General

People living with PWS usually have additional dental needs.

A common and sometimes persistent trait in PWS is “sticky” or viscous saliva and decreased saliva, which can lead to enamel erosion. Dental hygiene is therefore especially important.

Fine motor skills may not be as coordinated. Wide brush handles often make brushing easier. There are many brands and styles. One trick is to apply a bicycle handle grip, rubber pencil grip or other special grip device on to the toothbrush handle.

Use tablets or a stain to check for plaque build-up, 1-2 times a week. The dentist may be able to assist you with obtaining tablets.

Teaching your child about cleaning their teeth

The age at which teeth appear in children with PWS varies widely.

Cleaning teeth should be done twice daily, beginning as soon as the first teeth appear.

• Start cleaning your child’s teeth with an exceptionally soft toothbrush, a washcloth or finger toothbrush pads. Not only will this help establish good dental habits and minimise tooth decay, but this may also help with oral motor stimulation and strengthening.
• Encourage your child to start cleaning their own teeth but check and assist too. Most children can do this independently by the time they reach 10 years of age.
• Make tooth-brushing fun. Do not be afraid to vary things to keep it fun as well as novel. There are many fun toothbrushes which your child will like as they get older.
• Always provide supervision with toothpaste use to prevent your child from eating it. Toothpaste in lesser amounts will not hurt them.

What about the ‘tooth fairy’?

Some families have reported that their young child has pulled their own baby teeth before they were naturally loose, and in a few cases the teeth of other children. This behaviour is not widespread, however, in cases where this has happened some families have found that they needed to play down the concept of a tooth fairy leaving money for teeth, e.g., ‘the tooth fairy only leaves money for teeth that fall out by themselves.’ The behaviour does not seem to extend to the more difficult to pull second teeth.

Finding a dentist for a person living with PWS

It is important for people (children and adults) living with PWS to visit the dentist regularly, due to the possibility of weak enamel and/or sticky saliva which may need attention.

Poor tooth enamel and teeth-grinding are quite common in older individuals. Equally, over- crowding of teeth is a possibility. All these problems require advice from a helpful dentist.

Your own family dentist may be the ideal person to register your child with, especially if you have built a good relationship with them. But if not available, you may wish to seek out a dentist with experience of patients with special needs.

These are generally available at major children’s hospitals or through Australia’s school dental services – ask your health nurse or local hospital for details.

Further information

For more information about Oral Healthcare and PWS see the PWSA UK’s flyer Oral healthcare and Prader-Willi syndrome

To help improve dental health, state and territory governments provide public dental services. You can find out more at https://www.health.gov.au/health-topics/dental-health

For more information about dental care for special needs, see www.dentalhealth.org/tell-me-about/topic/caring-for-teeth/dental-care-for-people-with-special-needs

Thank you…

to PWSA UK for sharing the original source material used in formulating this resource.