Hesperian Health Guides

Care of the Teeth and Gums

Many disabled children develop problems in their teeth and gums. There are many reasons:

  • In children who have poor mouth and tongue control, food often sticks to gums and teeth and is not cleaned away by the natural movement of the tongue.
  • Many disabled children (even those with no eating problems) are fed soft, sticky ‘baby foods’ long after they should be eating rougher, more solid ‘adult foods’. So, their gums get soft, weak, and unhealthy.
  • Sometimes children with disabilities are ‘spoiled’ by giving them extra sweets— which increases tooth decay.
  • Some medicines for seizures (epilepsy) cause swollen, unhealthy gums.
  • Dental care is more difficult in some disabled children—especially those with cerebral palsy. (In some places, dentists refuse to care for these children.)

For these reasons, we must take care to keep the gums and teeth of the disabled child healthy and clean.


1. Avoid foods and drinks with lots of sugar — especially between meals.
2. Start child on solid food as early as he can take them. Toast, crackers, carrots, raw fruit, and other foods that rub the teeth and gums clean are especially helpful.
3. Clean the child’s teeth and gums, if possible after every meal.
Before the baby has teeth, clean his gums with a soft cloth over your finger. First, dip the cloth in boiled water with a little salt or baking soda in it. After the child has teeth, clean them with a small, soft toothbrush. Or use a piece of thick cloth or a bit of towel wrapped on a stick.DVC Ch39 Page 348-3.png Toothpaste is not necessary. Instead you can use salt, salt mixed with baking soda, or a burned and powdered piece of bread, chapati, or tortilla, or just water.

Clean all surfaces of the teeth well, and also rub or brush the gums.
illustration of the below: the right position for cleaning a child's teeth.
illustration of the below: the wrong position for cleaning a child's teeth.
Or use a stick from a Neem tree or other non-poisonous plant.
DVC Ch39 Page 348-4.png
This is a good position to clean the child’s teeth and gums. Be sure the head bends down. If his head bends up, he will be more likely to choke or gag. Sharpen one end to form a ‘toothpick’. Crush the other end to form a ‘brush’.
4. Help the child learn to do whatever she can to clean her own teeth and gums. At first you can guide her hand, then have her do a little more each time, and praise her when she does it well. DVC Ch39 Page 348-5.png
The child will be more likely to clean her teeth regularly if you have a special place, adapted to her needs.

REMEMBER: Brushing the gums is just as important as brushing the teeth!

For more information, see Where There Is No Dentist, Chapter 5, “Taking Care of Teeth and Gums”.

This page was updated:27 May 2020