What is Autism Spectrum Disorder?
Autism Spectrum Disorder (ASD) is the name for a group of developmental disorders that are characterized by repetitive behaviors with limited interests or activities. Its symptoms may hurt the person’s ability to carry on socially, in school/work, or other areas of life.
How does ASD affect the oral health of children?
Children with ASD may present with behavioral management problems in the dental setting due to increased anxiety, fear and increased sensory stimulation.
Oral manifestations of Autism Spectrum Disorder
- Around 20-25% of individuals with ASD may present bruxism.
- Some may exhibit self-injurious behaviors such as picking at the gums, biting lips, or creating ulcerations.
- Some medications may have oral side effects. Consider reviewing any oral signs and symptoms with the child’s dentist. Some of these side effects include dry mouth and gingival inflammation.
- Poor oral hygiene due to difficulty for some children / caregivers to practice home care.
Dental Management and Prevention
Prevention is essential in managing the dental health of the child with ASD. Scheduling the child for early professional
dental examinations as well as following a more frequent dental recall schedule is recommended.
Tips for Proper Dental Hygiene
- Determine the cognitive abilities of the child to best determine how to communicate.
- Try to use the same staff, dental operatory, and appointment time if needed.
- Repeat simplified instructions numerous times.
- You may use positive reinforcement/rewards for better results.
- Apply topical fluoride and visit the dentist every 6 months.
- Parents should begin brushing when the first baby tooth erupts and should assist their child in brushing.
- The use of a soft foam mouth prop might help to keep the child’s mouth open when brushing their teeth.
- Use fluoridated toothpaste; for children under 3 years old use a smear amount of fluoridated toothpaste and for children above 4 years old use a pea size amount.
- Parents should monitor dietary practices (i.e. avoid prolonged use of bottle, reduce amounts of sugar consumed, reduce frequency of sugar consumed).
Preparing a child with ASD for a Dental Appointment
Discuss the medications currently being taken with the child's dentist. Let the dental office know your child has special needs when scheduling a visit. Inform the dental office of any special considerations or if there are any sensory considerations such as sensitivity to lights, sounds, or tastes.
In some cases inhalation sedation may be useful, ask the dentist about sedation options. For those with severe disabilities, dental treatment may be completed under general anesthesia.
Nicole Erazo, DDS, MPH - Nicklaus Children's Pediatric Dentistry Residency Program
References
Centers for Disease Control and Prevention. (2017). Facts about ASD. Retrieved from: https://www.cdc.gov/ncbddd/autism/facts.html
National Institute of Health. (2017). Autism Spectrum Disorder Fact Sheet. Retrieved from: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Autism-Spectrum-Disorder-Fact-Sheet
University of Washington DECOD (Dental Education in the Care of Persons with Disabilities) Program. (2010). Oral Factsheet for Dental Professionals: Children with Autism Spectrum Disorder. Retrieved: http://dental.washington.edu/wp-content/media/sp_need_pdfs/Autism-Dental.pdf