Children with special health care needs include those with behavioral issues, developmental disorders, cognitive disorders, congenital or genetic disorders, or systemic disease. These conditions may place them at increased risk for oral diseases, making it important to establish preventive oral health strategies at an early age. These children should have an established dental home, through which preventive care can be initiated and maintained, by 12 months of age. Dentists can establish prevention-based care from a young age by understanding the child's condition and how that condition influences the delivery of oral health care. This article outlines common conditions among children with special needs, focuses on their influence on dental health, and describes how these conditions influence preventive, operative, surgical, and behavior management strategies. The goal is to provide an overview that will help guide practicing dentists to understand their role in the care of children with special health care needs.