Module 4: Prevention of Oral Disease
Special Care- Prevention of Oral Disease

4.4 Scaling and Prophylaxis

Some children with special health care needs develop calculus caused by mouthbreathing, changes in saliva, metabolic disorders, kidney failure, tube feedings, oral motor dysfunction, or inadequate oral hygiene. Scaling with hand or power instruments may be needed. Careful suctioning is required to prevent aspiration of water or fragments of calculus.

If plaque is heavy, a rubber cup prophylaxis may be useful to remove the debris or stain. However, the routine use of rubber prophylaxis is not recommended for general plaque removal in young children, because it removes the outer fluoride-rich layer of teeth that is important for preventing dental caries and remineralization. Toothbrushing is as effective for plaque removal and is generally more acceptable to children.