Improving Oral Health Outcomes: Cerebral Palsy and Dentistry

Cerebral palsy is a neurological disorder caused by brain damage that happens either before birth, or in the first few years of life. The condition affects muscle coordination and results in uncontrolled body movement, seizures, problems with balance, and sensory dysfunction. There may also be intellectual impairment.[1]

Special Needs Dentistry
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Cerebral palsy (CP) does not, in and of itself, cause dental health problems. But conditions that arise from it do. Dr. Zeyad Mady, who practices at the Center for Dental Anesthesia in Alexandria VA, says that people with CP develop more dental problems than the general population. “In addition to the poorer oral health outcomes,” he explains, “patients with special needs are more likely to have limited access to dental care services.”[2]

The symptoms associated with CP can make people more prone to a range of dental problems, including:

  • Tooth decay
  • TMJ disorders
  • Bruxism
  • Oral hygiene
  • Malocclusion
  • Traumatic dental injuries[3]

There are different types of CP. The severity of the disorder is generally grouped as mild, moderate, and severe. Those with mild or moderate forms can often be treated by a general dentist in an ordinary setting. But those with more severe forms are likely to present challenges that a general practice is not equipped to meet. The Center for Dental Anesthesia has made special needs dentistry central to its operation since 2015.[4]

Dental Care at Home

Everyone needs a good dental hygiene routine. In-home caregivers know the challenge of providing it to someone with a disability. It takes planning, time, and patience. Establishing a regular, unchanging routine can help.

“Caring for a special-needs patient is a full-time task,” Dr. Mady says. “We understand that. We commonly get questions about how to improve their home care, how to prevent problems, how to identify problems and what to do in case any dental issues arise.”[5]

“All patients with special needs
must have equal access and high-
quality treatment that focuses on
patient safety, patient-centered care
and treatment of all dental needs.”

Dr. Zeyad Mady, DDS, FAGD, FICOI

At-home dental care comes down to regular brushing and flossing, but it doesn’t necessarily need to be done in the bathroom. Wherever the patient feels most comfortable is probably the best place. Many home caregivers say the kitchen table works very well. The table allows you to keep everything you need – toothbrush and paste, dental floss, and water – close at hand. A bowl to spit in, of course, is also a good idea.

Whatever place you choose, make sure it is well-lit. You need to see inside the person’s mouth to make sure you get every area you need to get.

Some people with CP can brush on their own. That doesn’t mean it will be easy for them; a customized toothbrush with a wide handle may make brushing easier. An electric toothbrush may also be a good choice.[6]

For those unable to brush on their own, caregivers should wash their hands and wear disposable gloves. Beyond that, brushing teeth is about the same as for anyone else.

  • Use a soft-bristle brush (manual or electric)
  • Brush all teeth, making sure to get the front, side, back, and chewing surfaces
  • Use a small, pea-sized amount of fluoridated toothpaste
  • Brush the tongue
  • Help the person rinse
  • Replace the toothbrush every three months

Some people with cerebral palsy have difficulty swallowing. In cases like that, it may be better to skip toothpaste. Just use water.[7]

In the Office

All kids should see the dentist when their first tooth comes in, or by their first birthday – whichever comes first. After that, they should see the dentist for a checkup every six months.[8]

Caregivers should know the dental and medical history of the patient and be able to provide it. They should bring all relevant insurance, billing, and legal information to their appointments.

No matter the type of cerebral palsy, people with CP have problems with movement and posture. Some cannot be moved from their wheelchairs and must be treated there. Certain adaptations, such as a sliding board for support, can make the appointment go easier.[9]

For those who can be moved to the dental chair, the patient or a caregiver may be able to help with the best way to make the transfer.

Since uncontrolled body movements are common, dentist appointments can be challenging. A general dentist treating a CP patient should remain calm and supportive. A relaxing atmosphere can help. It won’t prevent uncontrolled movement, but it can reduce its frequency and intensity.

As the appointment begins, explain each procedure. Take as much time as necessary. Dentists should never assume that someone with CP is below normal intelligence. Check with a parent or caregiver.

In addition:

  • Keep the appointment short
  • Minimize distractions, like noises or sudden movement
  • Taking breaks can help
  • Consider sedation for longer appointments[10]

Prevention and Maintenance

Regular six-month checkups are as important to dental health as daily brushing and flossing. And yet it remains difficult for people with cerebral palsy to find dental practices able to treat them. “Despite remarkable progress in medicine and dentistry,” Dr. Mady says, “there are very few dentists nationwide who deal with special needs patients.”

The Center for Dental Anesthesia in Alexandria is committed to treating patients with many different special needs, including cerebral palsy. “There are an array of tips and tools to help maintain good oral health for patients with special needs,” Dr. Mady explained. “Primarily it is prevention and maintenance. We have an amazing team of professionals that help elaborate at their visits.”[11]

No matter their physical or intellectual condition, no one should be without professional dental care. Each member of the CDA team has years of experience in providing dental healthcare to people with cerebral palsy, Down syndrome, and many other special needs. Please call our office to schedule an appointment.

________

Sources

[1] Cerebral Palsy: A Dental Update. Referred to hereafter as “Dental Update”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212167/

Practical Oral Care for People with Cerebral Palsy (referred to hereafter as “Practical”)

https://www.nidcr.nih.gov/sites/default/files/2017-09/practical-oral-care-cerebral-palsy.pdf

Oral Health Fact Sheet for Medical Professionals: Children with Cerebral Palsy. Referred to hereafter as “Fact Sheet.”

http://www.thecenterforpediatricdentistry.com/intranet/special_needs_fact_sheets/medical_providers/CP-Medical.pdf

Why Are Children with Cerebral Palsy At Risk for Oral Health Issues? Referred to hereafter as “Why?”

https://www.cerebralpalsyguidance.com/cerebral-palsy/associated-disorders/oral-health-issues/

[2] Interview, March 2019. Referred to hereafter as “Interview.”

[3] Dental Update.

[4] Mild or moderate forms in a general practice: Practical.

[5] Interview.

[6] “Customized Toothbrush Can Improve Cerebral Palsy Patients’ Oral Hygiene, Study Shows.”

https://cerebralpalsynewstoday.com/2018/11/02/customized-toothbrush-can-improve-cerebral-palsy-patients-oral-hygiene/

[7] Dental Care Every Day: A Caregiver’s Guide.

https://www.nidcr.nih.gov/sites/default/files/2017-09/dental-care-every-day-caregiver.pdf

[8] Dental Health Guidance for Parents and Caregivers of Children with Cerebral Palsy.

http://dental.washington.edu/wp-content/media/sp_need_pdfs/CP-Parent.pdf

[9] Practical.

[10] Practical.

[11] Interview.

________

Contact Center for Dental Anesthesia:

703-379-6400

Location (Tap to open in Google Maps):

5284 Dawes Ave
Alexandria, Virginia
22311


Porcelain Veneers And Instant Orthodontics

Alexandria Porcelain Veneers and Instant Orthodontics

Is your smile beginning to look a little dull? Has its luster faded over the years? Maybe you’ve got a chipped tooth – or maybe even a couple. You don’t have to live with these imperfections if you don’t want to. At The Center for Dental Anesthesia in Alexandria, porcelain veneers can mask these and other dental flaws, leaving you with a magnificent smile.

Porcelain veneers are thin shells of medical-grade ceramic or composite resin. We custom fit veneers to go over the front part of your teeth, giving them an attractive, completely natural appearance. You can use veneers to fix stained or chipped teeth, or abnormally spaced teeth.

An In-Demand Procedure

Veneers are one of the most popular options available from modern cosmetic dentistry. They are very strong, and are made to match the color and shape of your teeth. They can even used to cover slightly crooked teeth, which why they’ve also been called “instant orthodontics.”

One caveat: a thin layer of enamel must be removed from the front of each tooth being covered with a veneer, in order for them to properly adhere. Once they’re cemented in place, they are permanent. But once they are in place, you’ll have the best-looking teeth of anyone you know.

To find out more, call The Center for Dental Anesthesia in Alexandria. We provide family and cosmetic dentistry, and many other services. Make an appointment today.

Contact Center for Dental Anesthesia:

703-379-6400

Location (Tap to open in Google Maps):

5284 Dawes Ave
Alexandria, Virginia
22311

 

ArticleID 1014

Dental Implants Don’t Require Several Visits

teeth implants Alexandria

Think you don’t have time to perfect your smile? At the Center for Dental Anesthesia in Alexandria, it may not take as long as you think.

How many visits does it take to get dental implants?

Each patient is different. But in most cases, complete implant procedures take fewer visits than they used to. Our team can restore missing teeth with just a couple of visits.

Dental implants look and feel like your own teeth. They can serve as a strong and stable foundation for dentures, support a dental bridge, or replace a damaged tooth. All without disturbing the surrounding teeth.

Since dental implant procedures fuse with your jaw bone, they help avert bone loss and gum recession.

Schedule a dental implant consultation at the Center for Dental Anesthesia in Alexandria and we’ll design a comprehensive treatment plan for you. We also offer family dentistry. Schedule an appointment today.

Contact Center for Dental Anesthesia:

703-379-6400

Location (Tap to open in Google Maps):

5284 Dawes Ave
Alexandria, Virginia
22311

 

ArticleID 8087

Creating Memorable Smiles At Center for Dental Anesthesia

Creating Memorable Smiles at Center for Dental AnesthesiaA smile takes but a moment, but the memory of it lasts forever. You can make your smile memorable and beautiful with a smile makeover at the Center for Dental Anesthesia in Alexandria.

A smile makeover means using the techniques of cosmetic dentistry to make positive changes to your smile. These techniques might include:

  • Teeth whitening
  • Porcelain veneers
  • Bonding
  • Gum contouring
  • Dental implants
  • Clear braces

A beautiful smile is the sum of its parts. With the patient’s input, we do a smile analysis to evaluate his or her smile. Our goal is to bring the teeth, skeletal structures, and muscles into harmony. It’s a complicated endeavor, requiring an understanding of how all of these components relate to one another.

Any one of the techniques listed above will go a long way toward transforming your smile. Two or more can leave you with the smile of your dreams.

To find out what cosmetic dentistry can do for your smile, call us at the Center for Dental Anesthesia in Alexandria. Other services include family and restorative. Schedule an appointment with us today

Contact Center for Dental Anesthesia:

703-379-6400

Location (Tap to open in Google Maps):

5284 Dawes Ave
Alexandria, Virginia
22311

 

ArticleID 850

Center for Dental Anesthesia Has A Solution For Dental Anxiety

Oral Conscious SedationAt the Center for Dental Anesthesia in Alexandria, we understand that some people have severe anxiety when they go to the dentist. With sedation dentistry, it is possible to relax during a checkup instead of being tense and fearful.

In some cases, people with dental anxiety avoid dentist appointments altogether. This, in turn, puts their dental health at risk.

You may want to consider sedation dentistry if you have any of the following issues:

  • Strong gag reflex
  • Fear of needles
  • Sensitive teeth
  • Fear and anxiety associated with dental treatment
  • Difficulty getting numb
  • A history of negative dental experiences
  • Trouble controlling body movement due to Parkinson’s disease, Cerebral Palsy or related condition
  • Need extensive dental treatment requiring lengthy dental visits

If you have avoided dental treatment due to any of these reasons, schedule an appointment with the Center for Dental Anesthesia in Alexandria. Sedation dentistry is our specialty. We offer a wide range of services, from family dentistry to special needs dentistry. Call our office today!

Contact Center for Dental Anesthesia:

703-379-6400

Location (Tap to open in Google Maps):

5284 Dawes Ave
Alexandria, Virginia
22311

 

ArticleID 611

Call Them What You Will, Just Keep Them Healthy

Alexandria Top Cosmetic dentist

Chompers. Pearly Whites. Dents. Gnashers. Grill. While you can switch up what you call them, the dentist at the Center for Dental Anesthesia in Alexandria VA remind you to never switch up a well-engrained oral health routine.

Practicing proper oral hygiene daily with pay off throughout your life. You’ll prevent tooth decay, plaque, and gum disease, not to mention bad breath (something friends, family, and coworkers will also appreciate).

  • By brushing your teeth twice every day, you remove the plaque that causes cavities. Plaque is that soft and sticky film that builds up on your teeth, a process that happens around the clock. It’s caused by food debris and bacteria.
  • It’s just as important to floss at least once a day. Flossing gets the plaque between your teeth, where your toothbrush cannot reach.
  • Scheduling twice-yearly checkups at our office is also very important. Regular checkups can prevent cavities and gum disease. Each checkup also includes an oral cancer screening.

Your teeth are meant to last a lifetime! At The Center for Dental Anesthesia in Alexandria VA, we want the best possible dental health for each of our patients. Our services include family dentistry, and special needs dentistry. Schedule your next checkup today!

Contact Center for Dental Anesthesia:

703-379-6400

Location (Tap to open in Google Maps):

5284 Dawes Ave
Alexandria, Virginia
22311

 

ArticleID 4556

Afraid Of The Dentist? Sedation Dentistry Can Help

Afraid of the Dentist? Your Alexandria Sedation Dentist Can HelpIf you experience severe anxiety when undergoing dental treatment, sedation dentistry from the Center for Dental Anesthesia in Alexandria is for you.

Sedation dentistry is completely safe and very popular for anyone coping with dental anxiety.

Though it may sound impossible, with sedation dentistry, patients can actually relax during dental visits. In addition, healing times for oral surgery and extensive cosmetic dentistry procedures are often shorter if the patient is sedated during treatment.

Sedation dentistry is great for alleviating anxiety, and can be effective for treating or working with the following:

  • Teeth sensitivity
  • Fear of needles
  • A powerful gag reflex
  • Difficulty in controlling body movement
  • Lengthy multi-procedure visits
  • Difficulty becoming numb with traditional injections

If you or a loved one is coping with dental anxiety, sedation dentistry from the Center for Dental Anesthesia in Alexandria may be just what you need. Our services include wide range of family dentistry procedures. Call to schedule an appointment with us today!

Contact Center for Dental Anesthesia:

703-379-6400

Location (Tap to open in Google Maps):

5284 Dawes Ave
Alexandria, Virginia
22311

 

ArticleID 1003

Change Your Life In 4 Steps

cosmetic dental and implants

There is no question that dentures are preferable to a toothless mouth, but they are not issue free. An increasingly popular alternative is state-of-the-art implant dentures from the Center for Dental Anesthesia in Alexadnria.

Traditional dentures can make it difficult to chew and taste food. It’s embarrassing to talk when they are slipping around in your mouth and laughing can dislodge them entirely. They can even make it hard to breathe – and it doesn’t get more basic than that.

Even if you have had dentures for many years, you may be a candidate for implant dentures. Mini dental implants (also called denture-stabilization implants) allow us to securely attach an appliance so that it won’t slip or irritate gums. Small titanium posts are implanted into the jawbone and fuse with the surrounding bone, building a substantial base for an over denture.

Here is the process:

1. Examination and Assessment
During your first visit, we will take x-rays and assess your mouth and the condition of your teeth, gums, and jawbone. We will assess options with you and together you will design a treatment plan.

2. Implant Placement
A complete tooth implant and restoration consists of the actual implant or root replacement, an abutment, and final restoration. The first step is to insert the titanium alloy implant into your jawbone. This is not as difficult or painful as it sounds. Most patients are surprised at how speedy and easy the procedure is.

3. Integration
Implant surgery would not be successful if your jawbone did not welcome an artificial and non-biological tooth root. Amazingly, in the vast majority of cases, the jawbone tightly fuses with the implant to design an extremely durable foundation for the final restoration. It takes from three to six months for your jawbone to work its extraordinary magic.

4. Final Restoration
The implant dentures are secured to the titanium posts. Dental implant restorations are virtually indistinguishable from initial teeth.

At The Center for Dental Anesthesia in Alexandria, we offer dental implants, including implant dentures. We also offer family dentistry, and many other services. Schedule an appointment with us today.

Contact Center for Dental Anesthesia:

703-379-6400

Location (Tap to open in Google Maps):

5284 Dawes Ave
Alexandria, Virginia
22311

 

ArticleID 7170

Cavity Fighting Chewing Gum?

Alexandria Oral DentistryAt the Center for Dental Anesthesia in Alexandria, we are sometimes asked if gum sweetened with xylitol is an effective substitute for brushing your teeth, and regular dental exams.

Before answering that question, let us tell you a little bit about xylitol:

Xylitol is a natural sweetener that was first discovered in birch tree bark but is also found in many fruits and vegetables. Unlike most other sweeteners (natural or synthetic), xylitol is actually useful for your teeth.

Numerous clinical studies have demonstrated that xylitol prevents the growth of the bacteria that initiates decay. It also lessens plaque and strengthens tooth enamel.

Xylitol has other benefits, as well. Because it is low on the glycemic index, many of my patients with diabetes enjoy it as a healthy alternative to sugar. For our patients that notice frequent dry mouth, we recommend xylitol gum or mints to stimulate saliva production while safeguarding against cavities.

Now, back to the golden question. Is xylitol gum just as effective as brushing your teeth and seeing your family dentist regularly? Absolutely not! If you cannot brush your teeth after a meal, chewing xylitol gum for five or ten minutes is probably a good idea. However, you should still brush your teeth thoroughly (with a soft brush) after meals and get twice-yearly exams and dental cleanings.

At the Center for Dental Anesthesia in Alexandria, our goal is to keep your smile healthy and beautiful for life by preventing dental problems before they start. We offer a wide range of servicers, from family and cosmetic dentistry, to special needs dentistry. Schedule an appointment today.

Contact Center for Dental Anesthesia:

703-379-6400

Location (Tap to open in Google Maps):

5284 Dawes Ave
Alexandria, Virginia
22311

 

ArticleID 1368

Serving Those With No Voice: Special Needs Dentistry

We hear the term “special needs” a lot. It’s often in reference to children whose physical or psychological condition requires a particular adaptation so they can access a facility or service. The term dates back to the Adoption and Safe Families Act of 1997, if not earlier, and the need to legally define children who needed more attention in foster care due to a disability.[1]

Special Needs Dentistry
Interested in more Special Needs

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Not everyone cares for the term. “I was confused with all the ‘special needs’ this and that,” said the mother of a special needs child, who has an impairment herself. “‘Disability,’ I was and am completely used to, both as a person with disabilities and as a professional working in the field … but ‘special needs’?”[2]

While some people do not care for it, “special needs” has long since entered everyday vocabulary. It is used in this article without any assumptions about those to whom it may refer. And there is no denying that physically and mentally challenged people are not always able to use facilities and services that most people take for granted.

This is as true for dentistry as anything else – and maybe more so. “There are very few dentists nationwide who deal with special needs patients,” said Dr. Zeyad Mady, who has made special needs dentistry a centerpiece of the Center for Dental Anesthesia, his practice in Alexandria VA. “In fact, the lack of willingness and the competence of dental care providers to treat patients with special health care needs, as well as the hurdles these providers face themselves, remain barriers to provide special needs access to dental care.”[3]

The need is there; the balance of this article examines the reasons why.

More Vulnerable

Everyone is susceptible to dental problems, of course. But people with disabilities, some of whom cannot communicate easily, may be more vulnerable than most. “Studies have shown that individuals with special health care needs have more risk of developing dental problems and untreated dental diseases compared with their healthier counterparts,” Dr. Mady notes.[4]

Broadly speaking, dental patients falling into the special needs category include people with:

  • Down syndrome
  • ADHD
  • Dental phobia
  • Muscular dystrophy
  • Alzheimer’s disease
  • Medically complex conditions
  • Blindness
  • Epilepsy

A handful of dental professionals have advocated for special needs dentistry as far back as 1981. “In the United States, Special Care Dentistry has been described as ‘an approach to oral health management tailored to the individual needs of people with a variety of medical conditions or limitations that require more than routine delivery of care,” wrote Ronald L. Ettinger and several colleagues in 2004. Special care or special needs dentistry, he added, “‘encompasses preventive, diagnostic, and treatment services.’”[5]

Dr. Mady further refines the term: “To me, ‘special needs’ means the inability to cope with a traditional dental office setting, whether it is voluntary or involuntary.”[6]

This segment of dental patients, Dr. Mady says, remains underserved by the profession. He noticed this early in his career. “Every time a patient with special needs was on our schedule, we would all accept compromised oral health and dentistry, and say, ‘we can only do the best we can,’” he recalls. “That wasn’t good enough for me. I sought out the partnership with some amazing mentors in our area that dealt with a lot of special needs patients, and together we were able to prove that excellent dentistry can be provided to all special needs patients with no compromise.”[7]

The Center for Dental Anesthesia

After the mentor retired in 2015, Dr. Mady partnered with other dentists and health care professionals to assume operation of The Center for Dental Anesthesia. Together they renovated the CDA with state-of-the-art technology to provide a more comprehensive approach to dentistry, including patients with special health care needs.[8]

The Center for Dental Anesthesia is equipped to handle all special needs dentistry patients:

  • The entire facility is wheelchair accessible
  • Dental chairs and equipment adapted for physically disabled patients
  • Private, non-threatening consultation rooms
  • Accurate medical and dental assessment
  • Personalized treatment plans
  • Monitored “spa” recovery rooms

All areas of special needs dentistry, Dr. Mady explains, require experience, training and facilities, since any single condition may bring with it increased medical concerns. “That is why a team approach is always a necessity,” he said. “This team should include both dental and medical professionals to thoroughly assess cases and make sure they all receive the best care possible. All patients with special needs must have equal access and high-quality treatment that focuses on patient safety, patient-centered care, and treatment of all dental needs.”[9]

Those With No Voice

With some twelve million children in the United States classified as “special needs,” the necessity for a practice like the Center for Dental Anesthesia is clear.[10]

The CDA provides a full range of dental services to the general public, and its team values all their patients. But they are proud to be one of the few practices in the country that serves disabled patients. “There is a sense of completion when you know that you have helped a patient who has no voice, and is unable to express their total satisfaction,” Dr. Mady says. “When we look in the eyes of our patients after treatment, we know they appreciate us as do the families that come to see us from all over the country.”[11]

The Center for Dental Anesthesia in Alexandria is committed to treating patients with many different special needs, and believes that no one should be without professional dental care. Each member of the CDA team has years of experience in providing dental healthcare to special needs patients. Please call our office to schedule an appointment.

______________

 

Sources

[1] Adoption and Safe Families Act of 1997: “What Does ‘Special Needs’ Mean?”

https://www.bestvalueschools.com/faq/what-does-special-needs-mean/, referred to hereafter as “What Does…?”

[2] Quote: “The Difference Between Special Needs and Disability”

https://www.meriahnichols.com/difference-special-needs-disability/.

See also, “3 Reasons to Say ‘Disability’ Instead of ‘Special Needs’”

https://www.meriahnichols.com/3-reasons-say-disability-instead-special-needs/

and “’Special needs’ is an ineffective euphemism”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5256467/pdf/41235_2016_Article_25.pdf

[3] Interview with Dr. Zayed Mady, DDS, FAGD, FICOI, March 2019, referred to hereafter as Interview.

[4] Interview, and “Oral Health for Families with Special  Health Care Needs”

https://scdhec.gov/sites/default/files/Library/CR-010418.pdf

See also “Special Care Dentistry: A professional challenge”

https://www.researchgate.net/publication/6302288_Special_Care_Dentistry_A_professional_challenge

[5] Quote: “Dentistry for Persons with Special Needs: How Should It Be Recognized?” by Ronald L. Ettinger, B.D.S., M.D.S., D.D.Sc., and Jane Chalmers, B.D.Sc., M.S., Ph.D., and Heather Frenkel, B.D.S., Ph.D., in the Journal of Dental Education. August 2004.

https://pdfs.semanticscholar.org/19d0/193ce7f7d95f088ea301df07722fadbdd5ab.pdf

The authors cite “National Oral Health Information Clearinghouse. Glossary of terms. In: Oral health care for people with developmental disabilities: information for patients and professionals. Rockville, MD: National Institute of Dental and Craniofacial Research, National Institutes of Health, U.S. Department of Health and Human Services, July 2003.”

[6] Interview.

[7] Interview.

[8] Dr. Mady, April 5, 2019.

[9] Interview.

[10] Number of children: Interview, and “What Does…?”

[11] Interview.

______________

Contact Center for Dental Anesthesia:

703-379-6400

Location (Tap to open in Google Maps):

5284 Dawes Ave
Alexandria, Virginia
22311