Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(2), 27-34, 2024

https://doi.org/10.62574/kkrbe174

Dental care for patients diagnosed with ASD

Atención odontológica en pacientes diagnosticados con TEA

Mario Andrés Fuertes-Paguay

ua.mariofp47@uniandes.edu.ec

Universidad Regional Autónoma de Los Andes. UNIANDES, Ambato,

Tungurahua, Ecuador

https://orcid.org/0000-0002-7746-5581

ABSTRACT

Objective: to analyse dental care in patients diagnosed with ASD. Method: A descriptive analysis

was carried out, supported by the systemic review technique, the documentary sample comprising

15 scientific articles selected by way of a systematic review was extracted from reputable sources

such as PubMed and Scopus. Results and conclusion: The dentist should treat an autistic child

with the same respect and expertise with which he/she treats non-autistic children. However, autism

should be seen as a complex syndrome in which the dentist's professional skills require him or her to

apply new strategies to treat the problematic child, often with the child's parents present. It is

necessary for the dentist to pay attention to any gestures or discomfort the patient may present during

the dental procedure.

Descriptors: autistic disorder; audiologists; dental staff. (Source, DeCS).

RESUMEN

Objetivo: analizar la atención odontológica en pacientes diagnosticados con TEA. Método: Se llevó

a cabo un análisis descriptivo respaldado por la técnica de revisión sistémica, la muestra documental

compuesta por 15 artículos científicos seleccionados de manera fue extraída de fuentes reputadas

como PubMed y Scopus. Resultados y conclusión: El dentista debe tratar a un niño autista con el

mismo respeto y pericia con el que trata a los niños no autistas. Sin embargo, el autismo debe verse

como un síndrome complejo en el que las habilidades profesionales del dentista requieren que

aplique nuevas estrategias para tratar al niño problemático, a menudo con los padres del niño

presentes. Es necesario que el dentista preste atención a los gestos o incomodidad que pueda

presentar el paciente durante el procedimiento odontológico.

Descriptores: trastorno autístico; audiólogos; personal de odontología. (Fuente, DeCS).

Received: 27/02/2023. Revised: 06/03/2023. Approved: 09/03/2023. Published: 01/05/2024.

Brief original

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(2), 27-34, 2024

Atención odontológica en pacientes diagnosticados con TEA

Dental care for patients diagnosed with ASD

Mario Andrés Fuertes-Paguay

INTRODUCTION

Care for patients diagnosed with Autism Spectrum Disorder (ASD) poses intrinsic

challenges that demand a comprehensive understanding of the neurobehavioural

and sensory complexities associated with this condition. ASD is characterised by

considerable clinical variability, ranging from sensory hypersensitivity to difficulty in

social communication and rigidity in behavioural patterns. These characteristics,

together with the possible presence of medical and psychiatric comorbidities, give

dental care in patients with ASD a multidimensional and multidisciplinary character.

1 2 3

The crossroads between dentistry and ASD lies in the need to adapt standards of

clinical care to accommodate the individual needs and specific challenges presented

by these patients. Research in this field has outlined a number of therapeutic

strategies and modes of intervention that seek to mitigate the stress associated with

the dental environment and encourage patient cooperation. From behavioural

management techniques to the use of augmentative and alternative communication

technologies, significant progress has been made in optimising patient-dentist

interaction in this context. 4

A central element in the dental care of patients with ASD lies in the creation of clinical

environments that minimise sensory overload and promote predictability and

perceived patient safety. Modifying the physical environment by reducing aversive

visual and sound stimuli, together with the implementation of structured routines and

sensory breaks, is an effective strategy to promote a more tolerable, as well as less

stressful, dental experience.5

In parallel, the establishment of effective communication is essential for establishing

a strong therapeutic relationship and facilitating patient cooperation. Since many

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(2), 27-34, 2024

Atención odontológica en pacientes diagnosticados con TEA

Dental care for patients diagnosed with ASD

Mario Andrés Fuertes-Paguay

individuals with ASD have difficulties in verbal and non-verbal communication, the

use of alternative communication systems, such as pictograms or communication

boards, can improve mutual understanding and expression of needs during dental

interactions.6

Another inherent challenge in the dental care of patients with ASD relates to the

heightened sensory sensitivity that many of them experience. Intolerance to tactile,

visual and auditory stimuli may manifest as active resistance to dental treatment or

as a passive avoidance response. In this context, careful selection of dental

materials as well as the application of gradual habituation techniques can contribute

to tolerance, patient participation in their oral care.7

In consideration; dental care in patients with ASD requires a holistic and

personalised approach that integrates a thorough understanding of the clinical and

behavioural characteristics of this population. Interdisciplinary collaboration between

dentists, psychologists, occupational therapists and other healthcare professionals

is essential to develop effective intervention strategies and promote oral health and

general wellbeing in this population. As greater understanding and sensitivity to the

needs of patients with ASD is achieved, more inclusive, equitable and patient-

centred dental care can be provided.8

Based on the above, the aim of this paper is to analyse dental care in patients

diagnosed with ASD.

METHOD

A descriptive analysis was carried out using the systemic review technique, guided

by ethical considerations at each stage of the research process.

The documentary sample composed of 15 scientific articles was selected from

reputable sources such as PubMed and Scopus, guaranteeing the quality and

integrity of the data analysed.

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(2), 27-34, 2024

Atención odontológica en pacientes diagnosticados con TEA

Dental care for patients diagnosed with ASD

Mario Andrés Fuertes-Paguay

The information collected was subjected to a documentary content analysis, where

objectivity and impartiality were prioritised in the interpretation of the results, avoiding

biases and conflicts of interest that could influence the validity of the findings.

transparency and recognition of the previous work of other researchers, using

documents no more than 10 years old, taking into account the limited number of

publications on the subject.

RESULTS

Patients with ASD, according to the literature, are at high risk of suffering health

problems. With regard to oral health, they have poor hygiene, due to a lack of manual

motor skills to perform proper brushing to remove dental biofilm, as well as repeated

resistance to daily oral hygiene. 9

These patients have been found to have several manias and harmful habits

associated with the stomatognathic apparatus such as mouth breathing, putting

fingers in the mouth, biting clothes, xylophagia, onychophagia, biting or sucking on

objects, hitting their faces, hitting their heads, etc. All of the above will depend on the

support provided by caregivers. 10

Scientific literature has shown that patients diagnosed with Autism Spectrum

Disorder (ASD) face a high risk of health problems, including complications related

to oral health. It has been observed that these patients tend to present deficiencies

in oral hygiene, attributed to difficulties in manual motor skills that limit their ability to

perform effective toothbrushing and remove dental biofilm adequately, and it is

important to take into account that they show a marked resistance to maintaining a

daily oral hygiene routine, which further aggravates their oral situation.11

In addition, a number of manias and harmful habits associated with the

stomatognathic system have been identified in this group of patients. These

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(2), 27-34, 2024

Atención odontológica en pacientes diagnosticados con TEA

Dental care for patients diagnosed with ASD

Mario Andrés Fuertes-Paguay

behaviours include oral breathing, frequent insertion of fingers into the mouth,

chewing or sucking on inappropriate objects, as well as the practice of habits such

as xylophagia and onychophagia. These behaviours can lead to an increased risk of

dental and oral damage, as well as possible temporomandibular joint disorders.12

It is critical to note that the manifestation and severity of these habits and

mannerisms can vary widely among individuals with ASD, and their frequency and

severity may be influenced by the support and supervision provided by caregivers

and health professionals. In this regard, the role of caregivers is crucial to encourage

healthy habits and provide the necessary assistance to ensure adequate oral health

in this vulnerable population.13

Ongoing information about ASD is important in determining the best way to treat an

autistic child in clinics and dental offices. Parents need ongoing education, training

and support in managing their child's oral health through nutritional advice,

information on available tools, telemedicine dentists, vision technology and medical

specialists. 14

The availability of dental care for patients with ASD presents some challenges, as

only a limited number of dental professionals are trained to treat patients with ASD.

Children with ASD are known to exhibit uncooperative behaviour in most cases. This

may be due to the high sensitivity of these patients, which discourages dentists from

offering their services, causing parents to fear dental work and feelings of

embarrassment because they cannot control their children's behaviour during dental

work; therefore, in some cases, these patients receive inadequate treatment.15

CONCLUSION

The dentist should treat an autistic child with the same respect and expertise with

which he/she treats non-autistic children. However, autism must be seen as a

complex syndrome in which the dentist's professional skills require him/her to apply

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(2), 27-34, 2024

Atención odontológica en pacientes diagnosticados con TEA

Dental care for patients diagnosed with ASD

Mario Andrés Fuertes-Paguay

new strategies to treat the problem child, often with the child's parents present. It is

necessary for the dentist to pay attention to any gestures or discomfort the patient

may present during the dental procedure.

FUNDING

Non-monetary

CONFLICT OF INTEREST

There is no conflict of interest with persons or institutions involved in the research.

ACKNOWLEDGEMENTS

To the research department of UNIANDES.

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Revista arbitrada de ciencias de la salud

Vol. 3(2), 27-34, 2024

Atención odontológica en pacientes diagnosticados con TEA

Dental care for patients diagnosed with ASD

Mario Andrés Fuertes-Paguay

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