Autism is a developmental disorder that affects social communication, behavior and the way we perceive the world around us. Approximately 1 in 54 children are diagnosed with autism in the United States, and this condition can present challenges for both individuals diagnosed with autism and the professionals who treat them.
Performing dental work on patients with autism requires adaptation on the part of the dentist because each case is different and requires a different approach.
Most patients suffering from a minor or moderate form of autism can be successfully treated in a conventional, mainstream practice.
Autism is a collection of behavioral disorders of varying degrees of severity that manifest in the early years of life.
Clinically, it can be characterized by three parameters:
Verbal and nonverbal communication problems
Stereotypies in behavior
Deficiencies in interactions with other people
The manifestations of autism vary from one patient to another so that we can find examples of disorders such as obsessive routines, uncoordinated and unpredictable movements or self-mutilation. The latter can also affect the health of the oral cavity.
Communication with the young patient will be done mainly with the help of images, in order to convey the message as clearly as possible and to capture his attention. Only half of patients are able to understand the doctor’s verbal messages. Parents need to continue at home the education and strategies that the dentist adopts in the dental office to stimulate the patient to perform their own hygiene.
Pathologies and abnormalities:
Tooth eruption – may be delayed. Teeth normally have a physiological order of eruption which, in these patients, may be severely disrupted. Thus, teeth may erupt in any order, leading to further dental crowding or rotation due to lack of space on the arches.
Vicious habits – the first of these is bruxism, which involves grinding and rubbing the teeth against each other, damaging the enamel layer and causing pathologies in the temporomandibular joint.
Food retention is also common, primarily due to dental malposition. Associated with a low level of hygiene, food retention is a factor that leads to increased bacterial plaque adhering to the teeth and thus to an increased caries risk.
Mouth breathing is common in patients suffering from autism, a vicious habit that leads to dry mouth. By decreasing the level of oral saliva, its ability to wash the tooth surfaces decreases and the caries risk increases considerably.
Dry mucous membranes can also lead to lesions in the mucous membranes which, left untreated, can become over-infected.
Biting the mucous membranes, especially the jugal mucosa, can also lead to discomfort and infectious pathologies, and there are special mouthguards to prevent this habit.
Malocclusion – is common in patients with locomotion disorders. They are secondary to dental eruption pathologies or muscle abnormalities. Malocclusions can be a hindrance both during the exercise of physiological functions such as chewing, swallowing and phonation but, more seriously, they can lead to periodontal pathologies or even temporomandibular joint pain.
Because of these complications and the particular situations encountered by patients suffering from autism, treatment is complex and a relationship based on trust must initially be established with the young patient, who must then be guided towards the best possible oral hygiene.
The dentist’s office can be a stressful and anxious place for anyone, but it can be particularly difficult for patients with autism. Approaching patients with autism in the dental surgery can be a delicate process and should be tailored to the needs of each individual patient.
Before visiting the dental office, it is important to communicate with patients with autism and their family to identify their specific needs and prepare the patient for the dental office experience. This may include introducing the dentist, describing procedures and explaining the equipment in the office.
It is also important to give patients with autism the opportunity to visit the dental office before having a procedure to familiarize themselves with the environment and reduce anxiety.
During the examination, the dentist should provide a safe and comfortable space for the patient with autism to feel as relaxed as possible.
This may include providing ear or eye protection to reduce noise and bright light, providing toys or favorite objects to reduce stress and keep the patient’s attention.
It is important to communicate with the patient with autism in a way that allows them to understand the procedures and be involved in the treatment process. This may include using simple, clear words, a calm and steady tone of voice, and physical signs and gestures to facilitate understanding.
Communication between the dentist and the autistic patient should be encouraged so that the patient can report any discomfort or pain during treatment.
In addition, it is important to provide a positive dental office experience for patients with autism by recognizing and rewarding positive behavior. This may include offering praise, simple rewards or an action plan to build the autism patient’s confidence in the dental office.
In conclusion, approaching patients with autism in the dental office can be a complex and sensitive process that requires effective communication, individualized attention and a flexible approach. The dentist should be prepared to provide a safe and comfortable environment for patients with autism, communicate in a clear manner and provide positive rewards for positive behavior. By approaching patients with autism in the dental office in an empathetic and personalized way, it can ensure the most comfortable and successful experience for the patient and build confidence in long-term dental treatment.
Each patient with autism is unique and that their approach in the dental office must be individualized.
Consultation with the patient’s family and other caring professionals can help identify the patient’s specific needs and prepare a personalized approach in the dental office. By approaching patients with autism with sensitivity and empathy, the dentist can help reduce anxiety and facilitate a positive dental office experience for patients with autism.