"A handicapped child is one who has a mental, physical, medical or social condition that prevents him or her from achieving full potential as compared to other children of the same age including those of a social, recreational, educational and vocational nature” (WHO)

A handicapped person (child) is one whose psychological development, social expression, play, and/or work is compromised due to a physical or mental problem, or both .

Classification of Handicaps:

• Physical handicap: e.g. Monoplegia, Paraplegia( paralyzed children)
• Mental handicap: e.g. Down’s syndrome.
• Sensory handicap:e.g. Deafness, Blindness.
• Medically compromised : e.g. Haemophilia, Leukaemia.
• Multi-handicap: A combination of multiple handicapping conditions.

The parents (or the guardian) have the initial responsibility for establishing good oral hygiene of the child. Home dental care should begin at infancy. The dentist should advice the parents to gently cleanse the incisors with a soft cloth or an infant toothbrush. For older children who are unwilling or physically unable to cooperate, the dentist should teach the parent or guardian correct tooth brushing techniques.

How it can be done ?

1. The standing or sitting child is placed in front of the parent so that the parent   can cradle the child’s head with one hand while using the other hand to brush the teeth.

2. The child reclines on a sofa or bed, with the head angled backward on the parent’s lap. Again, the child’s head is stabilized with one hand while the teeth are brushed with the other.

3. The brushing technique for disabled patients who have fine or gross motor deficiencies limiting their ability to brush should be effective and simple to follow. A soft multitufted nylon brush should be used.

4. Electric toothbrushes have also been used effectively by handicapped children, but their result is not as good as manual brushes for plaque removal.

Fluoride use

The judicious use of systemic fluoride is important in the comprehensive management of any dental patient. The amounts of systemic fluoride supplementation necessary are available in the form of drops, tablets and rinses. Low concentration fluorides should be used as these children can accidentally swallow the fluoride solution or dentifrice causing fluoride toxicity.

Pit and fissure sealants to reduce occlusal caries effectively. Sealants are appropriate in patients with disabilities. Patients with severe bruxism (grinding of teeth) and interproximal (between two adjoining teeth) decay may need their teeth to be restored with stainless steel crowns to increase the longevity of the restorations.