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Are there ways to position children with special health care needs to make it
easier for a parent or caregiver to effectively brush the child's teeth? There
are many ways to position a child with special health care needs for toothbrushing.
These may change with a child's age, and they depend on the child's condition.
No
matter what method is used to position a child, it is important to remember
to support the child's head, making sure you can see inside the mouth and
that you can move the toothbrush easily in the mouth. To prevent choking or
gagging,
do not tilt the child's head back. Also, make sure that you do not trigger
other types of reflexes. This is particularly important in children with
cerebral palsy. Work with the child's oral health professional to find the
safest and
most comfortable position for you and the child.
Two often-used
methods can be used for children in wheelchairs:
• Stand
behind the wheelchair. Use your arm to brace the child's head against the wheelchair
or against your body. A pillow can also be used to make the child more comfortable.
• Sit
behind the wheelchair and tilt it back into your lap. Remember to
lock the wheels of the wheelchair.
For children who are not in wheelchairs,
a variety of positions can be used:
• Sitting on the
floor—Have the child sit on the floor, and sit right behind the child, on a
chair. Lean the child's head against your knees. If the child is uncooperative,
you can gently place your legs over his or her arms to keep them still.
• On
a sofa or bed-—Place the child on a sofa or bed lying down, with his or her
head in your lap. Support the child's head and shoulders with your arm. If
the child is uncooperative, a second person can gently hold the child's hands
and feet.
• In a beanbag chair—If it is hard for the child to
sit up straight, sitting in a beanbag chair may allow the child to relax without
fear of falling. Use the same position as described previously for toothbrushing
on a sofa or bed.
• Lying on the floor—Place the child on the
floor lying down, with his or her head on a pillow. Kneel behind the child's
head, using your arm to help hold the child still, if necessary.
• Lap-to-lap
examination—Position the child's head in your lap, while another
parent or caregiver sits in a chair, gently holding the child's legs
in his or her lap.
Performance Standards
1304.21(a)(5)(ii)
1304.21(a)(5)(iii)
1304.23(b)(3)
References
Domoto PK, Oberg D. 1998. Lap-to-lap examination procedure. Seattle, WA: WSDA
News.
National Maternal and Child Oral Health Resource Center. 2005. Oral Health
for Children and Adolescents with Special Health Care Needs: Challenges and
Opportunities. Washington, DC: National Maternal and Child Oral Health Resource
Center. http://www.mchoralhealth.org/PDFs/SHCNfactsheet.pdf.
Perlman SP, Friedman C, Fenton SJ. 2008. A Caregivers Guide to Good Oral Health
for Persons with Special Needs. Washington, DC: Special Olympics, Healthy Athletes,
Special Smiles. http://media.specialolympics.org/soi/files/healthy-athletes/Special%20_Smiles_Good_Oral_Health_Guide.pdf. |
