with your child and cater their treatment methods and style to your child’s needs. It also allows the dentist to familiarize themselves with the patient’s oral health as they grow, and gives them the opportunity to discover and treat issues early. By taking the time to find a pediatric dental practice which understands how to care for children and adults with special needs, you’re setting your child up for greater success in their oral health. 

Provide Comprehensive Medical History

When we fully understand your child’s medical history, our team is better prepared to serve your child’s specific needs. The goal is to decrease the risk of agitating your child or aggravating a medical condition while providing necessary dental care. A comprehensive and up-to-date medical history also helps our team provide accurate diagnosis and more effective treatment. 

Helpful information can include: the primary dental issue or complaint; a list of current illnesses or history of medical conditions; a list of healthcare providers; a history of hospitalizations, surgeries, anesthetic experiences, current medications, allergies, sensitivities, and immunization statuses; medical history of immediate family; and thorough dental history.

Explore Behavior Guidance

Children with special health care needs are often resistant to dental care due to anxiety or a lack of understanding of the environment and/or procedures. If your child has the capacity to be comfortable while receiving dental care, their doctor will make every effort to help your child feel at ease in our office and with our team. This behavior guidance can take the form of visits to the dental office when not receiving treatment, getting to know the doctor and the staff, becoming familiar with the office and operatories, or having an appropriate conversation about what will happen during their procedure.

Explore Sedation Options

Sedation can be a powerful and helpful tool to give your child the dental care they need. Our team will consider your child’s special needs and the information you’ve provided to determine if sedation is necessary and which type will be most beneficial to your child. Consultation with your child’s other health care providers may be necessary when considering sedation options. Current medications, temperament, and your child’s specific needs will all affect this decision, so it’s important to be thorough in your child’s dental and medical history.

Establish an Individualized At-Home Oral Care Routine

Depending on your child’s abilities, they may be at an increased risk of developing caries and gingivitis simply from not being able to maintain a healthy oral care routine. It’s important to work around your child’s needs to provide sufficient and consistent at-home oral care. After an exam with your child’s dentist, they will be able to make appropriate recommendations that consider your family's lifestyle and your child’s needs.

Consider Diet in Terms of Oral Health

Diet and nutrition have huge effects on our dental health. The food we eat that’s good for our bodies is usually good for our teeth. However, patients with special health care needs often have special diets as well. Whenever possible, a diet rich in fresh fruits and vegetables, lean meats, and organic dairy products is recommended. When a carbohydrate-rich diet is necessary, dental sealants, fluoride treatments and certain types of dental fillings may be recommended. Discuss your child’s nutrition and diet with their dentist so we can make better recommendations for their dental care.

Did you know…

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Treatment plans and oral care routines will be customized to work around your child’s condition, disability or special needs.

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Have questions about special needs dentistry? Find answers here.

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Which conditions fall under special health care needs?

Conditions that may affect your child’s dental care include but are not limited to:

  • ADHD
  • Anxiety
  • Asthma
  • Autism
  • Cerebral Palsy
  • Cleft Lip & Palate
  • Depression
  • Diabetes
  • Down Syndrome
  • Epilepsy
  • Hearing Impairment
  • Traumatic Brain Injury

When you call to inquire about an appointment, let our team know your child’s condition and needs, and we’ll work together to determine if our practice is the right fit for your family.

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Why might my child’s medical condition affect their oral health?

Your child’s oral health may be affected by therapies or medications that have been used to treat their condition. The condition itself may also affect how the teeth and oral structures grow, how much calcium is in the body (affecting tooth enamel), how much saliva your child produces (saliva helps clear away food particles), and your child’s diet. 

Nutrition plays a critical role, not only in the health of our bodies, but in the health of our teeth. Even your child’s ability to chew solid foods will affect their dental health, as the pressure of chewing creates stimulation in the jaw bone and the friction helps clear away tartar and plaque build up.  

What are symptoms of a special health care need?

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The most common indicators that your child may have a special health care need include:

  • Teeth grinding or bruxism: Although many children grind their teeth and often grow out of the habit, the condition can be caused by stress and anxiety. It’s important to treat the underlying issue to stop bruxism and protect your child’s teeth.
  • Food pouching: Food or sensory sensitivities can cause children to hold food in their mouths for longer than they should. This creates a place for cavity-causing bacteria to thrive.
  • Bad breath: Certain conditions such as digestive diseases, diabetes or chronic sinusitis can cause bad breath.

How can medication affect my child’s oral health?

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Several kid-friendly, liquid medicines contain a syrup base with added sugar so children will actually take the medication and benefit from its effects. However, these sugars can cause cavities if they’re not properly rinsed or brushed away after use. 
Other medications can cause a reduction in saliva, or dry mouth. And since saliva helps clear away food particles, sugars and bacteria from the mouth, dry mouth can lead to tooth decay, gum disease, or infection. It’s important that you share a list of medications your child uses, so our team can provide oral care recommendations that work around your child’s medical needs.

How should I brush my child’s teeth if they are disabled or have special health care needs?

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Sometimes children with physical, emotional, behavioral, intellectual or communication disabilities may find it difficult to properly brush their own teeth. They may not possess the fine motor skills needed, and will need your help to maintain good oral health. Here are a few tips to help you brush your child’s teeth:

  • Choose a toothbrush with soft bristles that’s made for children. You child may be more interested in brushing if the toothbrush has their favorite character on the handle or if it’s their favorite color.
  • Use oral hygiene aids, like brushes with larger handles. If your child has trouble holding their toothbrush, try fastening the toothbrush with a string, strap or your own hand and guiding them on the right technique. 
  • Pick a fluoride toothpaste that your child likes. They come in many different flavors and colors, so you should be able to find one that they enjoy.
  • Monitor the amount of toothpaste used. You should apply the toothpaste to the brush, so they don’t use too much, and monitor your child as they brush, so they don’t swallow the toothpaste.
  • Make it fun! Sing songs, count, or say the alphabet while your child brushes so they get a sense of how long they should brush, and stay entertained while brushing.   

See What Patients And Parents Are Saying!

Reviews & Testimonials

Visiting Harmony Pediatric Dentistry was a joy. The staff was uniformly welcoming, professional and efficient. We brought in a 4 year old, non-English speaking boy for his first dental visit in the United States. The staff and Dr. Sholander treated him with such care, he left with clean teeth, a clear treatment plan, and a big smile.

Sandra F
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They have an amazing staff of Dentists (Dr. Heather Sholander), hygienists and desk staff. The space is newly decorated and very fun for the kids (lots of astronomy and dinosaur stuff and a Pac Man Machine), along with prizes for a job well done. They do a great job with my disabled child who needs extra appointments, time and patience. These appointments can be hard but I see the staff as non-judgemental, caring and very friendly. They have followed my kids for years. One more for the staff up front. They really are friendly, caring, thorough and no one compares.

Ellen G.
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Dr. Sholander and Dr. Goodman are the very best! Our son loved his first trip to the dentist and I have them to thank! And the office is beautiful too. I can’t say enough about the whole experience.

Sara Schapiro
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Call (301) 664-4220

Did you know…

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Toothbrushes with larger handles are easier to use for many children with special health care needs.

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