Autism Spectrum Disorder in a Dental Office - A Review

Abstract

Over the last few years there has been a growing interest to cater to the requirements of children with special health care needs, especially those with autism spectrum disorder (ASD). ASD is a neurodevelopmental condition characterized by limited communication skills and an obsessive need for structured patterns. Individuals with a genetic predilection to autism can be provoked by the various prenatal, natal, or post-natal environmental factors. Drugs such as thalidomide, valproic acid and consumption of antidepressants during pregnancy as well as high maternal age and viral infections are known to be prenatal triggers for autism. Autism affects 1 in every 110 children with a significant preponderance of boys to girls with a ratio of 4:1. According to Caries Risk Assessment tool (CAT) adapted by the American Academy of Paediatric Dentistry, children with ASD are at a high risk for dental caries due to their preference for carious food, pouching of food due to poor masticatory ability combined with inadequate maintenance of oral hygiene and help required for tooth brushing. These children do not behave positively to sudden changes in their environment thus a dental operatory might be intimidating to them. A thorough understanding of the individual’s needs of these patients along with combining various behaviour management techniques will help make their dental treatment a pleasant one. This articles reviews literature on the aetiology and diagnosis of Autism Spectrum Disorder with a special emphasis on the health status and issues encountered while treating these children. This study is also an update on the various strategies such as using Applied Behaviour management approaches, Picture Exchange Communication System, Video Pedagogy, Social stories as well as pharmacological ways to communicate and also manage a child with ASD in the dental clinic. KEY WORDS Autism, Oral Health Status, Behaviour Management, Dental Management