Autistic Spectrum Disorder (ASD) is a neurological disorder that appears during the first three years of life. It is a developmental disorder defined behaviourally as a syndrome causing abnormal development of social skills, limitations in interactive language and sensorimotor defects.
Autism is a life long condition, which may be influenced by environmental and genetic factors, although the true cause is unknown.
The dental management of autistic children can be a challenge for the dental professional due to the child’s impaired communication, behaviour being either erratic or unpredictable as well as possible hypersensitivity to smells, sights and sounds.
Therefore, it is of high importance to understand that children with autism may not be able to function or communicate in socially appropriate ways.
Due to this I would like to cover some simple strategies to ease the dental experience for autistic children.
Children with autism need steadiness and continuity in their environment. This is why a slow exposure of the dental clinic and staff is recommended.
It is best to make the first appointment a short and positive experience, during which questions can be asked and all the necessary dental equipment can be introduced and explored carefully.
Likewise, more frequent visits to the dental setting will give the child and dental team increased opportunities to learn about one another and to provide preventative support.
The dental practitioner should familiarise themselves with the different communication aids that the child may be using. Photographs or images can be put together in the form of a storyline so that the child is prepared for the dental visit. This will help reduce any build up of anxiety by making events more predictable.
Similarly, some patients’ behaviour may improve if they bring comfort items such as a stuffed animal or blanket with them to the appointment. As well as asking the caregiver to sit nearby or to hold the child’s hand.
Lastly, I would like to discuss the oral health problems in autism and strategies for care.
People with autism experience few unusual oral health conditions, although commonly prescribed medications and damaging oral habits may cause problems to the individual.
Damaging oral habits include bruxism, bitting on lips or chewing on objects such as pens. In this case the dental professional should recommend the use of a dental guard to prevent self-injurious behaviour, as well as bruxism.
The likelihood of dental decay increases in patients who have sticky or sweet foods, and difficulty brushing and flossing.
This is why children and caregivers should be advised about correct daily oral hygiene routines as early as possible.
Likewise, preventative measures such as additional fluorides, sealants, drinking water throughout the day and taking sugar-free medicines where appropriate are best recommended.
I would like to conclude that extraordinary children, particularly with autism, require the support of a dental team that truly cares about them as an individual.
By adopting these strategies we can provide the best care to autistic children, which will make a significant difference to their lives.