Orthodontic Treatment for Special Needs Patients

teen with braces

At McDonald Orthodontics in Salem, OR, we feel strongly that it’s important to include the special needs population in the benefits of orthodontics. We believe that everyone should have the opportunity to have a great smile and should be treated with dignity throughout the process.

Some children on the autism spectrum and who are developmentally delayed require a more individualized approach to orthodontic treatment. Depending on their unique situation regarding their reactions to various sensory stimuli that they may experience in the orthodontic setting. This can be a challenge to orthodontists, but with help of parents and caregivers, the proper resources, and a desire to provide high-quality care to all types of patients, an orthodontist can help almost any special needs child achieve a beautiful smile.

The Philosophy that Dr. John McDonald has Adopted

The philosophy that Dr. John McDonald has adopted in treating special needs patients is to follow the lead of the parent of that child. Parents are the ones who are most aware of what is successful for their child and what is the most beneficial route when it comes to treating their child. This collaborative approach has proven successful dozens of times in Dr. McDonald’s 22 years in orthodontic practice.


New experiences can be difficult for both children and adults. For special needs children, the orthodontic office can be overwhelming as well. To reduce the “newness” of any given appointment, Dr. McDonald will often offer parents and caregivers tools to use at home that will help normalize their experience at the orthodontist. Here are two examples:

  1. McDonald sends parents home with gloves and a dental mirror to practice with the child. The parents can use the tools to help the child become acclimated to the feelings of someone’s fingers and an instrument inside their mouth.
  2. Another example, which is less relevant now in the age of digital scanning, is getting patients ready to have a dental mold taken. In these cases, Dr. McDonald would send a tray home with the parent. That mold tray could be used to practice putting the tray in and out of the mouth. The parent could fill the tray with pudding or applesauce to act as the squishy wet substance that orthodontists use to make impressions.

The important point is that there are always ways to work with any patient’s unique needs in a non-traumatic way. Dr. McDonald and his team want to help the patient and parent both decide if orthodontic treatment is something the patient can undergo and then help them navigate the various steps involved in treatment.

It’s important to remember that there are several types of orthodontic treatments available. Besides traditional clear and metal brackets, clear aligner therapy such as Invisalign or Clarity aligners as well as active retainers called Spring Aligners are two common alternatives that can be used. This way, if one method of treatment does not work for the patient, there may be other options available. Dr. McDonald can discuss all of these treatment options with you before deciding on the best treatment for your child.

Other Considerations for Successful Orthodontic Treatment in Special Needs Patients

Here are some other considerations for parents and caregivers to consider before undergoing orthodontic treatment:

  1. Patients must be able to tolerate the orthodontic devices in their mouths. while they are not fragile, patients cannot break, play with, or remove the braces. To test if a patient will tolerate braces, it is common to start out with just a few braces on the front teeth to see how the patient does and to ease them into the orthodontic treatment so that it is not overwhelming at first.
  2. A lack of dexterity can be an issue when it comes to keeping teeth clean. If this is an issue for the patient, it is imperative that a parent or caregiver commits to taking an active role in helping the patient maintain good oral hygiene. Modern electric toothbrushes can be very helpful in this regard.
  3. Treatment goals must be realistic. A complex set of dental problems usually means a longer treatment period. This isn’t always ideal for patients with special needs. In these cases, a shorter treatment time can yield less-than-perfect results but may be in the best interest of the child.
  4. Sitting in a chair long enough to have braces placed and/or tightened can be a struggle for all patients, and especially for those with special needs. To reduce this challenge, we can schedule more frequent, shorter appointments.

Working with special needs patients all comes down to the office’s ability to accommodate them. At McDonald Orthodontics, we are passionate about helping patients of all ages and abilities achieve a smile they are proud to show off through individualized, compassionate care.

To schedule an initial consultation with our experienced Salem orthodontist, call (503) 585-5400 today.